Ignacio first noticed the signs of his non-Hodgkin lymphoma when he had trouble
breathing and was coughing a lot during football practice. He also started getting
a fever but didn't know why. His parents took him to the doctor. After doing
tests and a biopsy, Ignacio's doctors diagnosed him with non-Hodgkin lymphoma.
At first, Ignacio was scared when he heard that non-Hodgkin lymphoma is a kind
But he quickly learned that it's treatable, especially if it's caught early. Most
people who have it can be cured.
What Is Non-Hodgkin Lymphoma?
A lymphoma is a cancer of the lymphatic
system, which is a part of the body's immune system. It helps filter out bacteria,
viruses, and other unwanted substances. When someone has non-Hodgkin lymphoma, cancer
cells form in the lymphatic system and start to grow.
Most of the time, you're only aware of your lymphatic system when the
swell. This often happens when a person is sick — a sign that the lymphatic
system is working hard to filter harmful substances out of the body.
There are several different types of lymphomas. A lymphoma can be Hodgkin
lymphoma or non-Hodgkin lymphoma. Doctors tell which kind of lymphoma someone
has based on the way the cells look.
How Do People Get It?
No one really knows what causes non-Hodgkin lymphoma. Doctors know that some things
may increase a person's chances of getting it, like having AIDS
or other conditions that weaken the immune
People with a brother or sister who has had non-Hodgkin lymphoma are also more
likely to get it. Of course, having a sibling with the disease doesn't mean you will
get it. Non-Hodgkin lymphoma isn't contagious — you can't catch it from or give it
Signs of Non-Hodgkin Lymphoma
The signs of non-Hodgkin lymphoma vary from person to person depending on the type
of lymphoma and where a tumor is in the body. Some people may feel stomach pain, have
be less hungry than usual. Others may have trouble breathing, have a hard time swallowing,
cough or wheeze, or feel chest pain.
Other signs of lymphoma may include:
swollen lymph nodes that don't hurt
fever, chills, or night sweats
weight loss despite eating normally
bone or joint pain
lots of infections
For many people with lymphoma, the first sign is swollen lymph nodes. They're usually
in the neck, armpits, and groin. But swollen lymph nodes do not usually mean someone
has cancer. Most of the time, swollen lymph nodes are a sign of an infection or other
Because all the signs of lymphoma can be caused by other conditions, only a doctor
can figure out what's really wrong.
What Do Doctors Do?
If your family doctor thinks you might have non-Hodgkin lymphoma, he or she
will send you to an oncologist — a doctor who specializes in cancer. The oncologist
will then do tests to be sure of what's wrong.
If someone's swollen lymph nodes don't go down after other treatments, the oncologist
may want to do a biopsy.
Doctors do different kinds of biopsies to test for non-Hodgkin lymphoma, including:
excisional biopsy, where the doctor opens the skin to remove
an entire lymph node
incisional biopsy, where the doctor removes only a part of the
fine needle aspiration, where a very thin needle suctions out
a small amount of tissue from the lymph node
core biopsy, where a wider needle is used to remove tissue from
a lymph node
bone marrow biopsy, where a needle is used to take samples of
the soft tissue found in a bone
During a biopsy, the doctor will use
so the patient feels no pain. Depending on the kind of biopsy, this
might be local anesthesia (where part of the body is numbed) or general anesthesia
(where a person is asleep).
A doctor also may do these tests to help decide
if someone has non-Hodgkin lymphoma:
a positron emission tomography (PET) scan, which can tell the difference between
normal and abnormal cells based on metabolic activity
a gallium scan, if the doctor thinks a PET might not be a good option. In this
test, a radioactive material called gallium is injected into the body to help show
tumors and inflammation.
of non-Hodgkin lymphoma, doctors use what's called a "staging
system" to figure out how much the disease has affected the body. For example,
a cancer at stage one hasn't affected as much of the body as a cancer at stage four.
Knowing the stage of the disease helps the doctor choose the best treatment.
How Is It Treated?
Teens with non-Hodgkin lymphoma usually are treated
in a pediatric cancer center by a team of experts in childhood cancers.
Some of the treatments they can get are:
kills or stops the growth of cancer cells. This is the most common treatment for people
with non-Hodgkin lymphoma.
Targeted immunotherapy (sometimes called biological therapy).
With this type of cancer treatment, doctors give patients special medicines that identify
("tag") the cancer cells so that the body's own immune system can find them
and fight them off.
For people getting a lot of chemo or radiation treatments, doctors may do bone
marrow transplants or stem
cell transplants. These transplants replace cells damaged by chemo and radiation.
In a transplant, doctors put healthy new bone marrow or blood cells into the
patient's bloodstream through an IV.
These new cells are either taken from the patient before treatment or donated by someone
What to Expect
If you have non-Hodgkin lymphoma, you know how scary it can feel. There's a lot
to deal with emotionally. On top of that, appointments and tests can be tiring, and
treatments might make you feel lousy.
People who are being treated with chemotherapy or radiation can expect
from these treatments. Most side effects are temporary and will go away
after a few weeks. But, as with all medical treatments, each person feels them differently.
How strong side effects are and how long they last depends on the person and the treatment
The most common short-term side effects of chemo are feeling sick and throwing
up. Most patients get medicines to prevent this. Cancer treatment also can cause lower
blood counts, which can put people at risk for infection or bleeding.
Some people feel weak or dizzy after their treatments, or they have a fever. Others
get mouth sores in or don't feel much like eating. It's also common for patients to
lose some or all of their hair.
The short-term side effects of radiation can be similar to those of chemotherapy,
except they usually affect just the area being treated. So if someone is getting radiation
around the abdomen, he or she may feel sick or throw up. But people getting radiation
in the area of the neck are less likely to feel sick or throw — but more likely
to get mouth sores.
Tell your doctor if you have any side effects of treatment.
Some people have long-term side effects from cancer treatments. For example, some
cancer treatments can affect fertility.
Your doctor will let you know if your treatment might have long-term side effects
(also called "late effects").
People who have had non-Hodgkin lymphoma need to keep seeing an oncologist for
several years after treatment. Occasionally, cancer may return. Follow-up appointments
with a cancer specialist can help doctors treat it early if it does.
Non-Hodgkin lymphoma can be an aggressive disease. The good news is that treatments
have improved in recent years. Researchers are constantly developing new and better
ways to treat it. Today, most people who have non-Hodgkin lymphoma can be cured.