Your Care Instructions

Non-Hodgkin's lymphoma is a type of cancer that affects part of the immune system (lymph system). Cells normally found in the lymph nodes, spleen, and other parts of the lymph system increase in number and collect in areas where they cause problems. Non-Hodgkin's lymphoma is not contagious and is not caused by an injury.

Non-Hodgkin's lymphoma may occur in a single lymph node, a group of lymph nodes, or an organ. It can spread to almost any part of the body, including the liver, bone marrow, and spleen.

Treatment for non-Hodgkin's lymphoma depends on the stage of the lymphoma. It is usually treated with medicines called chemotherapy. Your doctor may also give you medicines that work on the body's immune system (immunotherapy). You may also need radiation treatments or a procedure called a bone marrow transplant. Your doctor will talk to you about what kind of treatment may be best for you.

When you find out that you have cancer, you may feel many emotions and may need some help coping. Seek out family, friends, and counsellors for support. You also can do things at home to make yourself feel better while you go through treatment. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Take your medicines exactly as prescribed. Call your doctor or nurse call line if you think you are having a problem with your medicine. You may get medicine for nausea and vomiting if you have these side effects.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. Drink liquid meal replacements for extra calories and protein. Try to eat your main meal early.
• Get some physical activity every day, but do not get too tired. Keep doing the hobbies you enjoy as your energy allows.
• Take steps to control your stress and workload. Learn relaxation techniques.
  • Share your feelings. Stress and tension affect our emotions. By expressing your feelings to others, you may be able to understand and cope with them.
  • Consider joining a support group. Talking about a problem with your spouse, a good friend, or other people with similar problems is a good way to reduce tension and stress.
  • Express yourself through art. Try writing, crafts, dance, or art to relieve stress. Some dance, writing, or art groups may be available just for people who have cancer.
  • Be kind to your body and mind. Getting enough sleep, eating a healthy diet, and taking time to do things you enjoy can contribute to an overall feeling of balance in your life and can help reduce stress.
  • Get help if you need it. Discuss your concerns with your doctor or counsellor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids (enough so that your urine is light yellow or clear like water) to prevent dehydration. Choose water and other caffeine-free clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• If you have not already done so, prepare an advance care plan. An advance care plan provides instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You have trouble breathing.
• You cough up blood.
• You vomit blood or what looks like coffee grounds.
• You pass maroon or very bloody stools.
• You have symptoms of a stroke. These may include:
  • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.

Call your doctor or nurse call line now or seek immediate medical care if:

• You have severe pain.
• You are dizzy or light-headed, or you feel like you may faint.
• You are sick to your stomach or cannot keep fluids down.
• You have any unusual bleeding, such as:
  • Blood spots under the skin.
  • A nosebleed that you cannot stop.
  • Bleeding gums when you brush your teeth.
  • Blood in your urine.
  • Vaginal bleeding when you are not having your period, or heavy period bleeding.
• Your stools are black and tar-like or have streaks of blood.
• You have signs of an infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from a bruise.
  • Pus draining from a wound.
  • A fever or chills.
  • Burning when you urinate.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

• You cough up yellow or green mucus.
• You have trouble controlling your pain.