Cancer can affect the spleen, although it is uncommon for it to start there. The spleen is a fist-sized organ located in the upper left abdomen, beneath the rib cage. It is part of the lymphatic system and acts as an important blood filter. The spleen removes old or damaged red blood cells, maintains a blood reserve, and houses white blood cells that fight infection. Cancer involving the spleen can disrupt these functions, leading to various health issues.
The Spleen’s Role and Cancer Origin
Cancer can involve the spleen in two distinct ways: originating within the organ (primary) or spreading to it from a different site (secondary or metastatic). Primary spleen cancer, where the malignancy begins in the spleen itself, is extremely rare. It typically arises from the lymphatic tissue, making Primary Splenic Lymphoma the most frequent type of cancer to originate there.
Primary Splenic Lymphoma is often a slow-growing non-Hodgkin lymphoma, such as splenic marginal zone lymphoma. An even rarer primary malignancy is Angiosarcoma, a highly aggressive tumor developing from the inner lining of the spleen’s blood vessels. Because the spleen is rich in immune and blood cells, it is more commonly involved in blood cancers, such as leukemia or lymphoma, that started elsewhere in the body.
Secondary spleen cancer occurs when malignant cells travel through the bloodstream from a tumor in another organ and settle in the spleen. This metastatic involvement is significantly more common than primary cancer. Cancers that frequently spread to the spleen include melanoma, breast, and lung cancers. The presence of cancer in the spleen often causes the organ to enlarge, a condition known as splenomegaly.
Recognizing the Signs
Symptoms associated with spleen cancer are frequently vague, making early diagnosis difficult. In some cases, the disease may be present without causing any noticeable symptoms. When symptoms do appear, they are often related to the spleen’s enlargement.
Localized symptoms include pain or a feeling of fullness in the upper left abdomen, beneath the ribs. This discomfort is caused by the enlarged spleen pressing on surrounding organs, which can also lead to feeling full quickly after eating. Systemic symptoms, particularly those associated with lymphoma, are sometimes referred to as “B symptoms.” These include unexplained fevers, drenching night sweats, and unexplained weight loss.
Other general signs involve fatigue, easy bruising, or anemia, reflecting the disruption of the spleen’s normal blood-filtering functions. Consulting a physician for any persistent changes is important, as these non-specific symptoms can be linked to many non-cancerous conditions.
How Spleen Cancer is Diagnosed
Diagnosis typically begins with a physical examination, where a doctor may feel an enlarged spleen in the upper left abdomen. Initial laboratory work involves blood tests, such as a complete blood count (CBC), to look for abnormalities in red blood cells, white blood cells, and platelets. Blood cancers involving the spleen can cause a reduction in normal blood cell counts or show abnormal cells on a peripheral blood smear.
Imaging techniques confirm the size of the spleen and identify suspicious lesions. An ultrasound is often the first test to assess the spleen’s size and texture. More detailed images are obtained using a Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI). A Positron Emission Tomography (PET) scan is useful for identifying metabolically active tumor areas and checking for cancer spread throughout the body.
A definitive diagnosis requires analyzing the malignant cells themselves, typically achieved through a biopsy. This involves collecting a tissue sample from the spleen. Although a biopsy carries a small risk of bleeding, it is necessary to determine the exact type of cancer, which guides treatment decisions. A bone marrow biopsy is also performed when blood cancers are suspected, to see if the disease has involved the bone marrow.
Treatment Options
The treatment strategy for spleen cancer is highly individualized, depending on whether the cancer is primary or secondary, its specific type, and its stage. A multidisciplinary team of specialists, including surgeons, oncologists, and hematologists, typically manages the care plan.
Surgery to remove the spleen, known as a splenectomy, is often a primary treatment for localized primary splenic cancers, such as Angiosarcoma or some lymphomas. A splenectomy may also be performed to alleviate severe discomfort caused by an enlarged spleen or to correct low blood cell counts. Following removal, patients require specific vaccinations to protect against bacterial infections, as the spleen’s immune role is lost.
Systemic therapies treat cancer cells throughout the body. Chemotherapy, which uses powerful drugs to destroy rapidly dividing cells, is a standard approach, particularly for lymphomas. Targeted therapies and immunotherapy are increasingly used, depending on the specific characteristics of the cancer cells. Targeted drugs block pathways cancer cells use to grow and survive, while immunotherapy harnesses the body’s own immune system to fight the malignancy.
Radiation therapy uses high-energy rays to destroy cancer cells. It may be employed to shrink an enlarged spleen and reduce symptoms in patients who are not suitable candidates for other treatments. For secondary spleen cancer, treatment focuses primarily on the original cancer, with splenic involvement managed as part of the overall disease.