Treatment for Non-Hodgkin lymphoma (NHL)
Your treatment will depend on the stage and grade of the lymphoma.
The main treatments for non-Hodgkin lymphoma are:
- Active surveillance (regular check-ups)
- Biological therapies
- High-dose treatment with stem cell support
- Active surveillance (regular check-ups)
Lymphomas like low grade lymphomas grow very slowly. If you have little or no signs of active disease, there is no benefit in giving you treatment. As a result, you may not need treatment for a very long time. During this time you will only need regular check-ups. It is possible to enjoy a full life with this grade of lymphoma. Active surveillance is also known as watchful waiting.
This treatment uses high-energy X-rays to kill the cancer cells in your lymph nodes. It is usually used to treat early stage lymphoma. It can be given before, together or after a course of chemotherapy. Please see our booklet Understanding Radiotherapy, which you can download from our "Important cancer information booklets" list on the right hand side of this page, for more information on radiotherapy.
Chemotherapy is the use of drugs to cure or control cancer. Chemotherapy drugs can be given on their own or with each other (in combination). Many patients receive a combination of two or three chemotherapy drugs. Chemotherapy drugs can either be injected into your bloodstream or given in tablet form.
The drugs most commonly used include:
- Doxorubicin (Adriamycin)
All these drugs can be used in combination with each other. The most common combinations are:
- CVP: cyclophosphamide, vincristine and prednisolone (a steroid)
- CHOP: cyclophosphamide, doxorubicin, vincristine and prednisolone
Please see our booklet Understanding Chemotherapy, which you can download from our "Important cancer information booklets" list on the right hand side of this page, for more information.
This therapy uses your body´s own immune system to treat lymphoma. There are different types of biological therapies. For example, monoclonal antibodies. A common drug used in non-Hodgkin lymphoma is rituximab (Mabthera).
Some monoclonal antibodies also have radioactive molecules attached to them, which give a dose of radiation directly to the cancer cells. The ones used to treat non-Hodgkin lymphoma include ibritumomab tiuxetan (Zevalin®) and tositumomab (BEXXAR®).
Steroids are substances made naturally in your body. They can be given with chemotherapy to treat non-Hodgkin lymphoma as they work well together. They can also be given to help with some side-effects that you might experience, such as feeling sick (nausea). Steroids are usually taken in tablet form but can also be given into a vein.
High-dose treatment with stem cell support
Your doctor may advise you to have treatment with high-dose chemotherapy or radiotherapy. This can happen if your lymphoma has not fully responded to treatment or comes back afterwards. The aim of the treatment is to give high doses of chemotherapy to destroy all the blood cells in your bone marrow and replace them with stem cells. These stem cells can then grow into new healthy blood cells.
Before the high-dose chemotherapy is given, the stem cells are taken from your bone marrow or your bloodstream (peripheral blood). If the cells are taken from you, it is known as an autologous transplant. If they are taken from someone else, it is known as an allogeneic transplant.
For more information, see our booklets and factsheets:
- Understanding High-Grade Non-Hodgkin Lymphoma Booklet
- Understanding Low-Grade Non-Hodgkin Lymphoma Booklet
- Understanding Stem Cell Collection
- Understanding Autologous Stem Cell Transplants
- Total Body Irradiation
The type of side-effects you get will depend on the kind of treatment, the dose, the duration and 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). Infertility may be a problem if you have chemotherapy. Steroids can increase your blood pressure and blood sugars and even cause mood changes.
Most side-effects do not last long and disappear once treatment is over. Your doctor or nurse will discuss any possible side-effects with you before treatment begins.
For more about coping with side-effects, see the booklets Understanding Chemotherapy, Understanding Radiotherapy, Coping with Fatigue, Diet and Cancer and Understanding Cancer and Complementary Therapies, all available to download under the "Important cancer information booklets" list on the right hand side of this page.
If a treatment looks like it might be helpful, it is given to patients in research studies called clinical trials. Trials may be taking place in the hospital you are attending. If you are interested in taking part, talk to your doctor. He or she can advise you if the trial would suit you or not.