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NON-HODGKIN LYMPHOMA

(DIFFUSE NON-HODGKIN LYMPHOMA OF EXTRANODAL SITE)
Non-Hodgkin Lymphoma

WHAT YOU NEED TO KNOW:

What is non-Hodgkin lymphoma? Non-Hodgkin lymphoma, or non-Hodgkin disease, is a cancer of the lymphatic system. The lymphatic system contains lymph vessels, lymph nodes, and glands, such as the spleen and thymus. Lymph vessels carry lymph fluid throughout the body. Lymph fluid contains lymphocytes (white blood cells) that help fight infection and disease. Non-Hodgkin lymphoma causes lymphocytes to grow and divide without control and to form tumors. Non-Hodgkin lymphoma can develop in any lymph tissue in the body. Common places are lymph nodes in the neck, underarm, and chest. Cancer cells can travel from lymph node to lymph node and spread through the body.

What causes non-Hodgkin lymphoma? There is no known cause of non-Hodgkin lymphoma. The following may increase your risk:

  • Long-term exposure to chemicals, such as pesticides, hair dyes, woodworking chemicals, or nitrates in drinking water

  • A family history of non-Hodgkin lymphoma

  • Certain drugs, such as amphetamines, LSD, or cocaine, or smoking cigarettes

  • Exposure to high amounts of radiation

  • A weakened immune system

What are the signs and symptoms of non-Hodgkin lymphoma?

  • Swollen lymph nodes in the neck, arm, or groin



  • Trouble breathing, chest pain, or a cough

  • Feeling more tired than usual

  • Fever, itchy skin, or night sweats

  • Pain or swelling in your abdomen and pain in the lower back or in both legs

  • Weight loss you cannot explain

How is non-Hodgkin lymphoma diagnosed? Your healthcare provider will ask about your symptoms and when they began. Tell him if you have a family history of non-Hodgkin lymphoma or other risk factors. Your healthcare provider will look for symptoms of a problem with an organ to help him diagnose non-Hodgkin lymphoma. For example, trouble breathing may mean your lung is affected. You may need any of the following to help diagnose non-Hodgkin lymphoma or find if it is early or later stage:

  • Blood tests may show abnormal white blood cells or signs of anemia (not enough red blood cells). The tests may also be used to measure the amount of inflammation in your blood. Blood tests can also be used to check your liver and kidney function, or see if the cancer has spread to bone.

  • A biopsy is a procedure to remove a sample of bone marrow or lymph node to be tested. Bone marrow is tissue inside the bone. Your healthcare provider may test a bone marrow sample to see if the cancer has spread to bone. He may use a needle to take a sample from a lymph node, or remove a lymph node during surgery.

  • X-ray, CT, MRI, or PET scan pictures may be taken of your chest, abdomen, and pelvis. The pictures may show where the cancer is located. Your healthcare provider may use the x-rays to look for tumors, blockages, signs of infection, or other problems. You may be given contrast liquid to help the cancer show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is non-Hodgkin lymphoma treated? Some types of non-Hodgkin lymphoma grow and spread slowly and are called indolent. Others grow and spread quickly and are called aggressive. Treatment depends on the type and how far it has spread in your body.

  • Chemotherapy is medicine used to treat cancer by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that contain cancer.

  • Radiation therapy uses x-rays or gamma rays to treat cancer. Radiation kills cancer cells and may stop the cancer from spreading. It may be given alone or with chemotherapy to treat cancer.

  • A bone marrow transplant is a procedure to replace your diseased bone marrow with healthy marrow. You are usually given bone marrow from a donor. Sometimes your own marrow may be used if it is collected when your cancer is in remission (not active). The bone marrow transplant is given to you in an IV while you are in the hospital.

What can I do to care for myself?

  • Rest as needed. Return to activities slowly, and do more as you feel stronger.

  • Eat healthy foods. Eat a variety of healthy foods to get the protein, carbohydrates, and other nutrients your body needs. You may need to change the foods you eat depending on your treatments and side effects. You may also need to eat more calories than usual. Work with a dietitian to plan the best meals and snacks for you. Ask if you should take vitamins.

  • Do not smoke. Talk to your healthcare provider if you need help quitting. E-cigarettes or smokeless tobacco still contain nicotine. Ask your healthcare provider for information before you use these products.

  • Avoid people who have a cold or the flu. Also try to stay away from large groups of people to decrease your risk.

When should I seek immediate care?

  • You have chest pain, your heart pounds or races, or you have trouble breathing.

  • You are too dizzy to stand, or you have trouble keeping your balance.

  • You have a seizure.

  • Your legs swell.

  • You cannot think clearly, or you feel confused.

  • You feel weak or numb on one side of your body.

When should I contact my healthcare provider?

  • You have a fever.

  • You have back pain and weakness in your legs.

  • You are vomiting and cannot keep any food or liquids down.

  • You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.