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How Do I Know If I Have It?

Lymphoma is diagnosed by a tissue biopsy. If you have an enlarged, painless lymph node that your doctor suspects may be due to non-Hodgkin's lymphoma, you will need to have a biopsy of this node. This can be done by cutting into the node to remove a sample of tissue or by removing the entire node. If a biopsy reveals that you do have non-Hodgkin's lymphoma, other tests will be performed to determine the specific cellular form of the disease, as well as to see where the disease has spread. Depending on your specific symptoms and the results from the biopsy, your doctor will probably order some or all of the following:

• Blood tests
• Bone marrow biopsy
• Chest X-ray
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
• Bone scans
• Spinal tap (lumbar puncture)
• PET scan

Tissue samples may be sent to laboratories for sophisticated testing to classify the type of non-Hodgkin's lymphoma based on cell size, cell arrangement, growth patterns, and invasiveness.

These tests will give your doctor important information that can help determine the best type of treatment for your disease. Your doctor will designate a stage that describes the severity and spread of your lymphoma. Stages run from I (very confined disease) to IV (extensive spread).

What Are the Treatments?

Your doctor will base his or her treatment decisions on the characteristics of your malignant cells and the stage of your disease. The goal is to get rid of the cancer cells with as little damage as possible to normal cells, and to minimize side effects of treatment. Talk with your doctor about any side effects you experience.

The most common treatments for non-Hodgkin's lymphoma include chemotherapy drugs, often along with radiation therapy (a focused beam of radiation) to kill cancer cells. New biological agents, such as antibodies that target cancer cells, can also be used.

Because chemotherapy and high-dose radiation kill bone marrow cells responsible for producing red and white blood cells and platelets, your doctor may recommend that you undergo a transplant of your bone marrow or stem cells (master cells that can develop into any of the other types of blood cells). This involves taking normal stem cells or bone marrow from you before you undergo chemotherapy or radiation. The stem cells or bone marrow are frozen and saved, and then returned to your body intravenously (through a needle in your arm) after your treatment.

How Can I Prevent It?

Because most causes of non-Hodgkin's lymphoma are not clearly understood, there are few ways to prevent its development. Researchers are looking into prevention of infections that have been associated with non-Hodgkin's lymphoma, including HIV, HTLV-1, and H. pylori. Avoid exposure to chemicals such as lead, arsenic, pesticides, vinyl chloride, and asbestos. Wear appropriate protective safety equipment on the job and around the house if you will be exposed to these (such as by scraping old lead-based paint or applying weed killer).