Non-Hodgkin’s lymphoma is a cancer that starts in the lymphatic system. It is not the same as Hodgkin’s lymphoma and is treated differently.
If you are looking for information about Hodgkin’s lymphoma, see our Hodgkin’s lymphoma page
The lymphatic system
The lymphatic system is part of your immune system. It consists of your spleen and bone marrow (amongst other things) and is connected by lots of vessels that are joined together by your lymph glands (also known as lymph nodes).
The lymphatic system helps your body fight against disease and infection. That is why, when you have a virus, you may have noticed that the lymph nodes under your armpits or in your neck or groin become swollen.
Types of non-Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma can be divided into two types: B-cell non-Hodgkin’s lymphoma, which usually occurs in the neck, head and abdomen and T-cell non-Hodgkin’s lymphoma, which usually occurs in the chest.
Non-Hodgkin’s lymphoma can affect people of all ages. T-cell non-Hodgkin’s lymphoma is more common in teenagers and young adults than older people. Non-Hodgkin’s lymphoma is slightly more common in males, accounting for 8% of all cancer diagnoses amongst young men aged 15 to 24
The main symptom of non-Hodgkin’s lymphoma is normally a swollen lymph gland in your neck, chest or under your armpit. This swelling is usually painless, but lasts for some time. If the swelling is in your chest, you may notice that you are having difficulty breathing, or have a cough that doesn’t go away. If the swelling is in your abdomen, you may develop abdominal pain, have trouble going to the toilet or have diarrhoea. Other symptoms include weight loss, fevers and tiredness.
Non-Hodgkin’s lymphoma is usually diagnosed through a biopsy. This involves removing part of the swollen gland, and examining the cells under a microscope.If the biopsy shows that non-Hodgkin’s lymphoma is present in the gland, you will also need scans, x-rays and/or blood tests to help your doctors determine the position and spread of the disease.
Non-Hodgkin’s lymphoma is usually treated with chemotherapy, often for a significant period of time. Your treatment will depend on the size of the affected area and how much the cancer has spread. It’s best to talk to your specialist or one of the team caring for you about your specific treatment plan.
When you are receiving chemotherapy a combination of drugs will be delivered into your bloodstream with the aim of killing the cancer cells. T-cell non-Hodgkin’s lymphoma is usually treated for at least two years, B-cell for less. Chemotherapy may also be injected into the fluid around your spinal cord to stop the lymphoma from spreading there.
High-dose chemotherapy with stem cell support may be used if your cancer does not respond to chemotherapy or if it returns after the initial treatment. For more information, see our high-dose treatment page.
If you are undergoing chemotherapy, you may experience side-effects such as tiredness, sickness, diarrhoea and temporary hair loss. You will also be at greater risk of infections. For more information about how side-effects can be managed, talk to your specialist or nurses, or see the side-effects section of our website.
After your treatment is complete you will still need to be seen regularly at an outpatient clinic. At this clinic, your specialist will be looking for any signs that your cancer has returned (this is known as a relapse) .They will also check that your major organs, such as your heart and lungs, are still functioning correctly and haven’t been affected by your cancer treatment.
Long-term follow up
Once your risk of relapse has reduced, the focus of on-going follow up changes to looking out for potential long term side effects of treatment. The risk of long term side effects depends on the type of cancer you had and the treatment you received. A personalised surveillance plan is usually created that outlines the specific long term follow up and on-going investigations that you require.
Many people are at low risk of future health problems but some will have significant on-going health needs.
Some of the treatments for non-Hodgkin’s lymphoma may affect your fertility (your ability to have children later in life). Where possible, your specialists will use drugs that have less chance of causing infertility, but treating your cancer needs to be their top priority. If you have concerns about the long-term effects of your cancer treatment, talk to your specialist or nursing team.
Updated December 2014, next review planned 2017.