Lymphoma is cancer that begins in the lymph system in white blood cells called lymphocytes. When these cells become abnormal, they don't protect the body from infection or disease. They also grow without control and may form lumps of tissue called tumors.
Non-Hodgkin lymphoma (NHL) can start almost anywhere in the body. It may start in a single lymph node, a group of lymph nodes, or an organ such as the spleen. Or it can spread to almost any part of the body, including the liver and bone marrow.
There are many types of NHL. Sometimes they are grouped as:
- Slow-growing lymphomas, which spread slowly and cause few symptoms. These may also be called indolent or low-grade lymphomas.
- Fast-growing lymphomas, which spread quickly and cause severe symptoms. These may also be called aggressive lymphomas and may be classified as intermediate-grade or high-grade.
Treatment can cure some people and may allow others to live for years. How long you live depends on the type of NHL you have and the stage of your disease (how far it has progressed).
What are the symptoms of non-Hodgkin lymphoma?
Symptoms of non-Hodgkin lymphoma (NHL) include:
- A painless swelling of the lymph nodes in the neck, underarm, or groin. This is the most common symptom.
- Fever not caused by another health problem.
- Night sweats.
- Feeling very tired.
- Weight loss you can't explain.
- Itchy skin.
- Reddened patches on the skin.
- A cough or shortness of breath.
- Pain in the belly or back.
What causes non-Hodgkin lymphoma?
Experts don't know what causes non-Hodgkin lymphoma (NHL).
When a person has non-Hodgkin lymphoma, abnormal rapid cell growth occurs. This abnormal growth may need a "trigger" to start, such as an infection or exposure to something in your environment. There is also a link between NHL and problems with the immune system.
NHL is not contagious and is not caused by injury.
What increases your risk for non-Hodgkin lymphoma?
Some things can increase your chances of getting non-Hodgkin lymphoma (NHL). These things are called risk factors. But many people who get non-Hodgkin lymphoma don't have any of these risk factors. And some people who have risk factors don't get the disease.
Risk factors include:
- Being male. NHL is more common in men than in women.
- Age. The likelihood of getting NHL increases as you get older.
- Impaired immune system. NHL is most common among those who have an impaired immune system, an autoimmune disease, or HIV or AIDS. It also occurs among those who take immunosuppressant medicines, such as medicines following an organ transplant.
- Viral infection. A viral infection, such as Epstein-Barr virus, increases the risk of developing NHL.
- Bacterial infection. Infection with Helicobacter pylori increases the risk of lymphoma involving the stomach.
- Environmental exposure. Exposure to agricultural pesticides or fertilizers, solvents, and other chemicals may increase the risk of developing NHL.
How is non-Hodgkin lymphoma diagnosed?
To diagnose non-Hodgkin lymphoma (NHL), your doctor will do a physical exam and ask you questions about your health. The exam includes checking the size of your lymph nodes in your neck, underarm, and groin.
Your doctor will take a piece of body tissue (biopsy) to diagnose NHL. The tissue usually is taken from a lymph node. You may have other tests to find out what kind of NHL you have.
How is non-Hodgkin lymphoma treated?
Treatment for non-Hodgkin lymphoma (NHL) depends on:
- The stage of the disease.
- The type of lymphoma. The kind of treatment you have will depend on whether you have B-cell or T-cell lymphoma and whether it is fast-growing or slow-growing.
- The size of the tumor, where the lymphoma is located, and what organs are involved.
- Your general health.
- Your age.
Your doctor will work with you and your medical team (which may include an oncologist, a hematologist, and an oncology nurse) to come up with your treatment plan.
- Watchful waiting (surveillance) is a period of time after the diagnosis of some types of NHL when you are not receiving treatment but are still being watched closely by your doctor.
- Radiation therapy is often the treatment of choice for localized slow-growing (indolent or low-grade) NHL.
- Chemotherapy kills cancer cells or stops them from dividing. The way chemotherapy is taken depends on the type and stage of cancer.
- Targeted therapy with monoclonal antibodies destroys cancer cells without harming normal cells.
- A stem cell transplant may be used to treat NHL that has come back. Or it may be used right after you have very high-dose chemotherapy.