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Types of Cancer - Non-Hodgkin's Lymphoma

Non-Hodgkin's lymphoma is cancer that starts in lymphoid tissue. Other types of cancer can start in other organs and then spread to lymphoid tissue. But these cancers are not lymphomas. Lymphomas start in the lymphoid tissue and can then spread to other organs.

Types of Cancer

What is Non-Hodgkins Lymphoma?

The lymphatic system is part of the body's immune system, its defense against disease and infection. The lymphatic system is composed of a network of thin lymph vessels and nodes that run like blood vessels throughout the body. Lymph vessels carry lymph, a watery, colorless fluid that contains infection-fighting white blood cells called lymphocytes. When lymphocytes become diseased and replicate at an abnormal, uncontrolled rate, lymphoma (lymphatic cancer) results.

There are two types of lymphoma: Hodgkin's disease, and non-Hodgkin's lymphoma. Hodgkin's disease is a rare lymphoma and accounts for less than 1% of all cancer cases in the United States; all other lymphatic cancers are classified as non-Hodgkin's lymphoma. Hodgkin's disease is discussed elsewhere on this web site.

Types and Stages of Non-Hodgkin's Lymphoma

Doctors use a variety of disease characteristics such as cell appearance, aggressiveness, and rate of growth to classify non-Hodgkin's lymphoma. Two general categories of non-Hodgkin's lymphoma are aggressive lymphomas and indolent lymphomas. Aggressive lymphomas, also called intermediate and high-grade lymphomas, tend to grow and spread quickly and cause severe symptoms. Indolent lymphomas, also known as low-grade lymphomas, tend to grow quite slowly and cause fewer symptoms.

Once non-Hodgkin's lymphoma has been diagnosed, the doctor performs tests to determine the stage, or extent, of the disease. Some important factors in staging include the number and location of affected lymph nodes, the position of the diseased lymph nodes with respect to the diaphragm, and whether or not the disease has spread beyond the lymph nodes to the bone marrow, spleen, or other non-lymphatic organs like the liver. The further from its source the disease has spread, the more advanced and serious its stage.

Treatment

Treatment for non-Hodgkin's lymphoma is tailored to every patient, and depends upon the stage of the disease, the type of cells involved, whether they are indolent or aggressive, and the age and general health of the patient. Non-Hodgkin's lymphoma is usually treated with chemotherapy, radiation therapy, or a combination of both. In some cases, bone marrow transplantation, biological therapies, or surgery may be options. For indolent lymphomas, the doctor may take an approach called "watchful waiting" and delay treatment until the disease causes symptoms.

Many patients and their families want to learn all they can about non-Hodgkin's lymphoma and the treatment choices so they can take an active part in decisions about medical care. The doctor is the best person to answer these questions. When discussing treatment, the patient may want to talk with the doctor about research studies of new treatment methods. Such studies, called clinical trials, are designed to improve cancer treatment. More information about clinical trials is in the Clinical Trials section.

Researchers are finding better ways to treat non-Hodgkin's lymphoma, and the chances of recovery keep improving. Still, it is natural for patients and their families to be concerned about the future. There are many resources available both on and off the web for patients and their families. Links to some good web sites can be found on our web resources page, or check out our recommended reading list for patients and their families.