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Non-Hodgkin's lymphoma

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read

Non-Hodgkin's lymphoma (NHL) is a type of blood cancer that develops from the lymphatic system. This system is a network of vessels throughout your body that work as part of your immune system, carrying fluid containing infection-fighting white blood cells, called lymphocytes, to where they detect a threat.

In NHL, these lymphocytes become dysfunctional and multiply out of control. They can then collect in different areas of the lymphatic system known as the lymph glands, and this can cause swelling you can see and feel in certain areas of the body. The consequence is that the lymphatic system becomes less able to fight infections.

NHL can occur at any age, but your chance of developing the condition increases as you get older, with over half of cases diagnosed in people over 65. It's fairly common in the US, within the top 10 most common cancers, and accounts for 4% of all cancers.

What causes NHL?

In most cases, we don't know what causes NHL. There are certain factors that can put you at higher risk, such as having a weakened immune system, either from a condition such as cancer, or from medication such as chemotherapy. It can run in families. Glandular fever, a common throat infection caused by the Epstein-Barr virus, may increase your risk.

What symptoms should I look out for?

You may notice swollen lymph glands – these sit in your neck, armpits, and groin area. These swell when you have an infection, as part of lymphocyte production in defense, but healthy lymph nodes responding to infection will feel rather tender to the touch, you may have other signs of infection, and they will shrink again after two weeks.

In contrast, lymph nodes that are swollen due to NHL are usually painless and persistent.

Other symptoms are more general for inflammatory processes, cancer, or infection, such as night sweats, unintentional weight loss, poor appetite, persistent fevers, and itching all over the body.

Abnormal cells in the bone marrow lead to fatigue, excessive bleeding, and an increased risk of infections.

What will my doctor do?

You should book an appointment urgently with your doctor if you notice any of these general signs or if you have one or more lymph nodes that are swollen for more than a couple of weeks, especially if you weren't unwell when it started.

Your doctor will ask detailed questions about your symptoms, medical history, and family history. They will examine your lymph glands looking for enlargement of these glands at particular points in your body. They will order blood tests. If there are any concerns about blood cancer, they will refer you urgently to specialists called hematologists who will do a biopsy of one of your swollen glands to see if there are abnormal cells in it. If this confirms NHL then further tests are done including ones such as a CT or MRI scan, blood tests and a bone marrow biopsy. These are done to ‘stage’ the NHL and see if it has spread to other parts of the body..

How is NHL treated?

Treatment depends on the type of NHL, how much it has spread, and your overall fitness and health. Chemotherapy is one option, where medications are designed to kill cancerous cells. Radiotherapy uses high-energy radiation to damage cancerous cells and stop them from growing. Targeted therapy is designed to seek and destroy vulnerable cancer cells. A combination of two or even three of these may be appropriate - treatment will be tailormade to each individual.

NHL can be classified by how quickly it grows, and this guides treatment. High-grade NHL is where the cancer grows quickly and aggressively. Treatment will need to be initiated right away, but it's usually more effective and curable than low-grade NHL. This is where the cancer grows slowly, and symptoms may not present for some time. This one is harder to cure but may not require treatment right away.

With any cancer diagnosis, one of the first questions people ask is will I survive it? The chance of survival with NHL is good, depending on how early the cancer is caught and treatment is started.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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