At Great Lakes Cancer Care, we understand a diagnosis of Non-Hodgkin lymphoma can be scary and confusing. We’ve helped patients from across Western New York get through treatment for Non-Hodgkin lymphoma, a cancer of the lymphatic system, which includes:
- Lymph fluid
- Lymph vessels
- Lymph nodes
- Bone marrow
- Adenoids and tonsils
To understand this type of cancer, it's helpful to know that non-Hodgkin lymphomas are also described by the rate and location of disease progression:
- Indolent: Slow-growing, often without symptoms. Indolent lymphomas can be managed, but are generally not curable.
- Aggressive: Fast-growing, often with symptoms (sometimes severe). Aggressive lymphomas can be treated and are generally curable.
- Contiguous: The affected lymph nodes are next to each other
- Noncontiguous: The affected lymph nodes are not next to each other, but are on the same side of the diaphragm
There are several symptoms that often accompany non-Hodgkin’s lymphoma, and early detection and treatment can improve your outcome. Although many of these symptoms can be caused by other, less serious conditions (like an infection), it’s important to discuss them with your doctor. Common symptoms include:
- Swollen lymph nodes in the neck, armpit or groin
- Persistent, recurring fever
- Intense itching (often after a shower or exposure to heat)
- Night sweats
- Unexplained bruising or bleeding
- Persistent, frequent infections
- Weight loss
- Decreased appetite
A risk factor is anything that increases your chances of developing non-Hodgkin’s lymphoma. While some factors cannot be controlled, like your age and family history, there are many that can. Some risk factors include:
- Suppressed immune system, which can result from:
- Chronic infection, like Epstein-Barr virus, HTLV or HIV infection
- Autoimmune diseases (such as celiac disease, rheumatoid arthritis, lupus or Sjorgren syndrome)
- Medications that suppress immune system, like those that prevent organ transplant rejection
- Occupational or environmental exposure to:
- Certain chemical solvents
- Nuclear accidents or explosions
- Family history
Diagnosis often happens when a patient sees their doctor for symptoms like swollen lymph nodes, or swollen nodes are found during a physical exam or chest X-ray. To start, a doctor will first ask about your symptoms, family history and medical history. From there, your doctor will perform a physical exam, paying special attention to your lymph nodes, as well as looking for swelling around the spleen and liver.
If non-Hodgkin lymphoma is suspected, diagnosis and staging are then confirmed by:
- Blood tests
- Lymph node biopsy
- CT scan
- PET/CT scan
- Gallium scan
- Abdominal ultrasound
- Bone scan
- Location-specific testing, such as:
- Lumbar puncture
- Bone marrow
- Fluid tests from lungs and abdominal cavities
- Heart ultrasound
- Pulmonary function testing
Rarely, abdominal surgery may be needed to remove the spleen or biopsy the liver, but the accuracy of today's noninvasive scans minimizes the need.
Some forms of non-Hodgkin’s lymphoma can be cured, and many other cases can be managed to maintain your quality of life. Our collaborative team will work with you to develop an individualized treatment plan for your unique situation, including the stage of your disease, location of affected lymph node(s), your age, your overall health and other factors. The types of treatment you might receive include:
Chemotherapy uses drugs to kill cancer cells. If you receive chemotherapy, you will be seen by a medical oncologist, who will determine how many cycles of chemotherapy you need and what combination of drugs will work best.
How it works
Chemotherapy can be given in many forms, including by pill, injection or catheter. The drugs then travel throughout your body to kill the cancer cells.
Although chemotherapy targets cancer cells, the drugs used can also affect healthy cells. Possible side effects of chemotherapy include:
- Hair loss
- Inflammation and sores in the mouth, throat and esophagus
- Loss of appetite
- Reduced blood cell counts (which can lead to anemia)
- Bone marrow suppression (which can lead to infection)
- Nausea and vomiting
- Increase of infections
- Easy bruising or bleeding
These side effects are usually short-term, and subside after treatment is finished. Your team can help you manage the side effects through medication, lifestyle changes and alternative treatments.
Radiation Therapy Treatment
Radiation therapy is used for most non-Hodgkin lymphomas, including as the first line of treatment for early stage cases and along with chemotherapy for more advanced stages. We are proud to offer the latest radiation treatment techniques, delivering a high dose of radiation to the specific area from outside the body, without harming the surrounding healthy tissues.
How it works
In external beam radiation therapy (the kind of radiation used for non-Hodgkin lymphoma), radiation is produced by a machine outside the body. Then, short bursts of x-rays are directed at the tumor site.
Each individual treatment takes only a few minutes, but is given five days a week for a total of 5-8 weeks (depending on the total dose required).
The side effects of radiation depend on where the treatment is directed. Side effects can include:
- Dry, irritated skin
- Reduced blood cell counts
- Nausea or vomiting
- Shortness of breath
- Chest pain
- Swallowing and eating problems
- Thyroid problems
- Heart and long problems
- Bladder irritation
- Anal/rectal irritation
- Vaginal dryness
- Erectile dysfunction
These side effects are usually short-term and subside after treatment is finished. Your team can help you manage the side effects through medication, lifestyle changes and alternative treatments.
Patients with non-Hodgkin’s lymphoma often receive both chemotherapy and radiation. In cases where the cancer does not respond to these treatments or where cancer is localized to an organ, other options include:
For some patients with non-Hodgkin’s lymphoma, the care team may recommend surgical removal of the spleen, an organ that’s part of the lymphatic system.
Tumor Removal Surgery
For patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, surgery can be performed to remove tumors from the stomach.