Some of the most common initial symptoms of NHL include painless swellings in the neck, armpits, or groin, persistent fatigue, and night sweats. Patients may also report shortness of breath and unexplained weight loss as some of the first signs of NHL.
A variety of tests may be needed to confirm the diagnosis and the stage or progression of NHL. In most cases, a biopsy is performed, taking a tissue sample from a lymph node or bone marrow. The sample is then examined under a microscope by a pathologist. A blood test may also be performed to rule out infection or other diseases. Other tests used to diagnose the type or stage of NHL include a lumbar puncture (spinal tap), flow cytometry to look for abnormal DNA, and imaging tests, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI).
One cannot prevent NHL. However, minimizing modifiable risk factors such as limiting exposure to certain infections, maintaining a healthy immune system, maintaining a healthy weight by keeping physically active and eating a healthy diet, will lower your risk for NHL.3
The key treatments for NHL are chemotherapy, immunotherapy, stem cell transplantation, radiation therapy and targeted therapy.
Chemotherapy may be used to fight all forms of NHL. A combination of up to four chemotherapy drugs are used to treat more aggressive types of the disease. Intensive treatment with higher doses of chemotherapy may be used prior to a stem cell transplant, in which healthy stem cells are given to the patient intravenously, similar to a blood transfusion. These healthy cells travel to the bone marrow, where they reproduce more healthy blood cells.
Radiation therapy utilizes high energy beams such as X-rays or other types of radiation to destroy cancer cells. Radiation can be used alone to destroy one or two targeted spots that contains cancerous lymphoma and can be used post-chemotherapy to destroy any lymphoma cells that remain.2
Immunotherapy uses a patient’s own immune system to fight cancer. Substances made by the body or made in a laboratory are used to enhance or restore the body’s immunity. Chimeric antigen receptor (CAR) T cell therapy and immune checkpoint inhibitors are two immunotherapies available for treatment of NHL.1,2
Targeted drug therapy is just what the name implies. It targets cancer-specific genes or proteins that are involved in cancer growth. These therapies may be used alone or in combination with one another.
NHL treatment can lead to physical and emotional/financial /social side effects.
Physical side effects can range from mild to severe and can include:
Additionally, patients can have long-term effects of treatment including infertility, heart disease, and secondary cancers.
Palliative or supportive care is an important component of your recovery and may include medications to counter side effects, nutritional changes, relaxation exercises, emotional/spiritual support, and other treatments. Talk to your doctor or healthcare team to explore specific palliative care options.2
The impact on quality of life depends largely on the type and stage of the disease, and the type of treatment prescribed. Because lymphoma affects B cells or T cells, it may make it difficult for a patient to fight off infection. Some cases of indolent, or slow-growing, lymphoma require only active surveillance and no immediate treatment. Other cases require aggressive treatment, such as high-dose chemotherapy, targeted therapy, and stem cell transplantation. These types of treatments often cause side effects, such as nausea, weight loss and a compromised immune system. Because lymphoma affects the lymphatic system, another symptom of non-Hodgkin lymphoma that may occur is lymphedema, which is swelling caused by a buildup of lymphatic fluid.
Ask your physician about your specific type of lymphoma, about your treatment plan, what to expect during and after treatment, and any other questions that can help you make informed decisions about your healthcare options.
Sample questions for your physician6:
At the time of diagnosis
Before the treatment begins
During treatment
If your cancer has relapsed or is not responsive after treatment, you may be eligible to enroll in a clinical trial that is testing new drugs for your condition. Talk to your doctor about your eligibility to be a part of an ongoing clinical trial. Check out the status of various ongoing clinical trials in the Resources section.
Patients should talk with their doctor about watching for certain symptoms and side effects. A patient’s doctor should be contacted if the patient experiences a side effect that is unexpected or lasts longer than expected, a medical problem—such as fever/chills, shortness of breath, prolonged or constant nausea and vomiting, chest pain, and/or dizziness—that cannot wait for a regularly scheduled appointment.
All URLs accessed July 2, 2024
