Lymphoma Treatment

Macmillan Cancer Support

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT). Your doctor or cancer specialist nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.

The treatment you have will depend on:

  • the type and stage of the lymphoma
  • its grade (if you have non-Hodgkin lymphoma)
  • the symptoms you have
  • which parts of your body are affected
  • your general health
  • your preferences.

Treating Hodgkin lymphoma

The main treatments for Hodgkin lymphoma are chemotherapy and radiotherapy. Some people only need one of these treatments. Others may have both.

Treating classical Hodgkin lymphoma

If you have early-stage classical Hodgkin lymphoma, you usually have chemotherapy and sometimes steroids, followed by radiotherapy. If the lymphoma is more advanced, chemotherapy is usually the main treatment but you may also have radiotherapy.

If the lymphoma is more advanced, chemotherapy is usually the main treatment. You may also have radiotherapy if there is any lymphoma left after chemotherapy. Radiotherapy may also be given if an area of lymphoma was large (bulky) at diagnosis.

Most people will not need any further treatment to get rid of the lymphoma. However, sometimes lymphoma comes back or there may still be signs of it after treatment. If this happens you might need more treatment.

Treating nodular lymphocyte predominant Hodgkin lymphoma (NLPHL)

If you have nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), your doctor may suggest you delay having treatment. Instead, you have regular appointments and tests to monitor the lymphoma. This is called watch and wait. If you start treatment, you may have radiotherapy or chemotherapy. Some people have both.  Other people will have a targeted therapy.

Rarely, NLPHL can change into a type of non-Hodgkin lymphoma. If this happens, you will have treatments for non-Hodgkin lymphoma instead.

Treating Non-Hodgkin lymphoma (NHL)

Treatment for non-Hodgkin lymphoma (NHL) depends on the type and stage of the lymphoma you have. Chemotherapy is the most common treatment for NHL.

Treating low-grade non-Hodgkin lymphoma (NHL)

If you have low-grade NHL you do not always need to start treatment straight away. This is because it usually grows slowly. Instead, you will be monitored for signs that you need to start treatment. This is called watch and wait.

The most common treatment for early stage (stage 1 or 2), low-grade NHL is radiotherapy. It is given to the affected lymph nodes and can usually make the lymphoma disappear completely. Some people are cured after radiotherapy alone.

If radiotherapy is not suitable for you, your treatment options will be the same as those used for advanced lymphoma.

Most people with low-grade NHL have advanced stage lymphoma (stage 3 or 4). Your treatment will depend on whether you have symptoms or not. Some people with stage 1 or 2 lymphoma may be treated as advanced stage.

Treatment aims to control the lymphoma rather than cure it. It is often very successful at shrinking the lymphoma. You will feel well and will not have any symptoms. This is called remission.

Remission may last years. After a period of remission, the lymphoma eventually comes back. But with more treatment, it often shrinks back down again and  you have another period of remission. This means the lymphoma can be controlled for a long time. Most people have a good quality of life between courses of treatment.

Treating high-grade non-Hodgkin lymphoma (NHL)

High-grade lymphoma is usually fast-growing and needs to be treated straightaway. The aim is to make the lymphoma disappear completely. This is called complete remission. The most commonly used treatments are:

  • chemotherapy and steroids.
  • a combination of chemotherapy and a targeted and immunotherapy drug, such as rituximab (chemoimmunotherapy) and steroids.

Treatment can often shrink high-grade lymphoma very quickly. Sometimes, radiotherapy is given after chemotherapy. This is usually if the lymphoma was only in one area of the body. It may also be used if the lymph nodes were very enlarged (bulky) before you had chemotherapy.

Many people with high-grade NHL are cured. But if the lymphoma does not completely respond to treatment your doctor may talk to you about having more intensive treatment. This may involve high-dose chemotherapy with a stem cell transplant using your own or a donor's stem cells. 

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