The spleen, a fist-sized organ located beneath the rib cage on the left side of the abdomen, plays an important role in the body’s defense and circulatory systems. It functions as a filter for blood, removing old or damaged red blood cells and recycling components like iron. The spleen also contains white blood cells that help fight infections and stores blood cells, including platelets, for emergencies. A person can survive without a spleen, as other organs like the liver can take over some of its functions. Cancer affecting the spleen is uncommon, and it can either originate within the spleen itself or, more frequently, spread there from other parts of the body.
Understanding Spleen Cancer Types
Spleen cancer is broadly categorized into primary and secondary types. Primary spleen cancer, originating in the spleen, is rare. These primary cancers are most often lymphomas, such as splenic marginal zone lymphoma (SMZL) or diffuse large B-cell lymphoma, which are types of non-Hodgkin lymphoma. Rarely, primary splenic angiosarcoma, an aggressive tumor of the blood vessels, can also develop in the spleen.
Secondary spleen cancer is more common and occurs when cancer from another part of the body metastasizes to the spleen. This often happens with blood cancers like leukemia or lymphoma that originate elsewhere in the lymphatic system. Solid tumors from organs such as the breast, lung, colon, stomach, pancreas, or ovaries can also spread to the spleen, though this is less frequent.
Identifying Symptoms and Diagnosis
Symptoms of spleen cancer can be subtle or non-existent in the early stages. When symptoms do appear, they are often non-specific and can include pain or a feeling of fullness in the upper left abdomen, which may be due to an enlarged spleen (splenomegaly). Other signs include fatigue, unexplained weight loss, fever, and night sweats. Some might also experience easy bruising, frequent infections, or swollen lymph nodes.
The diagnostic process begins with a physical examination, where a doctor might detect an enlarged spleen. Blood tests, such as a complete blood count, are performed to check for abnormal levels of blood cells. Imaging studies provide detailed views of the spleen and surrounding areas; these can include ultrasound, CT scans, MRI, and PET scans, which help identify tumor size and spread. A definitive diagnosis requires a biopsy from the spleen or bone marrow.
Treatment Approaches
Treatment for spleen cancer is individualized, depending on the specific type of cancer, its stage, and the patient’s overall health. Chemotherapy uses drugs to destroy cancer cells, particularly effective for lymphomas and leukemias involving the spleen. Radiation therapy may be used to target and shrink tumors, especially in localized cases of splenic lymphoma.
Targeted therapy and immunotherapy are strategies that aim to attack cancer cells or boost the body’s immune response against the disease. Targeted therapies block molecules involved in cancer growth, while immunotherapy helps the immune system recognize and eliminate cancer cells. Surgical removal of the spleen, known as a splenectomy, can be a treatment option, especially if the cancer originated in the spleen or if the enlarged spleen is causing significant symptoms. Further treatments may be necessary if the cancer has spread.
Prognosis and Factors Affecting Outcome
The prognosis for spleen cancer varies considerably among individuals. The prognosis is influenced by several factors. The specific type of cancer plays a role; for instance, primary splenic lymphomas often have a more favorable outlook compared to primary splenic angiosarcoma. The stage of the cancer at diagnosis, indicating whether it is localized to the spleen or has spread to other parts of the body, also impacts the prognosis. Cancers detected at an earlier, localized stage have a better outlook.
A patient’s overall health and age before beginning treatment can affect how well they tolerate therapies and recover. The effectiveness of the chosen treatment approach, as measured by how the cancer responds to chemotherapy, radiation, or other interventions, is another determinant. The presence of genetic markers within the cancer cells can influence both treatment effectiveness and the disease’s progression. While some forms of spleen cancer can be aggressive, others are treatable, leading to a good prognosis. A comprehensive evaluation of these factors is important for understanding each patient’s situation.