Non-Hodgkin lymphoma, also known as NHL for short, is a rare cancer of the tissue that makes up or surrounds the lymph nodes, among other things. The causes of the disease have not yet been precisely clarified. Since it can occur with very different characteristics, the prognosis and therapy always depend on the individual case.
What is non-Hodgkin lymphoma?
Doctors understand non-Hodgkin lymphoma to be malignant tumors of the so-called lymphatic cells. These are present in various places in the body, including in the lymph nodes and their immediate vicinity.
However, lymphatic cells are also found in the gastrointestinal tract or in the throat. They are responsible for the body’s immune system. If the well-known Hodgkin’s lymphoma can not be detected in the case of a malignant disease of these cells, it is automatically a non-Hodgkin’s lymphoma. See AbbreviationFinder for abbreviations related to NHL.
However, both denote equally malignant tumors. Non-Hodgkin lymphomas are divided into nodal (directly originating from the lymph nodes) and extranodal (not originating from the lymph nodes). After the first local appearance of the tumor, the cancer cells continue to spread through the bloodstream.
The exact causes of non-Hodgkin’s lymphoma have not yet been clearly clarified. However, there are various risk factors that experts say can increase the likelihood of developing NHL. These include infections with certain viruses, such as the Epstein-Barr virus or the HI virus.
Chronic inflammation of the gastric mucosa after a bacterial infection can also lead to an increased risk of NHL. Damage to the genome, for example due to radioactive effects, constant contact with certain chemical agents and long-term smoking can contribute to the development of the disease, as can increasing age. Most NHL patients are 70 years or older.
Typical Symptoms & Signs
Non-Hodgkin’s lymphoma does not initially cause any specific symptoms and therefore often remains undiagnosed. Generalized lymph node swelling is often the only symptom of the malignant disease. Unlike the swelling of the lymph nodes in infectious diseases, the lymph nodes in non-Hodgkin lymphoma are swollen but not painful.
People with non-Hodgkin lymphoma also show an increased tendency and susceptibility to infection. Some of the patients also report diffuse symptoms such as those that can occur with local inflammation or colds. These include loss of appetite, exhaustion and tiredness. These symptoms are caused by anemia.
Some of those affected also lose weight unintentionally. Other symptoms that can occur with non-Hodgkin lymphoma are paleness and generalized itching. Some patients also suffer from night sweats. The expression can be very different. A light and discreet film of sweat can form on the skin, or the bed linen can be completely soaked in sweat.
In addition, night sweats often lead to sleep disorders, since those affected wake up either through sweating or the subsequent feeling of cold. However, all these symptoms are by no means specific to non-Hodgkin lymphoma, but can also occur in other non-cancerous diseases.
Diagnosis & History
In most cases, non-Hodgkin lymphoma is diagnosed by swollen lymph nodes. A tissue sample provides the doctor treating you with reliable information about the presence of the disease. A comprehensive physical examination is then used to determine how far this has progressed.
This includes a blood test, as well as X-rays and ultrasound. How the disease progresses in detail depends largely on how malignant the tumor actually is. If left untreated, NHL can spread through the blood throughout the body, eventually leading to the patient’s death. In the case of an unfavorable course and a so-called highly malignant tumor, the life expectancy is only a few months.
Various complications can occur as a result of non-Hodgkin lymphoma. They show up either directly through the cancer or are side effects of the therapeutic measures. The disease-related consequences of non-Hodgkin lymphoma depend on the spread of the disease and which parts of the body are affected.
It depends on the size and location of the Hodgkin lymphoma how great the pressure is on the adjacent structures and their functions. It is not uncommon for non-Hodgkin lymphoma to have complications from the treatment of the cancer. These are side effects of chemotherapy and radiation therapy.
This increases the risk of Hodgkin’s lymphoma developing into leukemia in the further course. It usually shows up about ten years after starting treatment. Radiation therapy can cause lung cancer, breast cancer, or skin cancer.
Radiation therapy often causes side effects that appear shortly after treatment. These include gastrointestinal problems such as nausea and vomiting, hair loss and skin irritation. Possible long-term consequences are pneumonia, heart inflammation, infertility or an underactive thyroid gland.
In addition to radiotherapy, chemotherapy of non-Hodgkin lymphoma can also trigger complications. Tissues with rapid cell turnover such as skin, mucous membranes and bone marrow are particularly affected. This is noticeable through nausea, vomiting and complete hair loss.
When should you go to the doctor?
When growths appear in the chest, abdomen, neck, neck, and groin, non-Hodgkin lymphoma may be the cause. The person concerned should go to a doctor as soon as possible and have the symptoms clarified. The doctor can diagnose non-Hodgkin’s lymphoma using the typical examination methods and, if necessary, consult other specialists. Persons who have been exposed to large amounts of radiation either professionally or as a result of an accident are particularly at risk.
Contact with chemical substances and infection with certain viruses and bacteria are also risk factors that must be clarified in connection with the symptoms described. If the symptoms occur in connection with immunosuppressive or cytostatic therapy, the doctor responsible should be consulted. The same applies to HIV infections and certain autoimmune diseases such as Sjögren’s syndrome. Depending on the type and severity of the side effects, the general practitioner will involve other doctors, such as orthopaedists, gastroenterologists, dermatologists and ear, nose and throat specialists.
If the illness causes mental problems, the doctor will also refer the patient to a therapist. After the successful treatment of non-Hodgkin’s lymphoma, physiotherapeutic measures are indicated to compensate for any movement disorders and to strengthen the body that has been weakened by chemotherapy. Due to the relatively high risk of recurrences, medical supervision is necessary even after the end of the therapy.
Treatment & Therapy
Once NHL has been diagnosed, the treating physician can initiate appropriate treatment. Exactly what this looks like depends on the exact type of disease and how advanced it is. If the doctor diagnoses a form of NHL that is not aggressive and also progresses slowly, no therapy may be necessary at first, provided the patient has no symptoms.
However, regular monitoring of the state of health is strongly recommended, as this can change quickly and treatment must then be started. A very malignant NHL disease can be coupled with chemotherapy, among other things, and treated with what is known as antibody therapy. In the latter, antibodies are supposed to help the immune system to destroy the cancer cells.
Radioimmunotherapy can also be used to help. If the tumor is localized, it may be possible to surgically remove it before the cancer cells spread further. In most cases, however, chemotherapy or, alternatively, radiation therapy is required to completely remove the cancer.
Even in the case of healing, comprehensive follow-up care should be carried out regularly to prevent a relapse. Non-Hodgkin lymphoma tends to recur even after extensive therapy.
Outlook & Forecast
The prognosis for non-Hodgkin lymphoma is poor. The average life expectancy is reduced despite the best possible medical care given the current status of treatment options. If there is no comprehensive therapy, the lifespan is shortened by one more. The death of the person concerned is then to be expected within a few months.
The patient needs cancer treatment to stop the pathogen from spreading. According to the current scientific standards, a cure for this disease is not possible. It is documented that within a few years another outbreak of the cancer is to be expected, although treatment measures that have already been introduced have been successful. Regular check-ups are therefore necessary in order to be able to start the next cancer therapy immediately at the first signs and irregularities.
In overcoming the disease, patients with a healthy lifestyle and a balanced diet have had the best success to date. In addition to the side effects of cancer therapy, the knowledge that the symptoms will return represents an enormous emotional burden for those affected. Therefore, cooperation with a psychotherapist is advisable for an improved prognosis. Otherwise, the risk of suffering from a mental illness is increased. This in turn has a negative impact on the physical processes and the success of the necessary therapeutic measures.
Since the causes of non-Hodgkin’s lymphoma have not yet been fully clarified and the causes are diverse, prevention in the true sense of the word is not possible. However, risk factors such as smoking can be minimized by changing your lifestyle. If the first signs of NHL disease, such as swollen lymph nodes, are detected, a doctor should be consulted immediately. The earlier the disease is detected, the better the prognosis.
In most cases, those affected with non-Hodgkin’s lymphoma have only very few and usually only limited direct follow-up measures available. This disease is a very rare disease that has not yet been fully researched. Therefore, the affected person should consult a doctor at an early stage so that other complications and further spread of the tumor do not occur.
Most of those affected are dependent on various measures with which the tumor can be removed. During treatment, most of those affected are dependent on the support and care of their own families. Above all, psychological support is very important in order to prevent depression and other mental disorders.
Even after the non-Hodgkin lymphoma has been successfully removed, regular check-ups by a doctor should be carried out in order to identify and remove any other tumors in the body at an early stage. If you wish to have children, a genetic examination and counseling are advisable in order to prevent the disease from reoccurring. Non-Hodgkin lymphoma can also reduce the life expectancy of the affected person in some cases.
You can do that yourself
Non-Hogdkin lymphoma (NHL) is a cancer in which the patient can do a lot in everyday life to improve their general well-being and thus their quality of life. This applies to physical complaints as well as to the mental state. However, if over-the-counter medication or dietary supplements are used, prior consultation with the doctor treating you is strongly recommended.
In the physical area, it is often important to reduce the consequences of therapies such as surgery, chemotherapy and radiation therapy as best as possible. A healthy diet and drinking enough water are just as important as getting enough sleep. In addition, the physical exercises that have been learned in a possibly prescribed physiotherapy can also be continued at home. Strengthening the immune system and avoiding infections are also very important. Sports or at least regular exercise are important here. Infections caused by people in the immediate vicinity who have the flu, a gastrointestinal infection or another contagious disease should be avoided.
In the mental area, patients are often not over the severity of the illness, even if therapies may have long been completed. Self-help groups or discussions with relatives or friends can help here. Socializing is also an important factor: on the one hand because of the quality of life, on the other hand as a distraction from the cancer of non-Hodgkin’s lymphoma.