Treatment of non-Hodgkin lymphoma

Treatment for non-Hodgkin lymphoma (NHL) is given by cancer specialists (oncologists) or hematologists. Some specialize in surgery, some in radiation therapy and others in chemotherapy (drugs). These doctors work with the person with cancer to decide on a treatment plan.

Treatment plans are designed to meet the unique needs of each person with lymphoma. Treatment decisions for non-Hodgkin lymphoma (NHL) are based on:

• the type of NHL
• the stage of NHL
• how quickly the NHL is growing (grade) – whether it is slow growing (indolent) or fast growing (aggressive)
• prognostic factors
• a person's age
• a person's overall health and if they have other medical conditions that may interfere with treatment
• previous treatment, if any

Lymphomas are often very responsive to treatment.

Treatment options for NHL

• chemotherapy
  • The chemotherapy drugs used depend on the type and stage of NHL being treated.
  • Single chemotherapy drugs or combinations of chemotherapy drugs are often used to treat NHL.
• biological therapy
  • Biological therapy may be used on its own to treat certain types and stages of NHL. It may also be used in combination with chemotherapy.
• radiation therapy
  • External beam radiation therapy may be used on its own to treat localized areas of early stage lymphoma. It may also be used along with chemotherapy as part of a combination of treatments.
• watchful waiting
  • Watchful waiting is used when the lymphoma is progressing very slowly and there are no symptoms. The person is watched closely for signs or symptoms of disease progression without being given any treatment. Treatment is given when the person develops symptoms or there are signs that the lymphoma is progressing.
• surgery
  • Surgery is mainly used to remove all or part of a lymph node (biopsy) to diagnose lymphoma. More extensive surgery is rarely used to treat NHL.
  • The spleen may be removed (splenectomy) in certain situations.
• stem cell transplant
  • A stem cell transplant (SCT) may be used in certain situations, such as when the lymphoma has recurred after being treated or no longer responds to treatment.
• follow-up after treatment is finished
  • It is important to have regular follow-up visits, especially during the first 2 years after treatment because that is when the risk of recurrence is greatest.

Clinical trials

Clinical trials investigate new and better ways to prevent, detect and treat cancer. There are many clinical trials in Canada that are open to people with NHL. For more information, go to clinical trials.

See a list of questions to ask your doctor about treatment.