Non-Hodgkin's Lymphoma

What is Non-Hodgkin's Lymphoma?

Non-Hodgkin's lymphoma is a type of cancer that starts in your lymphatic system. Your lymphatic system is part of your immune system. It includes your lymph nodes, spleen, bone marrow, and other organs that help fight infection.

This cancer occurs when your body makes abnormal lymphocytes, a type of white blood cell. These abnormal cells grow out of control and can form tumors in your lymph nodes or other organs. There are more than 60 different types of non-Hodgkin's lymphoma. Some grow slowly over years, while others grow quickly and need immediate treatment.

Non-Hodgkin's lymphoma is more common than Hodgkin's lymphoma. It can happen at any age, but your risk increases as you get older. Most people diagnosed are over age 60. When caught early, many types of non-Hodgkin's lymphoma can be treated successfully.

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Symptoms

Swollen lymph nodes in your neck, armpits, or groin that do not hurt
Persistent fatigue that does not improve with rest
Fever without infection
Night sweats that soak your sheets
Unexplained weight loss of 10 pounds or more
Shortness of breath or chest pain
Abdominal pain or swelling
Loss of appetite
Frequent infections
Easy bruising or bleeding

Some people have no symptoms in the early stages. Others may notice swollen lymph nodes that come and go. Many of these symptoms can be caused by other conditions. If you have symptoms that last more than two weeks, see your doctor.

Causes and risk factors

Non-Hodgkin's lymphoma happens when your body produces too many abnormal lymphocytes. These cells live longer than normal cells and keep multiplying. Scientists do not know exactly why this happens. Your immune system may play a role. People with weakened immune systems have higher risk, including those with HIV or who take immune-suppressing drugs after organ transplant. Certain infections increase risk, including hepatitis C virus, Epstein-Barr virus, and H. pylori bacteria.

Other risk factors include age over 60, being male, exposure to certain chemicals like pesticides and herbicides, radiation exposure, and autoimmune diseases like rheumatoid arthritis or lupus. Having a family history of lymphoma slightly increases risk. Some types are more common in people of European descent. Most people with risk factors never develop lymphoma. Many people diagnosed have no known risk factors at all.

How it's diagnosed

Diagnosing non-Hodgkin's lymphoma requires several steps. Your doctor will examine your lymph nodes and check for swelling in your spleen or liver. A biopsy is needed to confirm diagnosis. During a biopsy, your doctor removes all or part of a lymph node to look at cells under a microscope. This helps determine the exact type of lymphoma you have.

Blood tests help assess your overall health and look for signs of lymphoma. Protein electrophoresis can detect abnormal proteins produced by lymphoma cells. Surface light chain testing measures proteins that lymphoma cells may produce in excess. Interleukin-2 receptor alpha chain levels may be elevated, showing increased T-cell activation. Testing for hepatitis C is important because it increases lymphoma risk. Your doctor may also order imaging tests like CT scans or PET scans to see where the cancer has spread. Talk to your doctor about which specialized tests are right for your situation.

Treatment options

Active surveillance for slow-growing types that cause no symptoms
Chemotherapy using drugs that kill cancer cells throughout your body
Immunotherapy that helps your immune system attack cancer cells
Targeted therapy drugs that attack specific features of cancer cells
Radiation therapy to destroy cancer cells in specific areas
Stem cell transplant for aggressive or recurring lymphoma
CAR T-cell therapy that modifies your immune cells to fight cancer
Surgery to remove tumors in certain situations
Treating underlying infections like hepatitis C or H. pylori
Nutritional support to maintain strength during treatment

Frequently asked questions

Both are cancers of the lymphatic system, but they involve different cell types. Hodgkin's lymphoma contains specific abnormal cells called Reed-Sternberg cells. Non-Hodgkin's lymphoma does not have these cells and includes more than 60 different subtypes. Treatment approaches and outcomes differ between the two types.

Blood tests alone cannot diagnose non-Hodgkin's lymphoma, but they provide important clues. Tests like protein electrophoresis can show abnormal proteins produced by lymphoma cells. Surface light chain tests can detect excess proteins that lymphoma cells release. A lymph node biopsy is still needed to confirm the diagnosis.

Growth rate varies widely depending on the type. Indolent or slow-growing types may develop over many years and cause few symptoms. Aggressive types grow quickly over weeks or months and need immediate treatment. Your doctor will determine which category your lymphoma falls into based on biopsy results.

Many types of non-Hodgkin's lymphoma can be cured, especially when caught early. Slow-growing types may not be curable but can be managed for many years. Treatment success depends on the specific type, stage at diagnosis, your age, and overall health. Many people live long, healthy lives after treatment.

Lymphoma causes abnormal lymphocytes to multiply and build up inside lymph nodes. These cancer cells take up space and make the lymph nodes swell. Unlike swollen nodes from infection, lymphoma nodes usually do not hurt. They often feel firm and rubbery and may grow slowly over time.

Risk increases with age, especially after 60. People with weakened immune systems face higher risk, including those with HIV or taking immune-suppressing drugs. Certain infections like hepatitis C and Epstein-Barr virus increase risk. Men are slightly more likely to develop it than women.

B symptoms are three specific warning signs of lymphoma. They include fever above 100.4°F without infection, drenching night sweats that soak your sheets, and unexplained weight loss of more than 10% of your body weight in six months. Having B symptoms may mean more aggressive disease and affects treatment planning.

Most cases cannot be prevented because the cause is unknown. You can reduce some risk factors by protecting yourself from HIV and hepatitis C infections. Avoid prolonged exposure to herbicides and pesticides. Treating H. pylori infections may help lower risk. Maintaining a healthy immune system through good nutrition and stress management may also help.

Staging describes how far the cancer has spread. Stage 1 means cancer is in 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 cancer has spread to organs like your liver, lungs, or bone marrow.

You will need regular follow-up visits to check for cancer recurrence. Your doctor will examine you and may order blood tests or imaging scans. Follow-up is frequent at first, then becomes less often over time. Many people experience side effects from treatment that need management. Healthy lifestyle choices support long-term recovery and reduce recurrence risk.