There are different types of non-Hodgkin’s lymphoma (NHL). Some are fast-growing, while others grow more slowly. Knowing the signs that it’s time to start treatment is important for managing the condition well.
NHL is a group of cancers that affect the organs and tissues of the lymphatic system. Some types of NHL are aggressive and progress very quickly, and doctors generally recommend starting treatment for these right away. Other types, known as indolent lymphomas, tend to grow or spread very slowly, even without treatment.
Doctors may recommend a “watch and wait” approach called active surveillance before starting treatment for indolent lymphomas. This approach involves monitoring cancer closely using blood tests and physical exams, without prescribing any medications or other treatments. In this way, people avoid potential side effects of treatment until it’s necessary.
In some cases, doctors
Here are 9 signs to be aware of that may help your healthcare team decide it’s time to recommend starting treatment for NHL.
Swelling of one or more lymph nodes is one of the most common and earliest signs of NHL. This swelling is typically painless and generally occurs in lymph nodes of the neck, armpit, or groin. Swollen lymph nodes may feel like a bump under the skin in these areas.
Some lymph nodes may already be swollen at the time of diagnosis. During watchful waiting, your healthcare team will likely be most interested in lymph nodes that are growing or ones that are newly affected.
In some cases, doctors can treat swollen lymph nodes with local radiation without beginning systemic medications. Depending on the size of the lymph node, your doctor may order additional testing, such as imaging or biopsies, to determine whether the cancer is spreading or changing.
Some people with lymphoma develop a high fever. It may come and go over several days or even weeks without any other signs of infection. Night sweats are also common.
These symptoms are known as B symptoms. According to the Leukemia and Lymphoma Society, B symptoms are crucial for understanding the severity and stage of NHL.
Unexplained weight loss is also a possible B symptom of NHL. Small weight fluctuations may not be cause for concern, but you should discuss any significant changes in your weight with a doctor.
According to the American Cancer Society, NHL-related weight loss may involve losing
If lymphoma begins progressing, you may feel very tired. This may be for a variety of reasons, including changes in your blood cell counts.
Anemia is common with lymphoma, and rapid declines in the number of red blood cells in your blood can lead to fatigue or extreme exhaustion.
Decreases in the levels of immune cells within the blood can leave a person more susceptible to infections. As a result, a person may experience more frequent or severe illnesses.
Non-Hodgkin’s lymphoma weakens the immune system, making it harder to fight off infections, which can become more common and severe as the condition progresses.
As lymphoma progresses, it can affect the blood cells responsible for clotting. This can lead to easier, more frequent, or excessive bruising or bleeding.
This occurs because the body’s ability to control bleeding is compromised, making even minor injuries potentially more serious. Monitoring these symptoms is crucial for monitoring NHL and its progression.
If lymph nodes or other lymphatic organs in the chest are affected, the swelling can create pressure within the chest cavity and push against other organs like the windpipe or lungs. This can cause symptoms such as:
- coughing
- difficulty breathing
- chest pressure or pain
Growing lymph nodes can put pressure on abdominal organs, leading to pain or bloating in the belly. The spleen is also part of the lymphatic system and may become swollen if lymphoma is progressing.
Swelling within the abdomen can put pressure on the stomach or intestines, causing symptoms such as:
- loss of appetite
- feelings of fullness after small meals
- nausea or vomiting
Inflammation caused by lymphoma can also affect the skin. Symptoms that suggest lymphoma may be more active include:
- itchiness
- rashes
- skin bumps
In many people with indolent (slow-growing) forms of NHL, doctors can monitor the condition for months or even years before the person begins treatment. It’s important to be aware of symptoms that may indicate lymphoma is progressing. This can help your healthcare team determine when it may be time to recommend starting treatment.
If you experience any of the symptoms in this article while on active surveillance, it’s important to communicate them to your healthcare team right away.
Even if your symptoms are mild, your care team may want to order additional tests to determine whether it may be time to begin treatment.