Non-Hodgkin Lymphoma

What is non-Hodgkin lymphoma?

Lymphoma is a growth of abnormal white blood cells that forms tumors in the lymph system. The lymph system is part of your body's system for fighting infection. The lymph system consists of lymph nodes that store blood cells (lymphocytes) to fight infection and vessels that carry fluid, nutrients, and wastes between your body and your bloodstream. This disease can occur in one lymph node, in a group of lymph nodes, or in an organ. It can then spread to almost any part of your body.

Non-Hodgkin lymphoma is one of the many types of lymphoma. Other types of lymphomas are called Hodgkin lymphoma. The type of lymphoma is determined by how the cancer cells look under a microscope. Non-Hodgkin lymphoma is much more common than Hodgkin lymphoma.

There are different types and stages of non-Hodgkin lymphoma based on where the cancer cells are found, what the cells look like, and how they grow. Knowing the type and stage of cancer you have can help your healthcare provider decide on the best treatment plan for you. It is important to diagnose and treat non-Hodgkin lymphoma as soon as possible. The main goals of treatment are to kill the cancer cells and prevent the cancer from spreading.

The cause of non-Hodgkin lymphoma is not well known. However, there are several things that may increase your risk. These include:

• Impaired immune system or autoimmune diseases
• Exposure to certain chemicals or radiation
• History of viral illnesses such as Epstein-Barr virus, Hepatitis C, or HIV
• Being overweight or obese

What can I expect in the hospital?

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

• You will be checked often by the hospital staff.
• Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
• Your fluid output may be monitored closely by keeping track of the amount of urine and bowel movements you produce.

Testing

You may need tests to confirm your cancer diagnosis. Other tests may be done to check to see if the cancer has spread to other parts of your body. Testing may include:

• Blood tests to check for certain hormones, proteins, or chemicals that may be at high levels if you have cancer.
• Blood tests to check your blood count and check for anemia or infections.
• Tests to look for abnormalities in your immune system, which may include:
  • Lymph node biopsy: A biopsy is the removal of a part or all of a lymph node for testing. This can be done in several ways:
    • Needle biopsy: The surgeon puts a long needle through the skin and into the lymph node to take a sample of tissue. The surgeon may use ultrasound or a CT scan to help guide the needle into the lymph node.
    • Surgical biopsy: The surgeon will make a cut in the skin over the abnormal tissue to remove all or part of the lymph node for testing
  • Bone marrow biopsy: A biopsy is the removal of a small sample of bone marrow for testing.
  • Lumbar puncture: A test that uses a needle to get a sample of fluid from the area around your spinal cord
  • Body fluid sampling: A procedure where a sample of fluid is taken from the peritoneal space (abdomen or belly) or pleural cavity (space around the lungs) to check for cancer cells in the peritoneal or pleural fluid
  • Computed tomography (CT) scan: A series of X-rays is taken from different angles and arranged by a computer to show thin cross sections of the inside of your body where lymph nodes are found.
  • Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the inside of your body where lymph nodes are found.
  • Ultrasound scan: Sound waves and their echoes are passed through your body from a small device that is held against your skin to create pictures of the inside of the body near the lymph nodes.
  • Chest X-ray: Pictures of the inside of your chest to check for cancer
  • Positron emission tomography (PET) scan: A series of detailed pictures is taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows areas where the radioactive material is being absorbed.

Treatment

The treatment for non-Hodgkin lymphoma depends on your symptoms, how well you respond to treatment, your overall health, and any complications you may have. Your chance of cure depends on how far the cancer has advanced. You may need to make lifestyle changes to stay as healthy as possible.

• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
• Treatments may include:
  • Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
  • Radiation therapy, which uses high-energy X-rays to kill cancer cells
  • Biological therapy, which uses medicine designed to help your immune system fight the cancer or block the growth of cancer cells
• You may need surgery to treat non-Hodgkin lymphoma. Surgery is usually only done if the cancer is affecting one organ, such as the spleen, thyroid, or stomach.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Treat or prevent low blood counts caused by the cancer or its treatment
  • Treat or prevent side effects, such as nausea or constipation, from other treatments
  • Help your immune system fight cancer
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Bloating or pain in your belly
  • Full feeling below your ribs, especially on the left
  • Nausea or vomiting
  • Chest pain
  • Cough or trouble breathing
  • Depression
  • Easy bruising or bleeding
  • Swollen lymph nodes in your neck, underarms, or groin
  • Tiredness
• Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many things, such as your general health, why you are in the hospital, and the treatment you need. The average amount of time to stay in the hospital with Non-Hodgkin lymphoma is 7 to 11 days. Talk with your provider about how long your stay may be.