If you've recently been diagnosed with one of the blood cancers (leukemia or lymphoma), you and your family might be overwhelmed with questions and concerns. Your first decision is where to get treatment.
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Non-Hodgkin's lymphoma (NHL) is cancer of the lymphatic system, which is part of the immune system. The lymphatic system is found throughout the body. When you have this disease, cells in the lymphatic system either grow without control or do not die as cells normally do.
There are many types of NHL. Sometimes they are grouped as:
Non-Hodgkin's lymphoma is different from Hodgkin's lymphoma. NHL can start almost anywhere in the body. It may start in a single lymph node, a group of lymph nodes, or an organ such as the spleen. NHL can spread to almost any part of the body, including the liver and bone marrow.
Treatment can cure some people and may allow others to live for years. How long you live depends on the type of NHL you have and how early it’s diagnosed.
The cause of non-Hodgkin's lymphoma (NHL) is unknown. The incidence of NHL has continued to increase over the years. When a person has non-Hodgkin's 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.
Symptoms of non-Hodgkin's lymphoma (NHL) depend on the area of the body affected by the disease. The most common symptom is a painless swelling of the lymph nodes in the neck, underarm or groin. Other symptoms may include:
If non-Hodgkin's 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.
A tissue sample (biopsy) is needed to make a diagnosis. A biopsy for non-Hodgkin's 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.
Different types of treatment are used depending on the stage of the disease, the type of non-Hodgkin's lymphoma, the size of the tumor and other factors.
Treatment recommendations for non-Hodgkin's lymphoma include:
You may use home treatment to help you manage the side effects that may happen with NHL or its treatment.
Hodgkin's lymphoma is cancer of the lymph system, which is the network that carries lymph fluid, nutrients and waste material between the body tissues and the bloodstream.
Along this network are lymph nodes located throughout your body in your neck, underarms and groin, behind your knees and in your chest, abdomen and pelvis. The nodes filter lymph and store cells called lymphocytes that mature into cells of the immune system to defend against infections caused by bacteria, viruses and parasites.
Lymphoma is caused when something goes wrong inside the lymphocytes so they don’t mature to completion and don’t die off like they are supposed to but instead collect in the lymph nodes.
The symptoms of Hodgkin’s lymphoma can be caused by other conditions so your should see a doctor if you have symptoms that concern you, such as:
Compared to non-Hodgkin’s lymphoma, lymph-node symptoms of Hodgkin’s lymphoma usually take longer to occur. For instance, a person may have some swelling for as long as a year before diagnosis.
Hodgkin's lymphoma affects men more often than women. The cause of Hodgkin's lymphoma is not known, although the following are risk factors associated with the disease:
Your doctor will do a physical exam first to look for signs of lymphoma. Your doctor will probably perform a tissue sample (biopsy) next to confirm the diagnosis. A biopsy for Hodgkin's lymphoma is usually taken from a lymph node, but may also be taken from bone marrow or the fluid around the lungs (pleural fluid) or in the membrane around the abdominal organs (peritoneal fluid).
Your doctor may also want you to have imaging studies, such as a chest X-ray, magnetic resonance imaging (MRI), computed tomography (CT) scan or positron emission tomography (PET) scan, to see pictures of the inside of your body. This allows the doctor to look for enlarged lymph nodes, tumors or areas of cancer activity.
Doctors may do further tests to detect whether the cancer has spread around the lymph system or to other areas. This helps your doctor determine the stage of your cancer, which will be important when it’s time to make decisions about your treatment.
Treatment for Hodgkin's lymphoma depends on the stage of the lymphoma. The most common treatments are radiation or chemotherapy.
Radiation therapy is the use of high-dose X-rays to treat cancer cells and may be used alone or in combination with other treatment options, such as chemotherapy. For lymphoma, radiation therapy may be given from a machine outside the body that directs radiation to the cancer (external radiation). Or it may be given inside the body (internal radiation), with radiation that is sealed inside of needles, seeds, wires or catheters.
Hodgkin’s lymphoma can also be treated with anti-cancer drugs, called chemotherapy. These medicines are usually given intravenously (by IV), though some forms may be taken by mouth. Chemotherapy can help kill cancer cells that are in the lymph system as well as those that may have spread to other areas. This type of treatment is usually given in cycles, with several days in between each dose.
People whose disease is not cured with initial treatment and who get recurrent lymphoma may have a bone marrow transplant in combination with chemotherapy, biologic therapies (used to restore or improve the immune system’s ability to fight disease) or other new treatments being studied.
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