Non-Hodgkin's Lymphoma

Different types of treatment are used for different types of non-Hodgkin's lymphoma (NHL). Treatment of NHL depends on:

• The stage of the disease.
• The type of lymphoma. The kind of treatment you have will depend on whether you have B-cell or T-cell lymphoma and whether it is fast-growing or slow-growing.
• The size of the tumor, where the lymphoma is located, and what organs are involved.
• Your general health.
• Whether you have had lymphoma in the past (recurrent disease). Although lymphoma that has come back (recurred) may be controlled, it often is not curable.

Initial treatment

Treatment recommendations that may be appropriate when you are first diagnosed with non-Hodgkin's lymphoma include:

• Watchful waiting (surveillance), a period of time after the diagnosis of some types of NHL when you are not receiving treatment but are still being watched closely by your doctor. Watchful waiting gives as good or better results than more aggressive treatment for some types of NHL, such as advanced low-grade indolent lymphoma.
• Radiation therapy, which is often the treatment of choice for early-stage, indolent NHL. Radiation therapy may be used alone or combined with other treatment options for more advanced NHL.
• Chemotherapy, which kills cancer cells or stops them from dividing. The way chemotherapy is given depends on the type and stage of cancer. This may include taking it by mouth or having it injected into a vein or muscle. Or chemotherapy may be placed directly into the spine, an organ, or into the belly.
• Monoclonal antibody therapy. This is a cancer treatment that uses special antibodies that attach to cancer cells and destroy them without harming normal cells. Examples include rituximab (Rituxan) and alemtuzumab (Campath).

If you have recently been diagnosed with non-Hodgkin's lymphoma, you may experience a lot of emotions. Most people experience some denial, anger, and grief. Other people may have fewer emotions. There is no "normal" or "right" way to react to a diagnosis of lymphoma. There are many steps you can take to help with your emotional reactions. You may find that talking with family and friends helps you with your emotions. Some people may find that spending time alone is what they need.

If your reaction is interfering with your ability to make decisions about your health, it is important to talk with your doctor. Your cancer treatment center may offer psychological or financial services. You may also contact your local chapter of the American Cancer Society to help you find a support group. Talking with other people who may have had similar feelings can be very helpful.

You may use home treatment to help you manage the side effects that may happen with NHL or its treatment.

Ongoing treatment

Schedule regular follow-up examinations with your doctor after you have been treated for non-Hodgkin's lymphoma. Follow-up care is an important part of the overall treatment plan. During regular follow-up care:

• You will probably be seen about every 3 months for the first year and then less often the next year or two. After that, you will only need a checkup each year if you have had no relapse.
• Changes in health can be discussed with your doctor. To monitor your health, your doctor may obtain lab tests, such as a chemistry screen and CBC, and imaging tests, such as a chest X-ray or CT scan.