Treatments for non-Hodgkin lymphoma
If you have non-Hodgkin lymphoma (NHL), your healthcare team will create a treatment plan just for you. It will be based on your needs and specific information about the cancer. When deciding which treatments to offer for NHL, your healthcare team will consider:
- the type of NHL
- the stageof the cancer
- the grade – if the NHL is indolent (low grade, slow growing) or aggressive (high grade, fast growing)
- your prognostic factors
- your age
- your overall health
- if you have already been treated for NHL
You may be offered a combination of the following treatments for NHL.
The chemotherapy drugs used depend on the type and stage of NHL. You may be given a single chemotherapy drug or a combination of drugs. High-dose chemotherapy is given in preparation for a stem cell transplant.
Immunotherapy may be used on its own or in combination with chemotherapy to treat some types of NHL.
Targeted therapy drugs may be used on their own or in combination with chemotherapy to treat some types of NHL. Some targeted therapy drugs are used to carry radiation directly to the lymphoma cells. This treatment is called radioimmunotherapy.
External beam radiation therapy may be given alone as the main treatment for some types of NHL that are in an early stage and haven’t spread to different parts of the body. It can also be used along with chemotherapy to treat aggressive or more advanced NHL.
Sometimes external beam radiation therapy is given to the whole body (called total body irradiation) in preparation for a stem cell transplant. It can also be given to the brain to prevent NHL from spreading to the central nervous system (CNS) or to treat NHL in the CNS.
Doctors may also use radiation therapy to shrink a tumour or larger than normal lymph nodes that are pressing on nerves and causing pain. Radiation therapy to these areas may help shrink large tumours and relieve pain.
Watchful waiting is also called active surveillance. It may be an option for some types of indolent NHL that are not yet causing symptoms. The healthcare team carefully watches for signs that NHL is progressing. They start treatment if the disease progresses and causes symptoms.
Surgery is mainly used to remove all or part of a lymph node to diagnose NHL. Sometimes surgery is used to remove the spleen (called a splenectomy). In some cases, surgery may be done to remove all of a tumour if it hasn’t grown into surrounding tissues or organs.
Stem cell transplant
A stem cell transplant may be used to treat some people who have a high risk of recurrence and are in remission. It may also be used for NHL that comes back (recurs) after treatment or that no longer responds to treatment.
Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits. They are usually scheduled every few months for the first year or more, and then you will gradually need to see your doctors less often. These visits allow your healthcare team to monitor your progress and recovery from treatment.
Some clinical trials in Canada are open to people with NHL. Clinical trials look at new and better ways to prevent, find and treat cancer. Find out more about clinical trials.
Questions to ask about treatment
To make the decisions that are right for you, ask your healthcare team questions about treatment.
A decrease in or the disappearance of signs and symptoms of a disease (such as cancer).
Complete remission means the disappearance of all signs or symptoms. Partial remission means a decrease in or disappearance of some, but not all, signs and symptoms. Spontaneous remission is an unexpected improvement that occurs with little or no treatment.
Great progress has been made
Some cancers, such as thyroid and testicular, have survival rates of over 90%. Other cancers, such as pancreatic, brain and esophageal, continue to have very low survival rates.