Non-Hodgkin Lymphoma Treatment

Your doctor can describe your treatment choices and the expected results. You and your doctor can work together to develop a treatment plan that meets your needs.

Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat non-Hodgkin lymphoma include hematologists, medical oncologists, and radiation oncologists. Your doctor may suggest that you choose an oncologist who specializes in the treatment of lymphoma. Often, such doctors are associated with major academic centers. Your health care team may also include an oncology nurse and a registered dietitian.

The choice of treatment depends mainly on the following:

• The type of non-Hodgkin lymphoma (for example, follicular lymphoma)
• Its stage (where the lymphoma is found)
• How quickly the cancer is growing (whether it is indolent or aggressive lymphoma)
• Your age
• Whether you have other health problems

If you have indolent non-Hodgkin lymphoma without symptoms, you may not need treatment for the cancer right away. The doctor watches your health closely so that treatment can start when you begin to have symptoms. Not getting cancer treatment right away is called watchful waiting.

If you have indolent lymphoma with symptoms, you will probably receive chemotherapy and biological therapy. Radiation therapy may be used for people with Stage I or Stage II lymphoma.

If you have aggressive lymphoma, the treatment is usually chemotherapy and biological therapy. Radiation therapy also may be used.

If non-Hodgkin lymphoma comes back after treatment, doctors call this a relapse or recurrence. People with lymphoma that comes back after treatment may receive high doses of chemotherapy, radiation therapy, or both, followed by stem cell transplantation.

You may want to know about side effects and how treatment may change your normal activities. Because chemotherapy and radiation therapy often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next. Before treatment starts, your health care team will explain possible side effects and suggest ways to help you manage them.

At any stage of the disease, you can have supportive care. Supportive care is treatment to control pain and other symptoms, to relieve the side effects of therapy, and to help you cope with the feelings that a diagnosis of cancer can bring. See the Supportive Care section.

You may want to talk to your doctor about taking part in a clinical trial, a research study of new treatment methods.

You may want to ask your doctor these questions before you begin treatment:

• What type of lymphoma do I have? May I have a copy of the report from the pathologist?
• What is the stage of my disease? Where are the tumors?
• What are my treatment choices? Which do you recommend for me? Why?
• Will I have more than one kind of treatment?
• What are the expected benefits of each kind of treatment? How will we know the treatment is working? What tests will be used to check its effectiveness? How often will I get these tests?
• What are the risks and possible side effects of each treatment? What can we do to control the side effects?
• How long will treatment last?
• Will I have to stay in the hospital? If so, for how long?
• What can I do to take care of myself during treatment?
• What is the treatment likely to cost? Will my insurance cover the cost?
• How will treatment affect my normal activities?
• Would a clinical trial be right for me?
• How often will I need checkups?