What is Non-Hodgkins Lymphoma?
Non-Hodgkins lymphoma (NHL) is a cancer in the lymphatic system. The American Cancer Society estimates that there will be about 70,000 new cases of non-Hodgkin lymphoma in 2013. Although NHL is among the most common cancers in childhood, more than 95 percent of cases occur in adults.
Non-Hodgkins lymphoma causes the cells in the lymphatic system to abnormally reproduce, eventually causing tumors to grow. Non-Hodgkins lymphoma cells can also spread to other organs.
Diagnosis and Staging
Lymphoma is not just one disease. Rather, it is more than 30 types of cancer that act differently and may need special treatment. To see if you have lymphoma and what kind it is, your doctor may order some or all of the following tests.
The doctor may order blood tests to evaluate a variety of factors, including the number of blood cells in your blood and how well your liver and kidneys are working.
During a lymph node biopsy, your doctor will perform surgery to take out a lymph node. It will then be examined under a microscope to look for cancer.
A bone marrow biopsy may help determine if lymphoma has spread to that part of the body.
Your doctor may order imaging tests to see if lymphoma has spread to other organs. These tests may include X-rays or CT, PET or MRI scans.
The stage of cancer is a term used to describe its size and whether it has spread. Knowing this helps doctors plan the best treatment.
- Stage I: Single lymph node or non-lymph node region is affected.
- Stage II: Two or more lymph node or non-lymph node regions are affected on the same side of the diaphragm (the muscle under the lungs).
- Stage III: Lymph node or non-lymph node regions above and below the diaphragm are affected.
- Stage IV: The cancer has spread outside the lymph nodes to organs such as the liver, bones or lungs. Stage IV can also refer to a tumor in another organ and/or tumor in distant lymph nodes.
Risk factors for developing lymphoma are unknown. However, doctors believe immune system problems as well as age may increase a person's chance of developing this disease.
- Non-Hodgkins is most commonly found in people in their 60s and 70s. However, the disease can affect anyone.
- People with auto-immune disorders, including HIV and AIDS, are more likely to develop non-Hodgkins lymphoma.
- People who have received an organ transplant have a high risk of developing non-Hodgkins. This is because they must take drugs that suppress the immune system.
Signs and Symptoms
The signs and symptoms of lymphoma are general and may also be associated with other, noncancerous conditions. Talk to your doctor about any of these problems.
- Swollen lymph nodes in your neck, underarm or groin
- Unexplained fevers
- Unexplained weight loss
- Constant fatigue
- Skin rash or itchy skin
- Unexplained pain in the chest, abdomen, pelvis or bones
- Drenching night sweats
Unexplained fevers, night sweats and weight loss are known as “B” symptoms. Ask your doctor about their significance in your case.
Treatment options depend on the type of lymphoma you have, the stage of the lymphoma and your overall health. Treatment may include radiation therapy or chemotherapy, either alone or in combination. Other treatments include watchful waiting and biologic therapy. It may help to talk to several cancer specialists before deciding on the best course of treatment for you, your cancer and your lifestyle.
- A radiation oncologist is a doctor who specializes in destroying cancer cells with high energy X-rays or other types of radiation.
- A medical oncologist is a doctor who is an expert at prescribing special drugs (chemotherapy) to treat cancer. Some medical oncologists are also hematologists, meaning they have experience treating blood problems.