Description

The non-Hodgkin's lymphoma is a type of cancer that affects the lymphatic system. The lymphatic system consists of organs, glands, vessels and tubular groups of cells called lymph nodes. It is part of the body's germ-fighting immune system.

The non-Hodgkin's lymphoma occurs when the germ-fighting cells in the lymphatic system grow out of control. The cells may form growths called tumors throughout the body.

The non-Hodgkin's lymphoma is a large group of lymphomas. There are many subtypes of this group. Diffuse large B-cell lymphoma and follicular lymphoma are among the most common of the subtypes. The other broad group of Hodgkin's lymphoma, the lymphoma.

Advances in the diagnosis and treatment of non-Hodgkin lymphoma have helped to improve the outlook for people with this condition.

Symptoms

The signs and symptoms of non-Hodgkin lymphoma may include:

  • Swollen lymph nodes in the neck, armpits or groin.
  • Stomach pain, or swelling.
  • Chest pain, cough, or difficulty breathing.
  • Feeling very tired.
  • Fever.
  • Night sweats.
  • The loss of weight without trying.

When to see a doctor

Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.

Causes

The cause of non-Hodgkin lymphoma often is not known. This type of cancer begins when the seeds of fighting white blood cells called lymphocytes develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do.

The DNA gives healthy cells are instructions to grow and multiply at a set rate. The instructions that tell cells to die at a set time. In cancer cells, changes in DNA gives other instructions. Changes in DNA tell the cancer cells to make the cells more quickly. Cancer cells can continue living when healthy cells would die. This makes too many cells.

In non-Hodgkin lymphoma, the cancer cells often accumulate in the lymph nodes. You can also accumulate in other parts of the lymphatic system.

The non-Hodgkin's lymphoma can affect the:

  • The lymph nodes.
  • The lymph vessels.
  • The adenoids.
  • The tonsils.
  • The spleen.
  • Thymus.
  • The bone marrow.
  • Rarely, the parts of the body that are not part of the lymphatic system.

The non-Hodgkin's lymphoma types

The non-Hodgkin's lymphoma often begins in:

  • Cells B. B cells are a type of lymphocyte that is fighting the infection. B cells produce antibodies against the foreign invaders. The majority of non-Hodgkin's lymphoma arises from b cells subtypes of non-Hodgkin's lymphoma involving B cells, which include diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma and Burkitt lymphoma.
  • Cells of T. The T-cells are a type of lymphocyte that kills foreign invaders directly. The non-Hodgkin's lymphoma occurs less often in the cells of T. subtypes of non-Hodgkin's lymphoma involving T cells include peripheral T-cell lymphoma cutaneous T-cell lymphoma.

The treatment depends on whether the non-Hodgkin's lymphoma arises from B cells or t cells.

Risk factors

Factors that may increase the risk of non-Hodgkin's lymphoma include:

  • Medications that decrease the immune response. Take medication to control the immune system after an organ transplant may increase the risk of non-Hodgkin's lymphoma.
  • Infection with certain viruses and bacteria. Certain infections appear to increase the risk of non-Hodgkin's lymphoma. Virus linked to this type of cancer include HIV and Epstein-Barr virus. The bacteria linked to non-Hodgkin's lymphoma include the stomach ulcer bacterium that causes the infection by Helicobacter pylori.
  • Chemicals. Certain chemicals, such as those used to kill insects and weeds, you may increase the risk of non-Hodgkin's lymphoma. More research is needed to find the possible relationship between pesticides and non-Hodgkin lymphoma.
  • Advanced age. Non-Hodgkin lymphoma can occur at any age. But it is more common in people of 60 years or more.

There is no way to prevent non-Hodgkin lymphoma.

Diagnosis

The non-Hodgkin's lymphoma diagnosis often begins with a test that verifies the presence of swollen lymph nodes in the neck, the armpits and the groin. The tests include imaging tests and removing some cells for analysis. The tests used to detect the non-Hodgkin's lymphoma may depend on the cancer's location and its symptoms.

Physical examination

A professional of the health checks for swollen lymph nodes in the neck, the armpits and the groin. The health professional also checked for a swollen spleen or liver.

Blood and urine tests

An analysis of blood and urine can help rule out an infection or other disease.

Imaging tests

Tests to look for lymphoma cells in other parts of the body may include CT, mri, and positron emission tomography, also called PET.

Lymph node biopsy

Your health care professional may suggest a lymph node biopsy to look for cancer cells. A biopsy is a procedure to remove a sample of tissue for testing in a lab. A lymph node biopsy involves removing all or part of a lymph node. In the laboratory, the tests can show if you have a non-Hodgkin's lymphoma and, if so, what type.

Bone marrow tests

Bone marrow aspiration and biopsy are procedures that involve the collection of cells of the bone marrow. The cells are sent for analysis.

In a bone marrow aspiration, a needle is used to remove a sample of fluid. In a bone marrow biopsy, a needle is used to collect a small amount of solid tissue. The samples more often come from the hip bone.

Lumbar Puncture

A lumbar puncture involves removing part of the fluid that surrounds the spinal cord. This procedure is also called a lumbar puncture. A healthcare provider may recommend this test if there is a concern that the lymphoma affects the fluid that surrounds the spinal cord. A lumbar puncture involves putting a small needle into the spinal canal in the lower part of the back to soak up the liquid.

Treatment

The non-Hodgkin's lymphoma to treatment often begins with medication or radiation therapy. Medications that are used for this type of cancer include chemotherapy, immunotherapy, and targeted therapy.

The treatments of your health care team you choose for you depends on your lymphoma. Your health care team considers the types of cells involved, and how quickly the cancer is growing. His team also considers your overall health and what you prefer.

If the lymphoma seems to be growing slowly and not causing symptoms, you may not need treatment right away. Instead, you can have check-ups every few months. The tests help health care professionals see their condition and to see if the cancer is growing.

Chemotherapy

Chemotherapy treats the cancer with strong medications. There are many chemotherapy drugs. The majority of chemotherapy drugs are given through a vein. Some come in the form of a pill.

For many types of non-Hodgkin's lymphoma, chemotherapy is the treatment of first. Sometimes it is combined with targeted therapy.

Immunotherapy

Immunotherapy for cancer is a treatment with a medication that helps the body's immune system destroys the cancer cells. The immune system fights diseases by attacking the germs and other cells that should not be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the cells of the immune system find and kill cancer cells.

People with certain types of non-Hodgkin's lymphoma may have immunotherapy if other treatments have not helped.

Targeted therapy

Targeted therapy for cancer is a treatment that uses drugs that attack specific chemicals in cancer cells. By blocking these chemicals, specific treatments can cause cancer cells to die.

For non-Hodgkin lymphoma, targeted therapy may be used alone. But more often, it is combined with chemotherapy. This mixture can be your first treatment. It may be your second treatment if the lymphoma comes back.

CAR-T cell therapy

Chimeric antigen Receptor T cell therapy, also called CAR-T cell therapy, the trains of the cells of the immune system to fight against non-Hodgkin lymphoma. This treatment begins with the removal of some white blood cells, including T cells, in the blood.

The cells are sent to a lab. In the laboratory, the cells are treated in such a way that they have special receptors. The receptors help the cells to recognize a marker on the surface of lymphoma cells. Then, the cells back in the body. You have to find and destroy the cell non-Hodgkin lymphoma.

CAR-T cell therapy could be an option for certain types of B-cell non-Hodgkin's lymphoma. Normally it is used when other treatments have not worked.

Bone marrow transplantation

A bone marrow transplant, also called a bone marrow stem cell transplantation, involves placing healthy bone marrow stem cells in the body. These cells replace the cells from damage by chemotherapy and other treatments. People with non-Hodgkin's lymphoma can have a bone marrow transplant if other treatments have not helped.

Radiation therapy

Radiation therapy treats cancer with powerful rays of energy. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.

For certain types of non-Hodgkin lymphoma, radiation therapy may be the only treatment needed. This may be true if the lymphoma is in only one or two points and it grows slowly.

People with non-Hodgkin lymphoma may also need radiation therapy after the chemotherapy to kill the lymphoma cells that may remain. The radiation can also relieve symptoms and improve quality of life.

Alternative medicine

There are alternative medicines that have been found to cure non-Hodgkin lymphoma. But alternative medicine may help you cope with a cancer diagnosis and the side effects of cancer treatment. Talk with your health care team about your options, such as:

  • Art therapy.
  • Exercise.
  • Meditation.
  • Music therapy.
  • The relaxation exercises.
  • Spirituality.

Coping and support

A non-Hodgkin's lymphoma diagnosis can be a challenge. The following ideas and resources that can help you to deal with the cancer:

Learn about non-Hodgkin's lymphoma

Learn enough about your cancer to feel good about the decision making about your treatment and care. Talk with your health care team. To search for information in the local library and on the internet. The U.S. National Cancer Institute and the Leukemia and Lymphoma Society are two good sources.

Maintain a strong support system

Maintaining strong relationships to help you deal with non-Hodgkin's lymphoma. Friends and family can give you the help that you may need, such as help to take care of your house if you're in the hospital. And they can give you emotional support.

It can also help to join a support group or talking with other people who have cancer.

Set goals you can reach

Set goals to help you feel in control and give you a sense of purpose. But do not set goals that are not willing to come. For example, you may not be able to work a 40 hours per week. But you can be able to work part-time.

Take time for yourself

Eat well, relax and get enough rest to help with the stress and tiredness of cancer. Also, the plan for times when you need to rest more, or limit what you do.

Stay active

Getting to a diagnosis of cancer does not mean that you have to stop doing the things you enjoy. For the most part, if you feel well enough to do something, do it. It is important to stay active and involved as much as you can.

Preparing for your appointment

Make an appointment with a health care professional if you have any symptoms that worry you. Your health care professional may be sent to a doctor that specializes in diseases that affect the blood cells, called a hematologist.

Here's some information to help you prepare for your appointment.

What you can do

  • Ask about what you need to do before your appointment. When you make the appointment, ask if there is something that you need to do in advance, such as restrict your diet before the test.
  • Write down your symptoms, including those that do not appear to be linked to the reason why you made the appointment, and when they began.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking, including the dosage.
  • Ask a family member or friend to come to help to remember the information that is obtained.
  • Write questions to ask their health professional.

For the non-Hodgkin's lymphoma, some questions are:

  • Do I have non-Hodgkin's lymphoma?
  • What type of non-Hodgkin's lymphoma do I have?
  • How advanced is my cancer?
  • Is my condition growing rapidly or slowly?
  • More evidence is needed?
  • I need treatment?
  • What are my treatment options?
  • What are the possible side effects of each treatment?
  • How will the treatment affect my daily life? Can I keep working?
  • You should see a specialist?
  • Do you have brochures or other printed material I can have? What websites do you suggest?

Be sure to ask all the questions that you have.

What to expect from your doctor

Your health care professional may ask you questions, such as:

  • Do you have symptoms all the time or come and go?
  • How bad are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Have had infections in the past?
  • Have you or your family has been exposed to poisons?
Symptoms and treatment of Non-Hodgkin's lymphoma