Non-hodgkin's Lymphoma

What is non-Hodgkin's lymphoma?

• Non-Hodgkin's lymphoma, also called non-Hodgkin's disease, is a cancer of the lymphatic system. The lymphatic system is made up of lymph vessels, lymph nodes, and glands, such as the spleen and thymus. Lymph vessels are tiny tubes that carry lymph fluid throughout the body. Lymph fluid contains lymphocytes, a type of white blood cell (WBC), that helps to fight infection and disease. Lymph nodes are in your groin, armpit, neck, stomach, behind your knee, and below your collarbone.
  
  
• In non-Hodgkin's lymphoma, lymphocytes grow and divide without control. When many lymphocytes collect in the lymph nodes, they form a tumor. Cells may break away from the tumor. When these cells are carried to other parts of the body by the blood, it is called metastasis. Once cancer cells spread, the cancer is harder to control.

What causes non-Hodgkin's lymphoma?

There is no known cause of non-Hodgkin's lymphoma. The following may put you at higher risk for having this disease:

• Being around chemicals for a long time: Chemicals, such as pesticides, hair dyes, woodworking chemicals, or nitrates in drinking water.
  
  
• Family history: You have a parent, brother or sister, or close family relative with this disease.
  
  
• Infections: Infections caused by bacteria, parasites, or viruses, such as the human immunodeficiency virus (HIV) virus.
  
  
• Radiation: Survivors of atomic bombs and nuclear reactor accidents have an increased risk of having this cancer.
  
  
• Use of certain drugs: These include amphetamines, LSD, and cocaine.
  
  
• Weak immune system: The immune system is the part of your body that fights infection. A weak immune system may be caused by radiation and chemotherapy. People who take medication that weakens their immune system, like transplant patients, may also get non-Hodgkin's lymphoma.

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

Non-Hodgkin's lymphoma may cause many different signs and symptoms, depending on where it is in the body. Swollen and painless lymph nodes in the neck, arm, or groin are the most common symptom. You may also have one or more of the following:

• Breathing problems or a cough.
  
  
• Feeling more tired than usual.
  
  
• Fever.
  
  
• Itchy skin.
  
  
• Pain or swelling in your abdomen and pain in the lower back or in both legs.
  
  
• Sweat a lot, especially at night.
  
  
• Weight loss.

How is non-Hodgkin's lymphoma diagnosed?

You may have one or more of the following tests:

• Biopsy:
  
  
  • Bone marrow biopsy: This is when a sample of bone marrow is removed and sent to a lab for tests. Bone marrow is the soft, spongy tissue inside the bone. The skin over your upper hipbone is first cleaned. Caregivers put numbing medicine into your skin so you will have little pain. A bandage is put on the biopsy area after the tissue sample is taken.
    
    
  • Lymph node biopsy: A lymph node biopsy is a procedure to remove lymph node tissue. Lymph nodes are part of your immune system and help your body fight illness. Caregivers may use a needle to take a sample from a lymph node, or remove a lymph node during surgery. The tissue will be sent to a lab to be tested for infection or disease.
  
  
• Blood tests: Different tests may be done to help caregivers diagnose and treat non-Hodgkin's lymphoma.
  
  
• Imaging tests: The following tests may be used to take pictures of the different parts of your body:
  
  
  • Computerized tomography scan: This is also called a CT or CAT scan. An x-ray machine uses a computer to take pictures of a specific part of your body. It may be used to look at your brain, bones, muscles, blood vessels, and other organs. You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
    
    
  • Gallium scan: This test uses a radioactive material called gallium. After an IV shot of gallium, pictures of your whole body will be taken using a special camera. The pictures will tell caregivers if there is an infection or inflammation (swelling).
    
    
  • Positron emission tomography scan: This test is also called a PET scan. The test finds tumors by following the way different body cells use sugar.
    
    
  • X-rays of chest, abdomen, or lymph nodes: These are pictures of the organs, bones, or lymph nodes in your chest and abdomen (stomach). Caregivers may use the x-rays to look for tumors, blockages, signs of infection, or other problems.
  
  
• Lumbar puncture: This procedure may also be called a spinal tap. During a lumbar puncture, you will need to lie very still. Caregivers may give you medicine to make you lose feeling in a small area of your back. Caregivers will clean this area of your back. A needle will be put in, and fluid removed from around your spinal cord. The fluid will be sent to a lab for tests. The tests check for infection, bleeding around your brain and spinal cord, or other problems. Sometimes medicine may be put into your back to treat your illness.

How is non-Hodgkin's lymphoma treated?

You may have one or more of the following treatments:

• Chemotherapy:
  
  
  • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.
    
    
  • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.
  
  
• Radiation: Radiation shrinks tumors and kills cancer cells with x-rays or gamma rays. Radiation may be given after surgery to kill cancer cells that were not removed. It may also be given alone or with chemotherapy to treat cancer.
  
  
• Surgery:
  
  
  • Laparotomy: This is surgery to open your abdomen. Caregivers may do a laparotomy to look closely at organs and lymph nodes inside your abdomen. Tissue samples may be taken and sent to a lab for tests.
    
    
  
  
• Transplant:
  
  
  • Bone marrow transplant (BMT): This is when your diseased bone marrow is replaced with healthy marrow. You are usually given bone marrow from someone else (a donor). Sometimes your own marrow may be used if it is collected when your cancer is in remission (not active). The bone marrow transplant is given to you in an IV while you are in the hospital. A BMT may cure your illness, but it can cause other very serious health problems. You may be in the hospital for a month after your BMT.
    
    
  • Peripheral stem cell transplant: During a peripheral stem cell transplant, blood cells called stem cells are put back into your body. To do this, blood is first taken from your body. The blood is then put through a process called apheresis. During apheresis, the stem cells are taken out of the blood. The stem cells are then put back into your body and they usually return to the bone marrow. In the bone marrow, stem cells can grow and become white blood cells to help fight infection.

Where can I find support and more information?

Non-Hodgkin's lymphoma is a life-changing disease. Accepting that you have non-Hodgkin's lymphoma is hard. You and those close to you may feel scared, depressed, angry, or sad. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group. This is a group of people who also have non-Hodgkin's lymphoma. Call or write one of the following organizations for more information:

• American Cancer Society
  250 Williams Street
  Atlanta , GA 30303
  Phone: 1- 800 - 227-2345
  Web Address: http://www.cancer.org
  

• National Cancer Institute
  6116 Executive Boulevard, Suite 300
  Bethesda , MD 20892-8322
  Phone: 1- 800 - 422-6237
  Web Address: http://www.cancer.gov
  

• The Leukemia & Lymphoma Society Inc.
  1311 Mamaroneck Avenue
  White Plains , NY 10605
  Phone: 1- 914 - 949-5213
  Phone: 1- 800 - 955-4572
  Web Address: http://www.leukemia-lymphoma.org
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Non-hodgkin's Lymphoma