Treatment for low-grade non-Hodgkin lymphoma

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Low-grade NHL treatment: Early stage  

In early-stage disease, usually one or two groups of lymph nodes in just one part of your body are affected. After the first course of treatment, there is a good chance of getting a complete remission, so the lymphoma won’t come back. It’s more usual for patients to be diagnosed at a later stage.

• Watch and wait: Having no treatment. Your doctor will give you regular check-ups to monitor your lymphoma. You can start treatment if things change. Read more about watch and wait.
• Radiotherapy: High-energy X-rays are aimed at a cancer to cure or shrink it. The X-rays are only aimed at the lymphoma. Radiotherapy may be used on its own when the lymphoma is found in one or two groups of lymph nodes in the same part of your body. It may also be given after a course of chemotherapy.
  Radiotherapy can also be used if the lymphoma is found in the fluid around your brain or if there is a high risk that it may develop there. Read more about radiotherapy 
• Drug treatments:  There is a risk that some lymphoma cells may be left behind after radiotherapy, increasing the risk of the disease relapsing. In this case, your doctor may advise a short course of chemotherapy or targeted/immunotherapy drugs, given either before or after radiotherapy.  
• Steroids:  Steroids can help to kill the lymphoma cells and to improve how chemotherapy works. They can also help with side-effects like feeling sick.

Low-grade NHL treatment: Advanced stages 

Advanced stage disease means that lymph nodes are affected in several places in your body. It is often hard to get rid of advanced stage lymphoma completely. It is likely to come back (relapse). In fact, it often behaves like a
chronic condition. This means having lymphoma can be like having a long-term illness, which needs treatment from time to time when the condition flares up. The treatment will aim to get the disease under control and bring about another remission.

• Chemotherapy: Drugs to kill the cancer cells. A number of chemotherapy drugs may be given to bring about a remission. Over the years, you may receive several courses of treatment, sometimes a repeat of the same treatment or a different drug. Steroids may also be given as well. Read more about chemotherapy.
• Targeted therapy / immunotherapy drugs: Monoclonal antibodies are the type most commonly used. Read more about targeted therapies.
• Radiotherapy: Using high-energy rays to target the cancer cells. Radiotherapy might be given to the small area of affected lymph nodes and nearby nodes. Read more about radiotherapy
• Stem cell transplant: All the blood cells in your bone marrow are destroyed with high-dose chemotherapy or radiotherapy and replaced with healthy stem cells. Transplants are not suitable for every patient. Transplants are not common and are only used if the lymphoma has come back. Read more about stem cell transplants

What side-effects will I get?

The type of side-effects you get will depend on:

• The kind of treatment
• The dose
• How long treatment lasts
• Your own general health

Some treatments might make you less resistant to infection, feel sick (nausea), vomit or have diarrhoea. You might also lose your appetite or your hair. Many treatments cause you to feel very tired (fatigue). Read about the different treatments for more about their side-effects. 

Most side-effects do not last long and disappear once treatment is over. The side-effects of stem cell transplant can be more severe. 
Your doctor or nurse will discuss any possible side-effects with you before treatment begins.