Lymphoma

Experts don't know what causes Hodgkin lymphoma. Some things are known to increase the chance that you will get it. These are called risk factors. Risk factors include:

• Having a weak immune system.
• Age. This cancer is most common in people ages 15 to 35 and people age 55 and older.
• A family history of the disease.

Symptoms of Hodgkin include swollen lymph nodes, a fever, weight loss, and night sweats.

Your doctor will ask you about your and your family's medical history and will do a physical exam. You may also get:

• A complete blood count, to check the number of white and red blood cells.
• A chest X-ray.
• A biopsy. The doctor may remove part or all of a lymph node to check for cancer. A biopsy is the only sure way to know if you have the cancer.
• A PET scan, a CT scan, or a PET-CT scan.
• A bone marrow biopsy.

Treatment for Hodgkin lymphoma depends on what type of lymphoma you have, the stage of the cancer, and other things, such as your overall health. Treatment options may include:

• Chemotherapy: This is the main treatment. These medicines kill fast-growing cells, including cancer cells and some normal cells.
• Radiation therapy: This uses high-dose X-rays to destroy cancer cells and shrink tumors.
• Stem cell transplant: This replaces damaged cells with healthy stem cells. They help your bone marrow make healthy blood cells.
• Immunotherapy: This treatment helps your immune system fight cancer. It may be given in several ways.
• Targeted therapy: These medicines attack only cancer cells, not normal cells. They help keep cancer from growing or spreading.

Your doctor will talk with you about your options and then make a treatment plan.

Experts don't know what causes non-Hodgkin lymphoma (NHL).

When a person has non-Hodgkin lymphoma, abnormal rapid cell growth occurs. This abnormal growth may need a "trigger" to start, such as an infection or exposure to something in your environment. There is also a link between NHL and problems with the immune system.

NHL is not contagious and is not caused by injury.

Symptoms of non-Hodgkin lymphoma (NHL) include:

• A painless swelling of the lymph nodes in the neck, underarm, or groin. This is the most common symptom.
• Fever not caused by another health problem.
• Night sweats.
• Feeling very tired.
• Weight loss you can't explain.
• Itchy skin.
• Reddened patches on the skin.
• A cough or shortness of breath.
• Pain in the belly or back.
   

If non-Hodgkin lymphoma (NHL) is suspected, your doctor will ask about your medical history and perform a physical exam. This exam includes checking for enlarged lymph nodes in your neck, underarm, and groin.

Diagnostic tests
A tissue sample (biopsy) is needed to make a diagnosis. A biopsy for non-Hodgkin lymphoma is usually taken from a lymph node, but other tissues may be sampled as well.

A bone marrow aspiration and biopsy is usually done to find out if lymphoma cells are present in the bone marrow.

Other tests
Your doctor may also order other tests, including:

• Blood tests, such as a chemistry screen to measure the levels of several substances in the blood and a CBC (complete blood count) to provide information about the kinds and numbers of cells in the blood.
• A chest X-ray, to provide a picture of the inside of the chest.
• A CT scan or MRI, to provide detailed pictures of the inside of the chest, abdomen, and pelvis.
• A PET scan, to show areas of increased metabolic activity. Metabolic activity is often high in cancer cells.
• Lab tests, such as flow cytometry, that check the types of cells in a biopsy sample. These tests help your doctor find out the type of lymphoma.
• Lumbar puncture (also called a spinal tap), to find out whether lymphoma cells are in the fluid (cerebrospinal fluid, or CSF) surrounding your brain and spinal cord.

Treatment for NHL is based on the type of lymphoma, the stage of the cancer, and other things, such as your overall health. Treatment options may include chemotherapy, immunotherapy, radiation therapy, and targeted therapy.

If the cancer comes back, treatment may also include a stem cell transplant. In some cases, a clinical trial may be a good idea.

For some people who have slow-growing (indolent) NHL, a wait-and-see approach to treatment may be the best option. Your doctor will watch your condition closely. You won’t have treatment unless you're bothered by symptoms.

Your doctor will talk with you about your options and then make a treatment plan.

• Medicines: Medicines may be used to control the growth of cancer cells and to relieve symptoms. Medicines used to treat NHL include:
• Chemotherapy: These medicines kill fast-growing cells, including cancer cells and some normal cells.
• Immunotherapy: This treatment helps your immune system fight cancer. It may be given in several ways. One type is CAR T-cell therapy in which a person's T cells are treated in a lab so they are more able to attack cancer cells.
• Targeted therapy: These medicines attack only cancer cells, not normal cells. They help keep cancer from growing or spreading.

One type of medicine may be used alone. Or it may be combined with another medicine or another type of treatment. For example, immunotherapy may be used with radiation therapy.

• Radiation therapy: This uses high-dose X-rays to destroy cancer cells and shrink tumors. It may be the treatment of choice for NHL that is slow-growing and in a small area (localized).
• Treatment for recurrent cancer: Sometimes NHL comes back after treatment. This is called recurrence or relapse. The treatments listed above are also used for recurrent NHL. Other options include:
• Stem cell transplant: This replaces damaged cells with healthy stem cells. They help your bone marrow make healthy blood cells. The stem cells may come from your own bone or blood or from a donor. A stem cell transplant may be done to restore the bone marrow after high-dose chemotherapy or whole-body radiation.
• Clinical trials: Clinical trials are research studies that test new treatments to find out how well they work. Your medical team can tell you if there’s a clinical trial that might be right for you.