Non-Hodgkin Lymphoma
What is Non-Hodgkin Lymphoma?
Non-Hodgkin lymphoma is a type of cancer that starts in your lymphatic system. Your lymphatic system is part of your immune system and helps fight infections. It includes lymph nodes, spleen, bone marrow, and other tissues throughout your body.
This cancer begins when certain white blood cells called lymphocytes grow out of control. These abnormal cells can build up in lymph nodes and other parts of your body. Non-Hodgkin lymphoma is actually a group of more than 60 different types of lymphoma, each behaving differently.
Some types grow slowly over years, while others develop quickly and need immediate treatment. Non-Hodgkin lymphoma is more common than Hodgkin lymphoma and can occur at any age. It affects about 80,000 Americans each year, making it one of the most common cancers in the United States.
Symptoms
- Swollen lymph nodes in your neck, armpits, or groin that don't hurt
- Persistent fatigue that doesn't improve with rest
- Fever without an obvious infection
- Night sweats that soak your sheets
- Unexplained weight loss of more than 10 pounds
- Persistent cough or trouble breathing
- Abdominal pain or swelling
- Chest pain or pressure
- Frequent infections
- Easy bruising or bleeding
Many people have no symptoms in the early stages. Others may experience vague symptoms that seem like common illnesses. Some types of non-Hodgkin lymphoma cause no noticeable problems until the disease has spread.
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Causes and risk factors
Non-Hodgkin lymphoma develops when your body produces too many abnormal lymphocytes. These cells don't die when they should and keep multiplying. Scientists don't know exactly why this happens, but certain factors increase your risk. Age is a major factor, as most cases occur in people over 60. Having a weakened immune system from HIV, organ transplant medications, or autoimmune diseases raises your risk significantly.
Infections with certain viruses and bacteria also play a role. These include Epstein-Barr virus, hepatitis C, H. pylori bacteria, and human T-cell leukemia virus. Exposure to chemicals like pesticides and herbicides may contribute. Previous cancer treatment with radiation or chemotherapy can increase risk years later. A family history of lymphoma raises your chances slightly, though most cases occur in people with no family history.
How it's diagnosed
Doctors diagnose non-Hodgkin lymphoma through several steps. A physical exam checks for swollen lymph nodes, enlarged organs, and other signs. Blood tests can show abnormal cell counts and other changes. The kappa/lambda light chains ratio test may reveal abnormal protein levels produced by some lymphomas. However, diagnosis requires removing tissue from a swollen lymph node or affected organ.
A pathologist examines this tissue under a microscope to confirm lymphoma and identify the specific type. Imaging tests like CT scans, PET scans, or MRIs show where the cancer has spread. A bone marrow biopsy checks if lymphoma cells are in your bone marrow. These specialized tests go beyond routine blood work. Talk to your doctor about testing if you have concerning symptoms. They can refer you to specialists who can provide the right diagnostic tests.
Treatment options
- Active surveillance for slow-growing types that cause no symptoms
- Chemotherapy using drugs that kill cancer cells throughout your body
- Radiation therapy to target specific areas affected by lymphoma
- Immunotherapy drugs that help your immune system fight cancer cells
- Targeted therapy drugs that attack specific proteins on lymphoma cells
- CAR T-cell therapy, which modifies your own immune cells to fight cancer
- Stem cell transplant to replace diseased bone marrow with healthy cells
- Antibiotics to prevent or treat infections during treatment
- Nutritious diet to maintain strength during treatment
- Gentle exercise as tolerated to reduce fatigue and maintain function
Frequently asked questions
The main difference is the type of abnormal cell found in the cancer. Hodgkin lymphoma contains Reed-Sternberg cells, which non-Hodgkin lymphoma does not have. Non-Hodgkin lymphoma is more common and includes more than 60 different subtypes. Treatment approaches and outcomes differ between the two types.
Blood tests alone cannot diagnose non-Hodgkin lymphoma, but they provide important clues. Tests like kappa/lambda light chains can show abnormal protein levels that suggest lymphoma. A complete blood count may reveal abnormal white blood cell numbers. However, tissue biopsy is always needed to confirm the diagnosis and identify the specific type.
Many types of non-Hodgkin lymphoma can be cured, especially when caught early. Fast-growing types often respond well to treatment and can be cured completely. Slow-growing types may not be curable but can be managed for many years. Your specific outlook depends on the lymphoma type, stage, and how well it responds to treatment.
People over age 60 face the highest risk, though it can occur at any age. Those with weakened immune systems from HIV, organ transplants, or autoimmune diseases have increased risk. Previous exposure to certain chemicals, viruses, or cancer treatments also raises your chances. However, many people diagnosed have no clear risk factors.
Survival rates vary widely based on the specific type and stage. The overall five-year survival rate is about 74 percent across all types. Some slow-growing types have survival rates above 90 percent. Fast-growing types may have lower rates but often respond better to treatment.
The spread rate depends entirely on the type. Indolent, or slow-growing, lymphomas may develop over years without causing problems. Aggressive types can spread within weeks to months and require immediate treatment. Your doctor will classify your lymphoma as indolent or aggressive to guide treatment timing.
While you cannot prevent all cases, certain habits may reduce risk. Maintaining a healthy immune system through good nutrition and exercise helps. Avoiding exposure to herbicides and pesticides when possible may lower risk. Treating infections like H. pylori and hepatitis C can also help, as these increase lymphoma risk.
Most swollen lymph nodes are caused by common infections, not cancer. However, see your doctor if a lymph node stays swollen for more than two weeks. Also get checked if the node is hard, grows quickly, or comes with fever and night sweats. Your doctor can determine if testing is needed.
Doctors use stages 1 through 4 to describe how far lymphoma has spread. Stage 1 means it affects one lymph node area. Stage 2 involves two or more areas on the same side of your diaphragm. Stage 3 affects lymph nodes on both sides of your diaphragm. Stage 4 means it has spread to organs like your liver, lungs, or bone marrow.
Not always. Some slow-growing types require no immediate treatment if they cause no symptoms. Your doctor may recommend active surveillance with regular monitoring instead. Fast-growing types usually need treatment to start within weeks of diagnosis. Your treatment plan depends on the type, stage, symptoms, and your overall health.