Treatments for non-Hodgkin lymphoma

Your healthcare team will create a treatment plan just for you. The plan is based on your health and specific information about the cancer. What you want is also important when planning treatment. When deciding which treatments to offer for non-Hodgkin lymphoma (NHL), your healthcare team will consider:

• the type or subtype of NHL
• the stage of the cancer
• the grade
• prognostic factors
• your age
• your overall health

When planning treatment, the healthcare will look at if the NHL is an indolent or aggressive type.

Indolent NHL means that the cancer is growing slowly. Because it grows slowly, some people will only ever need watchful waiting. If other treatments are used, like chemotherapy or targeted therapy, indolent NHLs usually respond well to treatment and can often be controlled for many years. They can come back after treatment or become resistant to treatment over time. Some indolent NHLs can also change into a more aggressive type of NHL and are treated the same as the aggressive type.

Aggressive NHL means that the cancer is growing quickly. An aggressive NHL often causes symptoms soon after it develops, and these symptoms usually need to be treated right away. Aggressive NHLs usually respond well to treatment.

The healthcare team will also consider how much cancer is in the body when planning treatment. They usually put NHL into 1 of 2 main stages.

Limited stage usually includes stage 1 and stage 2.

Advanced stage usually includes stage 3 and stage 4. Stage 2 may be considered advanced in certain situations, such as if you have B symptoms or bulky disease. Bulky disease refers to the size of the tumours or areas of lymphoma in the body. How bulky disease is defined may be different for different types of NHL, but it usually refers to tumours that are 10 cm or larger. Find out more about staging for non-Hodgkin lymphoma.

For some types of NHL, your healthcare team may use imaging tests to check how the cancer is responding to treatment. You may hear some of the following common terms.

Complete response (CR) means there are no signs of cancer.

Partial response (PR) means the lymphoma has shrunk by at least half or more but is still detectable.

Stable disease means the lymphoma doesn't get better or worse after treatment.

Disease progression means the lymphoma is getting worse. It may also be called treatment failure.

Refractory disease means the cancer doesn't respond to treatment or comes back soon after being treated.

Relapse means the lymphoma comes back after being treated.