Treatment Options

Chemotherapy and radiation are the most common treatments for lymphoma, and they are the place where almost all patients start. Many people with lymphoma are cured by one of these treatments or a combination of the two. Depending on your unique situation, your doctor may suggest any of several other treatments, including the very latest experimental treatments being studied.

Non-Hodgkin's lymphoma is divided into subtypes based on the specific type of cell affected, the level of maturity reached by the cells, their appearance under a microscope, or the way they grow. The subtype sometimes helps doctors decide which treatments are most likely to be effective. Non-Hodgkin's lymphoma is divided into two main subcategories:

• Indolent non-Hodgkin's lymphoma, which tends to grow slowly and cause fewer symptoms.
• Aggressive non-Hodgkin's lymphoma, which tends to grow and spread quickly, and causes severe symptoms.

Doctors may also specify whether your lymphoma is contiguous (lymph nodes affected by cancer are next to each other) or noncontiguous (lymph nodes affected by cancer are not next to each other but are on the same side of the diaphragm, the muscle that divides the chest from the abdomen).

Lymphoma and its treatment in children can be different than the disease and treatment in adults. If you are concerned about a child who has lymphoma, please visit our section on childhood lymphoma [2.1].

Treatment

Treatment for non-Hodgkin's lymphoma depends on these factors:

• The stage of your disease. The type of cells involved.
• Whether your lymphoma is indolent (slower growing, usually with milder symptoms) or aggressive (faster growing, usually with more severe symptoms).
• Your age.
• Your general health.

Usually people with non-Hodgkin's lymphoma are treated with chemotherapy, antibody therapy, radiation therapy, or a combination of these treatments. Doctors usually use surgery for a biopsy to establish a diagnosis. People whose disease is not cured with initial treatment and who get recurrent lymphoma may also have a bone-marrow transplant or use chemotherapy or biologic therapies or other new treatments being studied.

If you have slow-growing (also called “indolent” or “low-grade”) lymphoma and have no symptoms, your doctor may recommend “watchful waiting.” This means closely monitoring your health for any changes. During watchful waiting, patients do not receive treatments such as chemotherapy or radiation therapy. Studies have shown that an initial period of watchful waiting does not compromise overall survival for patients with indolent lymphomas. Watchful waiting is not appropriate for patients with aggressive non-Hodgkin's lymphoma, who should always be treated promptly.

The five-year survival rate for non-Hodgkin's lymphoma is about 60 percent. About one-third of patients are permanently cured with currently available treatments.

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