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What are the symptoms?

The most common symptom of non-Hodgkin’s lymphoma (NHL) is a painless swelling in the neck, armpit or groin. Many other symptoms often occur, including feelings of being generally unwell. But all the symptoms of NHL can be put down to other causes. Using tests to confirm the diagnosis is therefore very important when the doctor is deciding whether you have NHL.

Swellings

The swellings, or tumours, that are caused by white blood cells (lymphocytes) in non-Hodgkin’s lymphoma (NHL) are known as lymphomas. They are often first noticed in the neck, collarbone region, armpits or groin. They are caused by affected white blood cells collecting in the lymph nodes (or glands).

The lymph nodes also swell up when people just have a normal cold or infection. So it is important to remember that swollen lymph nodes alone do not necessarily mean you have lymphoma. The swelling will go down when the infection is over.

The difference with NHL is that the swelling goes on for much longer. Doctors
sometimes call this lymphadenopathy.

Cough, chest pain or shortness of breath

Many symptoms of non-Hodgkin’s lymphoma (NHL) can depend on where the swellings have formed. For example, chest pain and shortness of breath may happen if the lymph nodes behind the sternum, in a gland called the thymus, contain a swelling. This gland is near the heart and it may swell up and press on the heart causing chest pain, or on the windpipe causing shortness of breath.

Completely different symptoms can occur if the swelling forms in lymph nodes or in another part of the body, outside the lymph nodes. For example, swellings in the stomach or intestines might cause abdominal pain, indigestion or diarrhoea.

Drenching night sweats, tiredness and loss of appetite

The white blood cells (lymphocytes) that are affected by non-Hodgkin’s lymphoma (NHL) are an important part of the immune system – the body’s natural defence against infection. Some of your symptoms happen because your immune system is not functioning properly and your body is finding it harder than normal to fight off infections caused by viruses or bacteria. These include tiredness, drenching night sweats and loss of appetite.

Feeling generally unwell

Feeling unwell is also common when you have non-Hodgkin’s lymphoma (NHL). And many of the specific symptoms of NHL can be thought of as general feelings of illness. These include:

  • Recurrent or persistent, unexplained fevers (with body temperature over 38°C)
  • Night sweats, which may drench nightclothes and sheets
  • Unintended weight loss (defined as losing more than 10% of the body weight in 6 months)
  • Severe and persistent fatigue or tiredness
  • Decreased appetite 

Other general symptoms that people with NHL may experience include:

  • Breathlessness or cough
  • Itchiness that is persistent and may be felt all over the body
  • The first three of these symptoms – fevers, night sweats and weight loss – are often used in the staging of NHL and are sometimes called 'B symptoms'.


The B symptoms - fevers, night sweats and weight loss -  are important for staging NHL
Find out more about the diagnosis and staging of NHL

Indolent non-Hodgkin’s lymphoma

  • Treatment might not be needed straight away and it could be better to wait for symptoms to develop before you start treatment – known as ‘Watch and wait’
  •  If you have advanced-stage NHL and you are having symptoms, you will usually receive an initial induction treatment made up of immunotherapy and chemotherapy
  • Continuing the immunotherapy on its own after the initial induction treatment has finished, through what is called a maintenance course, is being investigated as a treatment option for newly diagnosed patients in Europe. This treatment pathway is already approved for newly diagnosed patients in some countries such as Canada, and is also approved as an option for patients whose symptoms have returned after treatment (relapsed) in most countries
  • Complete or partial remission - disappearance of symptoms - can often be achieved through treatment
  • Symptoms may return and need more treatment, but patients can often live normal lives for many years

 

Find out about indolent non-Hodgkin’s lymphoma

Aggressive non-Hodgkin’s lymphoma

  • Treatment is usually needed straight away
  • Normally requires a combination of immunotherapy and chemotherapy
  • Radiotherapy can sometimes be given to specific sites after chemotherapy
  • Remission is likely, with the possibility of cure in the majority of cases

 

Aggressive non-Hodgkin’s lymphoma


Not sure which type of non-Hodgkin’s lymphoma you have? Follow our test

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8 common symptomsof non-Hodgkin’s lymphoma

Painless swellings in the neck, armpits or groin

Unexplained recurrent or persistent fevers

Drenching night sweats

Weight loss

Tiredness

Loss of appetite

Persistent itching all over the body

Breathlessness or cough