Non-Hodgkin lymphoma

Non-Hodgkin lymphoma (NHL) is a cancer that begins in the cells of the immune system. The lymphatic system is part of the immune system and is made up of lymph vessels, lymph and lymph nodes, among other things, and is found in very many parts of the body.

Overview of NHL

The lymphatic system is part of the immune system that includes the following: 1  

  • Lymph vessels: The lymphatic system has a network of lymph vessels that branch into all the tissues of the body
  • Lymph: The lymph vessels carry clear fluid called lymph which contain white blood cells, especially lymphocytes such as B cells and T cells.
  • Lymph nodes: Lymph vessels are connected to small, round masses of tissue called lymph nodes found in the neck, underarms, chest, abdomen, and groin. Lymph nodes store white blood cells and trap and remove bacteria or other harmful substances that may be in the lymph.

Other parts of the lymphatic system include the tonsils, thymus, and spleen. Lymphatic tissue is also found in other parts of the body including the skin, stomach, and small intestine.1

Non-Hodgkin lymphoma begins when a lymphocyte called a B cell (a type of white blood cell that develops from stem cells in the bone marrow that produces antibodies) becomes abnormal. The abnormal cell divides to make copies of itself, and the new cells divide further, making more abnormal cells. This buildup of extra cells results in a tumor.1

Symptoms

NHL can cause many different signs and symptoms, depending on where it is in the body. Sometimes it doesn't cause any symptoms until it has grown quite large.2

NHL can have specific or general symptoms. General symptoms can include: 2

  • Weight loss with no known reason
  • Fever
  • Heavy night sweats

Other symptoms can be caused by low blood counts. Blood counts can become low when lymphoma spreads to the bone marrow and crowds out the normal, healthy cells that make new blood cells. This can lead to problems like: 2

  • Severe or frequent infections (from low white blood cell counts)
  • Easy bruising or bleeding (from low blood platelet counts)
  • Fatigue (from low red blood cell counts or anemia)

As NHL can be in many parts of the body, there can be more specific symptoms. Some examples are:

Swollen lymph nodes: If the cancer involves lymph nodes close to the surface of the body (on the sides of the neck, in the groin, in the underarm areas, or above the collar bone), the patient, a family member, or the doctor will most likely notice swelling that appears as a lump under the skin. Although enlarged lymph nodes are a common symptom of lymphoma, they are much more often caused by infections.2

Lymphoma in the abdomen: Lymphomas here may cause the abdomen to become tender and swollen. This may be because of swollen lymph nodes, but it can also be caused by large amounts of fluid.  It can also cause the spleen to become enlarged and press on the stomach which can cause a person to feel full after eating only a small amount of food.2

Statistics

NHL is a very common cancer. According to The Canadian Cancer Society, about 7,800 people (4,300  males and 3,500 females) will be diagnosed with NHL in 2012.3

An indolent lymphoma is a type of lymphoma that has a good prognosis and longer median survival time, but is not usually curable. This means that there is a high chance of recurrence.

  • About 40-50% of NHL cases are indolent.

The number of people getting NHL has been fairly steady for over a decade.Although some types of NHL are among the more common childhood cancers, more than 95% of cases occur in adults; the types of NHL seen in children are often very different from those seen in adults.  The risk of developing NHL increases throughout life.4

Seeking diagnosis and care

If NHL is slow growing, treatment may not be needed, but this is for the doctor to decide. If no treatment is needed at this stage, the patient will be closely watched and monitored.5

If NHL is aggressive there treatment options such as chemotherapy, radiation therapy. stem cell transplant and different types of medications.5  

A diagnosis of cancer can be overwhelming and it takes time to learn how to cope with it. It’s usually helpful for the patient to learn as much possible about the cancer, to build a strong support system of friends and family, to stay active and to relax and eat well.6

Sources

1. National cancer Institute. What you need to know about non-Hodgkin lymphoma.  http://cancer.gov/cancertopics/wyntk/non-hodgkin-lymphoma/page2. Accessed 29/05/2012.

2. American Cancer Society.  Non-Hodgkin lymphoma overview: early detection, diagnosis, and staging topics.  www.cancer.org/Cancer/Non-HodgkinLymphoma/OverviewGuide/non-hodgkin-lymphoma-overview-diagnosed. Accessed 29/05/2012.

3. Canadian Cancer Society’s Steering Committee on Cancer Statistics. Canadian Cancer Statistics 2012. Toronto, ON: Canadian Cancer Society; 2012.

4. American Cancer Society. Non-Hodgkin lymphoma: what are the key statistics about non-Hodgkin lymphoma? www.cancer.org/Cancer/Non-HodgkinLymphoma/DetailedGuide/non-hodgkin-lymphoma-key-statistics. Accessed 29/05/2012.

5. Mayo Clinic. Non-Hodgkin’s lymphoma: treatment and drugs. www.mayoclinic.com/health/non-hodgkins-lymphoma/DS00350/DSECTION=treatments-and-drugs. Accessed 29/05/2012.

6. Mayo Clinic. Non-Hodgkin’s lymphoma: coping and support. www.mayoclinic.com/health/non-hodgkins-lymphoma/DS00350/DSECTION=coping-and-support. Accessed 29/05/2012.

Additional resources:

Leukemia & Lymphoma Society of Canada® http://www.llscanada.org/

Lymphoma Foundation Canada http://www.lymphoma.ca

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