Non-Hodgkin Lymphoma

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KEY POINTS

• Lymphoma is a growth of abnormal white blood cells that form tumors in the lymph system. The lymph system is part of your body's system for fighting infection.
• Treatment may include radiation therapy, chemotherapy, or a stem cell or bone marrow transplant. Often, more than 1 treatment is used.
• After treatment, you will need to have regular follow-up visits with your healthcare provider.

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What is non-Hodgkin lymphoma?

Lymphoma is a growth of abnormal white blood cells that form 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.

The sooner cancer is found and treated, the better your chances for recovery. However, even advanced cancer can usually be treated. Treatment may slow or stop the growth of the cancer and ease symptoms for a time. Ask your healthcare provider what you can expect with the type of cancer that you have.

What is the cause?

The exact cause of non-Hodgkin lymphoma is unknown. Unlike normal white blood cells, the abnormal white cells of non-Hodgkin lymphoma don't protect your body from infections or other diseases.

Most people with this disease are older than 60. A weakened immune system, such as from an inherited condition or certain drugs used after an organ transplant, may increase your risk.

Some infections increase the risk of lymphoma, such as:

• Human immunodeficiency virus (HIV), which is the virus that causes AIDS
• Helicobacter pylori (H. pylori), which are bacteria that can cause stomach ulcers
• Epstein Barr Virus (EBV)

What are the symptoms?

Signs and symptoms may include:

• Swelling of lymph nodes in the neck, armpits, or groin (often the swelling is painless)
• Fever and night sweats
• Tiredness
• Itching
• Loss of appetite
• Unexplained weight loss

If you notice lumps in your neck, armpit, or groin, tell your healthcare provider.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. You may have a lymph node biopsy, which uses a needle passed through the skin to take a small sample of tissue for testing. If cancer is found, other tests may be done to see how far the disease has spread and to help decide the best treatment. You may have tests such as:

• Blood tests
• Chest X-ray
• CT scan, which uses X-rays and a computer to show detailed pictures of the lymph nodes
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the lymph nodes
• PET scan, which is a series of detailed pictures that are 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.
• A bone marrow biopsy, which uses a needle passed through the skin to take a small sample of tissue for testing

How is it treated?

Treatment depends on where the lymphoma is found. You and your healthcare provider will discuss possible treatments. You may also talk with a cancer specialist. Some things to think about when making treatment decisions are:

• Your age
• Your overall health
• The stage of the cancer (how advanced the cancer is)
• Whether the cancer has spread to other parts of your body

Possible treatments are:

• Radiation therapy, which uses high-energy X-rays to kill cancer cells
• Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
• Stem cell or bone marrow transplant, which uses your own healthy cells or cells from a donor
• Biological therapy, which uses medicines that help your immune system fight the cancer

Your treatment will also include:

• Preventing infections (You may be more at risk for serious infections during and after your treatment.)
• Controlling pain or other symptoms you may be having
• Controlling the side effects from treatments
• Helping you manage your life with cancer

Often, more than 1 type of treatment is used. You will need to have regular follow-up visits with your healthcare provider.

Ask your healthcare provider about clinical trials that might be available to you. Clinical trials are research studies to find effective cancer treatments. It’s always your choice whether you take part in one or not.

How can I take care of myself?

If you have been diagnosed with Non-Hodgkin lymphoma:

• Talk about your cancer and treatment options with your healthcare provider. Make sure you understand your choices.
• Follow the full course of treatment prescribed by your healthcare provider.
• Ask your healthcare provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

Other things that may help include:

• Eat a healthy diet and get regular exercise as recommended by your healthcare provider.
• Get plenty of rest.
• Try to reduce stress and take time for activities that you enjoy. It may help to talk with a counselor about your illness.
• Talk with your family and your healthcare providers about your concerns. Ask your healthcare provider any questions you have about the disease, treatments, side effects of the treatments, sexual activity, support groups, and anything else that concerns you.
• If you smoke, try to quit.
• Ask your provider if you need to avoid drinking alcohol. It may interfere with medicines you are taking. Alcohol can also make it harder for white blood cells to fight infections.
• Tell your provider if your treatment causes discomfort. Usually there are ways to help you be more comfortable.

For more information, contact:

• American Cancer Society, Inc.
  800-227-2345
  http://www.cancer.org
• National Cancer Institute
  800-422-6237 (TTY: 800-332-8615)
  https://www.cancer.gov/