What are the symptoms?
The symptoms of aggressive non-Hodgkin’s lymphoma (NHL) often develop quite quickly and people commonly go to see their doctor about them at an early stage of the disease.
The most common symptom of NHL is a painless swelling in the neck, armpit or groin. Many other symptoms often occur, including feelings of being generally unwell. However, each of the common symptoms of NHL can also be explained by other possible causes. That is why you would have had diagnostic tests to help your doctors confirm your diagnosis of aggressive NHL.
Swellings
The swellings or tumours caused by 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 (cancerous lymphocytes) collecting in the lymph nodes (or glands).
The lymph nodes also swell up when people have a normal cold or infection. So it is important to remember that not everyone with swollen lymph nodes will 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 can depend on where the swellings have formed. For example, chest pain and shortness of breath may happen if the lymph nodes in a gland called the thymus contain a lymphoma. 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 is in another part of the body, outside the lymph nodes. For example, lymphoma in the stomach or intestines might cause abdominal pain, indigestion or diarrhoea.
Tiredness, drenching night sweats and loss of appetite
The white blood cells (lymphocytes) that are affected by non-Hodgkin’s lymphoma are an important part of the immune system – the body’s natural defence against infection. So some 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'.