Non-Hodgkin lymphoma (NHL) is one of the main broad categories of lymphoma. NHL consists of several types of cancer and can cause a variety of signs and symptoms, some of which can also be caused by other conditions. If you are experiencing symptoms associated with NHL, it is important to communicate with your health care provider as soon as possible to explore a possible diagnosis.
NHL arises from abnormal growth of lymphocytes (white blood cells). Lymphocytes play an important role in the immune system and are located throughout the lymphatic system, which includes tissues such as the lymph nodes, spleen, gastrointestinal tract, and bone marrow. Although NHL primarily forms in the lymph nodes, it may also arise in other lymphatic tissues and frequently spreads to the bone marrow or blood.
Although the terms are often used interchangeably, “signs” and “symptoms” refer to different aspects of a condition. Symptoms are experienced by the affected person and cannot be outwardly observed. Headache and fatigue are examples of symptoms, and you’d need to report them to your health care provider. In contrast, a sign can be observed or measured, such as a rash or a low blood cell count.
Many common symptoms of NHL are systemic, meaning they cause an effect throughout the body. Systemic symptoms are typically experienced with aggressive, fast-growing NHL subtypes such as diffuse large B-cell lymphoma, Burkitt lymphoma, and mantle cell lymphoma.
B symptoms are symptoms commonly experienced across many forms of lymphoma. These symptoms include:
Any B symptoms should be reported promptly to your health care provider because they are linked with more advanced disease and a poorer outlook (prognosis).
People with NHL often feel persistent fatigue, which may be caused by anemia (low red blood cell counts). Red blood cells are responsible for transporting oxygen throughout the body. Lymphoma can reduce the number of healthy red blood cells, which leads to low oxygen levels and fatigue, shortness of breath, or weakness.
A doctor can order a complete blood cell count (CBC) to measure whether red blood cell levels are an underlying cause of fatigue and another indicator of lymphoma.
Learn more about causes and treatments of fatigue in lymphoma.
Platelets, another type of blood cell, are responsible for helping the body repair an injury. NHL can lead to low levels of platelets, which can cause a person to bruise very easily or bleed profusely when cut. A CBC can also measure platelet levels.
NHL may also cause low levels of white blood cells, weakening the immune system so that a person gets sick more easily. A CBC can detect low levels of white blood cells in the body.
Unlike systemic symptoms, local symptoms affect particular parts of the body. Many local symptoms are associated with NHL subtypes that affect a specific organ and may be aggressive or indolent (slow-growing) forms of lymphoma.
NHL typically involves abnormal growth of cancer cells in the lymph nodes, often leading to painless swelling. Swollen lymph nodes are the most common localized symptom of NHL. Doctors can often feel them during physical exams, usually in regions like the groin, neck, or armpits. Imaging technologies such as a CT scan can help health care providers visualize enlarged lymph nodes that cannot be felt from outside the body.
Certain infections can also cause swollen lymph nodes, so people experiencing this symptom are often screened for a viral infection when they’re being assessed for NHL.
Some forms of lymphoma affect the skin, resulting in an itchy rash, bumps, or other types of lesions. These skin symptoms are most commonly associated with a form of NHL called cutaneous T-cell lymphoma.
Some cases of NHL — such as in primary mediastinal B-cell lymphoma — may form masses in the chest. As a result, a person may experience symptoms such as chest pain or trouble breathing. In severe cases, the mass may be associated with superior vena cava syndrome, a condition that affects a large vein called the superior vena cava. The cancerous mass can put pressure on the vein, leading to facial swelling.
When NHL forms in the spleen or liver, these organs can become enlarged. This can cause a person to feel full (even when their stomach is empty). It can also lead to generalized symptoms such as bloating or loss of appetite. Additionally, NHL can affect the gastrointestinal tract, resulting in abdominal discomfort and nausea.
In rare instances, NHL can spread to the brain or spinal cord, affecting the central nervous system. People may experience various neurological (nerve-related) problems such as seizures, lack of coordination or sensation, or trouble focusing.
NHL can also lead to psychological problems. Anxiety and depression are common among people living with NHL. These symptoms may be a response to the diagnosis itself or to physical symptoms that greatly affect quality of life. Some cancer treatments also have side effects that can affect mood.
Although NHL can take a toll on a person’s physical and mental well-being, there are ways to help manage symptoms. Be sure to report any symptoms as soon as possible to your doctor, who can make a diagnosis and recommend the best treatment options based on your symptoms. If you have NHL, your doctor may also prescribe pain medication or suggest lifestyle changes, such as maintaining a healthy diet, to boost quality of life while living with NHL.
For those living with NHL who experience depression, managing it may improve disease outcomes. Treatment options for depression include medications and psychotherapy. Building a network of family, friends, support groups, and online communities can help you cope with the emotional challenges of cancer.
MyLymphomaTeam is the social network for people with lymphoma and their loved ones. On MyLymphomaTeam, members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.
Are you or a loved one living with non-Hodgkin lymphoma? What signs or symptoms are you experiencing? Share your story in the comments below, or start a conversation by posting on MyLymphomaTeam.