Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma is a cancer of the white blood cells in the lymphatic system. Non-Hodgkin lymphoma happens when the cells grow in a way that is not normal.

Your lymphatic systemin your body helps to fight infections and diseases.. It is made up of:

lymph nodes, which are small lumps in under your arms, in your groin and in many other places
lymphatic vessels, which are like arteries and veins, but smaller
lymph, which is a fluid carried in the lymphatic vessels
white blood cells, which are found both in lymph and in blood
your spleen, which is an organ that sits under your ribs on the left.

There are a number of symptoms to look out for, including:
- painless, swollen lumps around the neck, groin or under the arms
- feeling really tired
- night sweats
- fever
- itchy skin
- losing weight without meaning to
- not feeling hungry
- getting sick a lot
- bleeding or bruising easily
People and kids can also have swollen tummy, coughs and trouble breathing, headaches or skin changes like lumps or blotches.

Having these symptoms may not mean you have cancer, but it is important to check.

If you have any of these problems, or are worried about something else, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander Health Worker.
You won’t know if you have non-Hodgkin lymphoma until your doctor has yarned with you, complete a physical examination, and done some tests.

The tests might include:
- blood tests
- a biopsy, when a small bit of lymph node is removed through a needle, and this is looked under a microscope
- imaging tests like an ultrasound, a CT scan or MRI scan to see what your insides look like.
Having these tests does not mean you have cancer, but it is important to check.

If you have any of these problems, or are worried about something else, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.
If you have non-Hodgkin lymphoma, you might be told it’s at a certain stage. This describes whether or not it has spread to other parts of the body, and how far. Knowing the stage of the cancer helps you and your doctors to decide on the best treatment for you.
- Stage I: Lymphoma is in only 1 lymph node area or organ.
- Stage 2: Lymphoma is in 2 or more lymph node areas on only one side of the diaphragm (above or below your abdomen) or is in a nearby organ of the body.
- Stage 3: Lymphoma is in more lymph node areas both above and below the diaphragm and spread to a nearby organ of the body.
- Stage 4: lymphoma has spread to one or more organs or other parts of the body far away – this is also known as metastatic cancer.
There are many ways to treat non-Hodgkin lymphoma. The main ones are chemotherapy and radiotherapy, which are often used together. Some people might have targeted therapies, immunotherapy, stem cells transplant or, rarely, surgery If you have non-Hodgkin lymphoma, you might need one of these, or a combination of them.

Your doctors will talk to you about what treatments they recommend and what the best options are for you.

Yarn with your doctor, specialist, nurse or Aboriginal and/or Torres Strait Islander Health Worker about which treatment you might have.

Chemotherapy

Chemotherapy, or ‘chemo’ is one of the main treatments for non-Hodgkin lymphoma. Chemo involves you taking strong drugs to kill or slow the growth of the cancer cells.

Many people have chemo in cycles – usually two days every three weeks, or one day every three weeks. Some people have chemotherapy tablets at home, but most need to go to a hospital or clinic. But you usually don’t need to stay in hospital for chemo.

Your doctor may recommend that you need to have chemotherapy at the same time as you are having radiotherapy Most chemo comes as injections into your arm or hand that drip in over a few hours. Some chemo or medications come as tablets. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Chemo can make people feel sick for a while, but there are things they can do to help.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker Mob who have had chemo before say that spending time on Country, traditional healing, bush medicines and engaging in cultural practices can help.

Read more about chemotherapy and side effects.

Radiotherapy

Radiotherapy, also called radiation therapy, uses X-rays to destroy cancer cells in one part of your body.

Most people who have radiotherapy have it every day (Monday to Friday) for 4-6 weeks, and each session can take 15 minutes. But it might be different for you.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks radiotherapy would help, and you don’t live near a radiotherapy site, assistance is available for travel and accommodation for you and your family.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker or social worker.

Read more about radiotherapy.

Targeted therapies

Targeted therapies are newer drugs for certain types of lung cancer to try to stop the cancer growing. They are usually in the form of tablets that you can take at home.

If your doctor thinks they might help, here are some questions to ask.

Read more about targeted therapy.

Immunotherapy

Immunotherapy is treatment with drugs that help your immune system attack the cancer cells.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker, and with mob who have had the treatment.

Read more about immunotherapy.

Stem cell transplant

Stem cell transplant usually happens after chemo. The chemo might be given in high doses, to kill all the cancer cells which can also lead to the bone marrow losing all the normal, healthy cells.

A stem cell transplant is given to restore the bone marrow and allow new healthy cells to start being produced. The stem cells might be from your own body, or from a close (blood) relative, or someone who has donated theirs to be used.

A stem cell transplant can mean a stay in hospital of 3-4 weeks.

Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker.

Read more about stem cell transplant.

Surgery

Surgery is rarely used to treat non-Hodgkin lymphoma. . If you do need to have surgery, you’ll need to stay in hospital and have an anaesthetic and an operation.

The doctor will talk to you beforehand about what is going to happen.

Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander Health Worker or social worker. If you need to travel away from home for surgery, assistance is available for travel and accommodation for you and your family.

Read more about surgery.
It is important for you to understand why you are getting the treatment your doctor chooses and how it is supposed to help you. Different treatments try to do different things. It depends on what cancer you have, and whether it has spread, and where you live, and what you want. Ask your doctor or specialist if the treatment they suggest:
- is meant to cure you, by getting rid of the cancer and stopping it spreading, or won’t cure you but is meant to make you feel better and prolong your life.
Your doctors yarn with you and explain this. You can yarn with them and tell them what you think, and what you want. Some people will want to try everything possible to stay alive. Others want simpler treatments, or don’t want to leave Country for treatment, or don’t want any treatment. It’s your choice. You can also talk to another doctor to help you decide.
It can take time to decide about treatment. There are usually some options to hear about and choices to make.

It can be helpful to write things down, and have someone else come to appointments to help remember information. Mob who have been diagnosed with cancer say that yarning with trusted family, friends and Elders helps with making decisions.

Talk to your doctor, specialist, nurse or Aboriginal and/or Torres Strait Islander health worker.

You can read about treatment.
Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Ask your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Learn more about financial support.
It all depends on the type of treatment you’re having. But most people will have treatment for several months. After treatment is finished, your doctors will keep in touch so they can check how you’re going. Your cancer journey gives you an opportunity to build trust and safe relationships with your doctors and medical team that may last for many years.
A risk factor is any factor that can increase the person’s risk of developing that condition, in this case, non-Hodgkin lymphoma. Having one or more risk factors does not mean that you will develop cancer. It can also be unclear whether a risk factor contributed to the development of the cancer in a person.

The known risk factors for prostate cancer are:
- Increasing age
- Exposure to certain chemicals such as pesticides and some chemotherapies
- Weakened immune system – such as a result of infections (e.g. HIV) or medicines that suppress the immune system
Infection with certain viruses such as HIV, Epstein-Barr virus and chronic infections
Clinical trials might be an option for you. Yarn with your doctor to help you decide if taking part is a good option. Read more about clinical trials.

Read more detail on non-Hodgkin lymphoma here.

Leukaemia Foundation.