What is non-Hodgkin’s lymphoma?

Non-Hodgkin’s lymphoma, also called non-Hodgkin lymphoma, is cancer that originates in your lymphatic system, the disease-fighting network spread throughout your body. In non-Hodgkin’s lymphoma, tumours develop from lymphocytes (a type of white blood cell).  Non-Hodgkin’s lymphoma occurs when your body produces too many abnormal lymphocytes.

Non-Hodgkin’s lymphoma is more common than the other general type of lymphoma (Hodgkin Lymphoma). Many different subtypes of non-Hodgkin’s lymphoma exist. The most common non-Hodgkin’s lymphoma subtypes include diffuse large B-cell lymphoma and follicular lymphoma.

Non-Hodgkin’s lymphoma can begin in the:

  • B cells: B cells fight infection by producing antibodies that neutralize foreign invaders. Most non-Hodgkin’s lymphoma arises from B cells.
  • T cells: T cells are involved in killing foreign invaders directly. Non-Hodgkin’s lymphoma occurs less often in T cells.

Whether your non-Hodgkin’s lymphoma arises from your B cells or T cells helps to determine your treatment options.

What are the risk factors for non-Hodgkin’s lymphoma?

A risk factor is anything that changes your chance of getting a disease like cancer.  But risk factors don’t tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. Many people who get cancer may not have had any known risk factors.

Researchers have found several factors that may affect a person’s chance of getting non-Hodgkin’s lymphoma.

  • Age: Getting older is a strong risk factor for lymphoma overall
  • Gender: Overall, the risk of non-Hodgkin lymphoma is higher in men than in women, but there are certain types of non-Hodgkin lymphoma that are more common in women. The reasons for this are not known.
  • Certain chemicals: Certain chemicals, such as those used to kill insects and weeds, may increase your risk of developing non-Hodgkin’s lymphoma.
  • Immune system deficiency: People with weakened immune systems have an increased risk for non-Hodgkin lymphoma. For example, HIV can weaken the immune system, and thus, people infected with HIV are at increased risk of non-Hodgkin lymphoma.
  • Certain infections: Certain viral and bacterial infections appear to increase the risk of non-Hodgkin’s lymphoma. Viruses linked to increased non-Hodgkin’s lymphoma risk include HIV and Epstein-Barr virus. Bacteria linked to an increased risk of non-Hodgkin’s lymphoma include the ulcer-causing Helicobacter pylori.
  • Body weight and diet: Being overweight or obese may increase your risk of non-Hodgkin lymphoma. A diet high in fat and meats may increase your risk.

What are the signs and symptoms of non-Hodgkin’s lymphoma?

Non-Hodgkin lymphoma may cause many different signs and symptoms, depending on where it is in the body. In some cases it may not cause any symptoms until it grows quite large. Common symptoms include:

  • Enlarged lymph nodes in your neck, armpits, or groin
  • Swollen abdomen (belly) or abdominal pain
  • Feeling full after only a small amount of food
  • Chest pain or pressure
  • Shortness of breath or cough
  • Fever and night sweats
  • Weight loss and fatigue

How is non-Hodgkin’s lymphoma diagnosed?

If the symptoms suggest you might have non-Hodgkin lymphoma, your doctor will want to get a thorough medical history, including information about your symptoms, possible risk factors, family history, and other medical conditions. Next, the doctor will examine you, paying special attention to the lymph nodes and other areas of the body that might be involved, including the spleen and liver. Because infections are the most common cause of enlarged lymph nodes, the doctor will look for an infection in the part of the body near the swollen lymph nodes. If the doctor suspects that non-Hodgkin lymphoma might be causing the symptoms a biopsy of the area will be recommended.

Once non-Hodgkin lymphoma is diagnosed, tests are done to determine the stage (extent of spread) of the disease. The treatment and prognosis (outlook) for a patient with non-Hodgkin’s lymphoma depend on both the exact type and the stage of the lymphoma. Tests used to gather information for staging include:

  • Physical exam
  • Biopsies of enlarged lymph nodes or other abnormal areas
  • Blood and urine tests
  • Imaging tests, such as CT scans

What are my treatment options?

Your treatment options are determined based on the type and stage of your lymphoma, your age, and your overall health.  If your non-Hodgkin’s lymphoma is aggressive or causes signs and symptoms, your doctor may recommend treatment. Options may include:

  • Chemotherapy. Chemotherapy is drug treatment that kills cancer cells. Depending on the type and the stage of the lymphoma, chemotherapy may be used alone or combined with radiation therapy. Doctors give chemo in cycles, in which a period of treatment is followed by a rest period to allow the body time to recover. Each chemo cycle generally lasts for several weeks. Many chemo drugs are useful in treating lymphoma patients. Often, several drugs are combined. The number of drugs, their doses, and the length of treatment depend on the type and stage of the lymphoma, in combination with other chemotherapy drugs or combined with other treatments.
  • Radiation therapy: Radiation therapy uses high-powered energy beams to kill cancerous cells and shrink tumours. Radiation might be used as the main treatment for some types of lymphoma if they are found early, because these tumours respond very well to radiation. For more advanced lymphomas and for some lymphomas that are more aggressive, radiation is sometimes used along with chemotherapy.

” Courtesy of the Aga Khan Hospital”