Lymphoma - diagnosis and treatment (2023)


Frequently asked questions about lymphoma

Hematologist Stephen Ansell, MD, answers the most frequently asked questions about lymphoma.

Well, often we don't really know. We know exactly what happens in cells. We can see that the cells have undergone genetic changes. If this is the case, they may grow faster than they should and may get stuck instead of dying as expected. This causes them to slowly accumulate over time. But what exactly causes this genetic change, we don't always know.

It is not a disease that runs in families, although families may be more susceptible. However, we believe that there are certain predisposition genes that can increase the risk of developing lymphoma. However, this requires something else to happen, usually exposure to a toxin, a virus, or something similar.

Well, I think it's important to realize what the goal of treatment is. The advantage of low-grade lymphomas is that they can take a long time to develop symptoms and even more so before they become dangerous to the patient's health. However, we do not have treatments that can cure cancer instantly. So we want to weigh the potential risks and side effects of the treatment against the risks and side effects of the cancer. So if you have very low grade cancer that grows very slowly and you have no symptoms, we will delay treatment and only start it when you really need it.

Well, it's important to realize that chemotherapy can have two components. Chemotherapy or anti-cancer chemotherapy drugs, immunotherapy, or antibody therapy that targets proteins outside of cancer or lymphoma cells. The goal of chemotherapy is to kill fast-growing cells, which is good because these cells often grow very quickly in lymphoma. However, the challenge lies in healthy cells, which can also grow quickly. As I mentioned earlier, immunotherapy binds to or attacks proteins outside of cells. But some lymphoma cells have the same protein as some normal cells. This can cause these cells to become exhausted and your immune system to become weaker, which is one of the possible side effects of the treatment.

Well I really hope it's true. Unfortunately, that's not entirely true. There are no treatment or training programs that directly target or monitor lymphoma cells. In general, however, a healthy, balanced diet and a good exercise program will improve your overall health, improve the function of your immune system, and allow you to better tolerate chemotherapy and fight cancer more effectively. The good news is that many studies have shown that healthy patients who are in good health actually do better when treated for lymphoma. Therefore, staying healthy through healthy eating and regular exercise is a powerful motivator.

Get as much information as possible. Collaborate with your doctor, nurse, personal assistant, and other members of your team and ask questions. The goal for the future is to achieve the best possible results. Therefore, the exchange of information between you and your team is crucial for your results and hopefully the best possible results.

bone marrow examination

Lymphoma - diagnosis and treatment (1)

bone marrow examination

During a bone marrow biopsy, a doctor uses a thin needle to remove a small amount of bone marrow fluid from a spot in the back of your hip (pelvis). Bone marrow biopsy is usually performed at the same time. In this second procedure, a small piece of bone tissue and embedded bone marrow are removed.

Tests and procedures used to diagnose lymphoma include:

  • physical examination.Your doctor will check for swollen lymph nodes, including those in the neck, armpits, and groin, and an enlarged spleen or liver.
  • Lymph nodes are removed for examination.Your doctor may recommend a lymph node biopsy, in which all or part of a lymph node is removed for laboratory testing. Advanced tests can determine whether lymphoma cells are present and what cell types are involved.
  • blood test.A blood test to determine the number of cells in a blood sample can give your doctor a clue to your diagnosis.
  • A bone marrow sample is taken for testing.Bone marrow aspiration and biopsy procedures involve inserting a needle into your hip bone to obtain a sample of bone marrow. The sample is analyzed for lymphoma cells.
  • Testillustration.Your doctor may recommend imaging tests to look for signs of lymphoma in other parts of the body. Tests may include CT, MRI, and positron emission tomography (PET).

Depending on your situation, other tests and procedures may be used.

There are many types of lymphoma, and knowing exactly what type it is is important to developing an effective treatment plan. Research shows that having biopsy samples examined by a specialized pathologist increases the chances of an accurate diagnosis. Consider getting a second opinion from a specialist who can confirm your diagnosis.

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Which lymphoma treatment is right for you depends on the type and stage of your disease, your general health and your preferences. The goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission.

Treatment for lymphoma includes:

  • Active Surveillance.Some forms of lymphoma grow very slowly. If lymphoma is causing signs and symptoms that interfere with your daily activities, you and your doctor may decide to wait to treat it. Until then, you can take regular tests to monitor your condition.
  • Chemotherapy.Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. These drugs are usually given through a vein, but depending on the drug, they can also be taken in pill form.
  • Radiotherapy.Radiation therapy uses high-energy rays, such as X-rays and protons, to kill cancer cells.
  • bone marrow transplant.A bone marrow transplant, also called a stem cell transplant, uses high doses of chemotherapy and radiation to suppress your bone marrow. Healthy bone marrow stem cells, either from your own body or from a donor, are then injected into your bloodstream, where they travel to your bones and rebuild your bone marrow.
  • other treatments.Other drugs used to treat lymphoma include drugs that target specific abnormalities in the cancer cells. Immunotherapy drugs use your immune system to kill cancer cells. In a special treatment called chimeric antigen receptor (CAR) T cell therapy, your body's bacteria-fighting T cells are redesigned to fight cancer and then injected back into your body.

More information

  • Lymphoma care at the Mayo Clinic
  • Frequently asked questions about lymphoma

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alternative medicine

No dietary supplements were found to treat lymphoma. But integrative medicine can help you deal with the stress of a cancer diagnosis and the side effects of cancer treatment.

Discuss your options with your doctor, including:

  • physical activities
  • art therapy
  • Meditation
  • music therapy
  • relaxation exercises
  • Acupuncture
  • Massage

processing and support

Being diagnosed with lymphoma can be overwhelming. Over time, you will find ways to deal with the stress and uncertainty that cancer brings. Until then, you might find it helpful:

  • Learn more about lymphoma.If you want to learn more about your lymphoma, ask your doctor for details about the cancer—type, stage, and prognosis. A good source for up-to-date information on your treatment options. Learning more about your cancer and your options can help you feel more confident about making treatment decisions.
  • Keep your friends and family close together.Your friends and family can offer you emotional support and provide you with the practical support you need, such as: B. by helping you with household chores when you are in the hospital.
  • Find someone to talk to.Find a good listener and talk to them about your hopes and fears. This can be friends or family. The care and understanding of a counselor, medical social worker, minister, or cancer support group may also be helpful.

    Ask your doctor about support groups in your area. You can also contact cancer organizations like the National Cancer Institute or the Leukemia and Lymphoma Society.

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Prepare for your appointment

Make an appointment with your GP if you have any signs or symptoms that worry you. If your doctor suspects that you have lymphoma, they may refer you to a doctor who specializes in blood cell disorders (haematologists).

Since the appointments can be short and often cover a wide area, it is advisable to be well prepared. Here's some information to help you prepare and what to expect from your doctor.

what can you do

  • Find out about any restrictions before the appointment.When making the appointment, be sure to ask if there is anything you need to do beforehand, such as restricting your diet.
  • Write down any symptoms you experience.Add anything that doesn't seem relevant to the reason you're making the appointment.
  • Gather basic personal information.Consider any major stressors or recent life changes.
  • list all medicationsVitamins or supplements you are taking.
  • Consider going with your family or friends.Sometimes it can be difficult to remember all the information given during the appointment. Someone who is with you may remember things you have lost or forgotten.
  • Write the questions you want to askyour doctor

Since you only have a limited amount of time with your doctor, creating a list of questions will help you make the most of your time together. In case you are running out of time, list your questions from most important to least important. Some of the top questions to ask your doctor about lymphoma include:

  • Do I have lymphoma?
  • What type of lymphoma do I have?
  • What stage is my lymphoma at?
  • Is my lymphoma aggressive or is it growing slowly?
  • Do I need further tests?
  • Do I need treatment?
  • What treatment options do I have?
  • What are the possible side effects of each treatment?
  • How will the treatment affect my daily life? Can I keep working?
  • How long will the treatment take?
  • Is there a treatment that you think is best for me?
  • If you had a friend or loved one in my situation, what advice would you give that person?
  • Should I See a Lymphoma Specialist? How much will this cost and will my insurance cover it?
  • Do you have brochures or other printed material that I can take with me? Which site do you recommend?

Feel free to ask other questions than those you would ask your doctor.

what to expect from your doctor

Your doctor may ask you some questions. Be prepared to respond that they may allow more time to discuss other issues you wish to raise. Your doctor may ask you:

  • When did you experience symptoms?
  • Are your symptoms constant or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, seems to be making your symptoms worse?
  • Has anyone in your family ever had cancer, including lymphoma?
  • Do you or someone in your family have a disease that affects the immune system?
  • Have you or your family been exposed to toxins?

Mayo Clinic staff

December 14, 2022


Lymphoma - diagnosis and treatment? ›

Most often, the treatment is chemotherapy (chemo), usually with a regimen of 4 drugs known as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), plus the monoclonal antibody rituximab (Rituxan). This regimen, known as R-CHOP, is most often given in cycles 3 weeks apart.

What is the most common treatment for lymphoma? ›

Most often, the treatment is chemotherapy (chemo), usually with a regimen of 4 drugs known as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), plus the monoclonal antibody rituximab (Rituxan). This regimen, known as R-CHOP, is most often given in cycles 3 weeks apart.

What is the first step in diagnosing lymphoma? ›

Lymph Node Biopsy

Your team may order a test of your lymph nodes to check the cells in the lymphatic system, where lymphoma starts. A specialist removes part or all of a lymph node for testing. Many lymph nodes are close to the skin's surface, so the procedure is usually simple.

What are the steps to diagnose lymphoma? ›

Tests and procedures used to diagnose lymphoma include:
  • Physical exam. Your doctor checks for swollen lymph nodes, including in your neck, underarm and groin, as well as a swollen spleen or liver.
  • Removing a lymph node for testing. ...
  • Blood tests. ...
  • Removing a sample of bone marrow for testing. ...
  • Imaging tests.
Dec 14, 2022

How treatable is lymphoma cancer? ›

Predictive factors. In general, lymphoma is considered to be very treatable. However, each patient's outlook can vary based on several factors, most notably the type and severity of the diagnosis and how early the cancer was detected.

What is the life expectancy for someone with lymphoma? ›

The overall 5-year relative survival rate for people with NHL is 74%. But it's important to keep in mind that survival rates can vary widely for different types and stages of lymphoma.

Is chemo worth it for lymphoma? ›

Some types of lymphoma are more likely to spread to the central nervous system (the brain and spinal cord). In certain situations, your doctor might want you to have treatment to prevent this. The most common treatment is to have injections of the chemotherapy drug methotrexate into the fluid around your spinal cord.

Does lymphoma show up in blood work? ›

Blood tests are not used to diagnose lymphoma, but they can sometimes help determine how advanced the lymphoma is.

What confirms lymphoma? ›

To diagnose non-Hodgkin lymphoma, NYU Langone doctors perform a biopsy, in which they take a tissue sample from a swollen lymph node found during the physical exam or with imaging tests, such as CT, PET, or MRI, which doctors often use when diagnosing cancer, and evaluate it under a microscope.

Where does lymphoma usually start? ›

Lymphomas can start anywhere in the body where lymph tissue is found. The major sites of lymph tissue are: Lymph nodes: Lymph nodes are bean-sized collections of lymphocytes and other immune system cells throughout the body, including inside the chest, abdomen, and pelvis.

What are the warning signs of lymphoma? ›

Some common signs and symptoms include:
  • Enlarged lymph nodes.
  • Chills.
  • Weight loss.
  • Fatigue (feeling very tired)
  • Swollen abdomen (belly)
  • Feeling full after only a small amount of food.
  • Chest pain or pressure.
  • Shortness of breath or cough.
Aug 1, 2018

Do you need a biopsy to diagnose lymphoma? ›

Usually, a biopsy is the only way to confirm a diagnosis of lymphoma. To diagnose lymphoma, a biopsy sample is often taken from a gland (lymph node). Very occasionally, you might instead have a sample removed from an organ, such as your liver, or another site, such as part of your skin.

How do you treat Stage 1 lymphoma? ›

Limited stage usually means stage 1 or 2A lymphoma. You will probably have a short course of chemotherapy if you have limited disease. Your doctor might then recommend radiotherapy to the affected lymph nodes. You might also have radiotherapy to your spleen or other lymph nodes.

What is the main cause of lymphoma? ›

In most cases, there is no known cause for lymphoma. However, for a few types of lymphoma, scientists have identified a cause: Most cases of gastric MALT lymphoma are caused by a common bacterial infection called Helicobacter pylori. Usually, Helicobacter pylori causes stomach ulcers and indigestion.

Can lymphoma be cured without chemo? ›

Non-Hodgkin lymphoma is usually treated with chemotherapy or radiotherapy, although some people may not need treatment straight away. In a few cases, if the initial cancer is very small and can be removed during a biopsy, no further treatment may be needed.

Is it hard to cure lymphoma? ›

Not all lymphomas can be cured. Of the two main types, HL tends to be the most treatable. Certain aggressive forms of NHL can also be cured with aggressive chemotherapy. By contrast, indolent (slow-growing) NHL is not curable, although it can be managed successfully for years and even decades.

Which is the easiest lymphoma to cure? ›

Lymphoma is considered one of the most treatable forms of cancer if found early. For NHL, the overall five- and 10-year relative survival rates are 69% and 59%, respectively. For Hodgkin's lymphoma, the survival rates are equally improved, with a five-year survival rate of 85% and a 10-year survival rate of 80%.

What is the aggressive treatment for lymphoma? ›

Chemotherapy is usually the main treatment. A combination of chemotherapy drugs is usually given along with targeted therapy. Radiation therapy is often given as well. If radiation therapy is going to be given after chemotherapy, fewer cycles of chemotherapy may be needed.

What is the most survivable lymphoma? ›

Follicular lymphoma

almost 90 in 100 people (almost 90%) survive their cancer for 5 years or more after diagnosis.

What is the most difficult lymphoma to treat? ›

Blastic NK cell lymphoma

This very rare type of T cell lymphoma only affects a few people each year. It usually affects adults. Blastic NK cell lymphoma tends to grow very quickly and can be difficult to treat. It can start almost anywhere in the body.


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