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Non-Hodgkin lymphoma (NHL) is a type of cancer that begins in the lymph system in white blood cells called lymphocytes. When these cells become abnormal, they don't protect the body from infection or disease. They also grow without control and may form lumps of tissue called tumours.
NHL can start almost anywhere in the body. It may start in a single lymph node, a group of lymph nodes, or an organ such as the spleen. It can be slow-growing or fast-growing. And it can spread to almost any part of the body.
Treatments can work well for some people. For others, treatment may allow them to live longer than without treatment.
The cause of NHL is not known. The abnormal cell changes may be triggered by an infection or exposure to something in the environment. There is also a link between NHL and problems with the immune system. Or it may be linked to gene changes (mutations). NHL is not contagious.
The most common symptom of NHL is a painless swelling of the lymph nodes in the neck, underarm, or groin. Other symptoms include fever, night sweats, feeling very tired, a cough or shortness of breath, and weight loss you can't explain. Itchy skin or reddened patches of skin can also be symptoms.
To diagnose NHL, you will get an exam. It includes checking the size of certain lymph nodes. Your doctor will take a piece of body tissue (biopsy) to diagnose NHL. Also, you will likely get blood or lab tests, or have imaging tests, such as a CT scan or MRI.
Treatment for NHL is based on the type of lymphoma, the stage of the cancer, and other things, such as your overall health. Treatment options may include chemotherapy, immunotherapy, radiation therapy, and targeted therapy. In some cases, treatment may also include a stem cell transplant.
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Some things can put you at risk for getting NHL. These things are called risk factors. But many people who get NHL don't have any of these risk factors. And some people who have risk factors don't get the disease.
Risk factors include:
Symptoms of NHL include:
With NHL, white blood cells in the lymph system grow out of control.
Lymph tissue is present in many areas of the body, so NHL can start almost anywhere. And it can spread to almost any part of the body, including the liver, bone marrow, and spleen.
NHL may be classified as:
Over time, lymphoma cells may replace the normal cells in the bone marrow. When bone marrow fails, your body can't produce red blood cells that carry oxygen, white blood cells that fight infection, and platelets that stop bleeding.
How NHL affects you and how long you will live depends on many things. These include the type of NHL you have, the stage of the disease when you were diagnosed, and your response to treatments.
Call your doctor to schedule an appointment if you have any symptoms, such as:
If you have been diagnosed with cancer, be sure to follow your doctor's instructions about calling when you have problems, new symptoms, or symptoms that get worse.
To diagnose NHL, your doctor will do a physical examination and ask you questions about your health. The examination includes checking the size of your lymph nodes in your neck, underarm, and groin.
Your doctor will take a piece of body tissue (biopsy) to diagnose NHL. The tissue usually is taken from a lymph node. You may have other tests to find out what kind of NHL you have.
Your doctor also will likely order:
Treatment for NHL is based on the type of lymphoma, the stage of the cancer, and other things, such as your overall health. Treatment options may include chemotherapy, immunotherapy, radiation therapy, and targeted therapy.
If the cancer comes back, treatment may also include a stem cell transplant. In some cases, a clinical trial may be a good idea.
For some people who have slow-growing (indolent) NHL, a wait-and-see approach to treatment may be the best option. Your doctor will watch your condition closely. You won't have treatment unless you're bothered by symptoms.
Your doctor will talk with you about your options and then make a treatment plan.
Medicines may be used to control the growth of cancer cells and to relieve symptoms. Medicines used to treat NHL include:
These medicines kill fast-growing cells, including cancer cells and some normal cells.
This treatment helps your immune system fight cancer. It may be given in several ways. One type is CAR T-cell therapy in which a person's T cells are treated in a lab so they are more able to attack cancer cells.
These medicines target cancer cells and may cause less harm to normal cells. They help keep cancer from growing or spreading.
One type of medicine may be used alone. Or it may be combined with another medicine or another type of treatment. For example, immunotherapy may be used with radiation therapy.
This uses high-dose X-rays to destroy cancer cells and shrink tumours. It may be the treatment of choice for NHL that is slow-growing and in a small area (localized).
Sometimes NHL comes back after treatment. This is called recurrence or relapse. The treatments listed above are also used for recurrent NHL. Other options include:
This replaces damaged cells with healthy stem cells. They help your bone marrow make healthy blood cells. The stem cells may come from your own bone or blood or from a donor.
A stem cell transplant may be done to restore the bone marrow after high-dose chemotherapy or whole-body radiation.
Clinical trials are research studies that test new treatments to find out how well they work. Your medical team can tell you if there's a clinical trial that might be right for you.
Palliative and end-of-life care is a continuum of care from the time of diagnosis of a life-limiting illness through to the time of death and into bereavement. The palliative approach to care can occur simultaneously with a curative approach or during treatment.
Some people use complementary therapies along with medical treatment. They may help relieve the symptoms and stress of cancer or the side effects of cancer treatment. Therapies that may be helpful include:
Talk with your doctor about any of these options you would like to try. And let your doctor know if you are already using any complementary therapies. They are not meant to take the place of standard medical treatment. But they may help you feel better and cope better with treatment.
Relationships take on new importance when you're faced with cancer. Your family and friends can help support you. You may also want to look beyond those who are close to you.
Remember that the people around you want to support you, and asking for help isn't a sign of weakness.
Your friends and family want to help, but some of them may not know what to do. It may help to make a list. For example, you might ask them to:
Places to turn for support include:
Adaptation Date: 2/21/2023
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
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