What is non-Hodgkin lymphoma (NHL)?

Non-Hodgkin lymphoma (NHL) is a cancer of the lymphatic system

NHL usually starts in the lymph nodes. Different areas of lymph nodes around the body may be affected.  We have more information about how lymphoma develops.

Some types of NHL grow very slowly and may not need treatment for months or years. Other types grow quickly and need treatment soon after diagnosis. 

NHL is the sixth most common cancer in the UK. Around 14,000 people are diagnosed with it each year. It can affect people at any age but is more common as people get older.  Most people diagnosed with NHL are over 55.

We also have information about another type of lymphoma called Hodgkin lymphoma.

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Symptoms of non-Hodgkin lymphoma (NHL)

The most common symptom of lymphoma is a painless swelling in the lymph nodes in the neck, armpit or groin. 

We have more information about the signs and symptoms of lymphoma.

Causes of non-Hodgkin lymphoma (NHL)

The causes of non-Hodgkin lymphoma are mostly unknown. But some things may increase your risk of developing it. These are called risk factors. 

We have more information about causes and risk factors for NHL.

Diagnosis of non-Hodgkin lymphoma (NHL)

If you have symptoms, you usually start by seeing your GP. If they think your symptoms could be caused by cancer, they may arrange for you to have blood tests or scans. Your doctor will refer you to hospital for tests and for specialist advice and treatment.

If you think you may be pregnant, tell your doctor. Some tests and treatments for lymphoma can be harmful to a baby in the womb. If you are pregnant you usually still have tests and treatment for lymphoma. But it is important to talk to your doctor so they can plan your care safely.

Biopsy for lymphoma

The most common test for diagnosing lymphoma is a biopsy. A doctor will take a sample of tissue from the affected area. The most common place to take a biopsy from is an enlarged lymph node. This is called a lymph node biopsy. You may have all or a part of the lymph node removed. The tissue will be sent to a laboratory for testing. You may also have biopsies taken from other areas of your body.

You can find out more about further tests you may have in our information about non-Hodgkin lymphoma.

Waiting for test results can be difficult. You may find it helpful to talk to your family, friends or specialist nurse.

Further tests for lymphoma

You will have more tests before you start treatment for lymphoma. Some tests help to show the stage of the lymphoma.

You may have other tests, such as blood tests or x-rays to check your general health and how well your heart, lungs, liver and kidneys are working.

For example, your doctor will do blood tests to check the levels of different blood cells in your blood. They may also talk to you about having blood tests to check for certain viruses, such as HIV and hepatitis. 

You may have some of the following tests.

  • CT scan

    A CT scan makes a three-dimensional (3D) picture of the inside of the body using x-rays taken by the CT scanner.

  • Ultrasound

    An ultrasound uses sound waves to build up a picture of internal organs. It can be used to guide a biopsy. The scan helps to guide them to the exact area.

  • PET-CT scan

    A PET-CT scan uses low-dose radiation to check the activity of cells in different parts of the body. It is sometimes given together with a CT scan. This is called a PET-CT scan.

  • MRI scan

    An MRI scan uses magnetism to build up a detailed picture of areas of your body.

  • Bone marrow sample

    A small sample of bone marrow is taken from the back of the hip bone (pelvis). The sample is sent to a laboratory to be checked for abnormal cells.

  • Lumbar puncture

    In some types of non-Hodgkin lymphoma, the lymphoma cells may get into this fluid. A lumbar puncture takes a sample of the fluid that surrounds the brain and spinal cord.

Waiting for test results can be a difficult time, we have more information that can help.

Types of non-Hodgkin lymphoma (NHL)

There are many different types of NHL. Your doctors need to know which type you have so they can give you the best treatment.

We have more information about the different types of NHL.

Stage and grade of non-Hodgkin lymphoma (NHL)

The results of your tests help your doctors find out how many areas of the body are affected by lymphoma and where these areas are. This is called staging.

Lymphomas are also grouped as either low-grade or high-grade.

We have more information about staging and grading of non-Hodgkin lymphoma.

Treatment for non-Hodgkin lymphoma (NHL)

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

There are different types of treatment for NHL. You may need just one type of treatment or a combination of treatments.

Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.

Treating lymphoma will depend on:

Types of treatment you may have include:

  • Watch and wait

    During watch and wait, you do not need to start treatment straight away. Instead, you have regular tests and appointments to monitor the lymphoma and check for signs that you need to start treatment.

  • Chemotherapy

    Chemotherapy is often used to treat lymphoma. It uses anti-cancer (cytotoxic) drugs to destroy lymphoma cells. You can have chemotherapy with steroids and targeted therapy drugs.

  • Steroids

    Steroids are drugs given with chemotherapy to help treat lymphoma.

  • Targeted therapies

    Targeted therapies target specific proteins on cells and also encourage the body’s immune system to attack and destroy lymphoma cells. They are given with chemotherapy (called chemoimmunotherapy) or on their own.

  • Radiotherapy

    Radiotherapy treats cancer by using high-energy rays that destroy cancer cells, while doing as little harm as possible to normal cells. It may be used as the only treatment if you have early stage low grade NHL.

  • Stem cell transplant

    Some people may have a stem cell transplant. A stem cell transplant is an intensive treatment, so it is not suitable for everyone. You may have a transplant using:

We have more information about treating non-Hodgkin lymphoma.

You may have some treatments as part of a clinical trial.

After non-Hodgkin lymphoma (NHL) treatment

You will have regular follow-up appointments after your treatment. You can talk to your doctor or nurse about any concerns you may have at these appointments. Your doctor will want to know how you are feeling, and to check you are recovering from any side effects of treatment.

Late effects

Sometimes side effects may continue or develop months or years after treatment. These are called late effects. We have more information about long-term and late effects of treatment for lymphoma.

Sex life and fertility

Cancer and its treatment can sometimes affect your sex life. There ways to improve your sexual well-being and to manage any problems.

Treatment for lymphoma may affect your fertility. If you are worried about your fertility it is important to talk with your doctor before you start treatment. We have more information about:

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.

Getting support

Everyone has their own way of dealing with illness and the different emotions they experience. You may find it helpful to talk things over with family and friends or your doctor or nurse.

Macmillan is also here to support you. If you would like to talk, you can:

The organisations below also offer information and support:

  • Blood Cancer UK

    Blood Cancer UK offers support and information to people affected by blood cancers, including lymphoma.

  • Lymphoma Action

    Lymphoma Action gives emotional support, advice and information for people with Hodgkin lymphoma or non-Hodgkin lymphoma and those close to them. It has a national network of people with lymphoma, as well as local groups. Their website has a section called trialslink where you can see information about lymphoma clinical trials.

About our information

  • References

    Below is a sample of the sources used in our non-Hodgkin lymphoma (NHL) information. If you would like more information about the sources we use, please contact us at  cancerinformationteam@macmillan.org.uk

    National Institute of Health and Care Excellence (NICE). Blood and bone marrow cancers. NICE Pathways. Last accessed 3 December 2020.

    Non-Hodgkin’s lymphoma: diagnosis and management; NICE Guideline (July 2016).

    Newly Diagnosed and Relapsed Follicular Lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up; European Society for Medical Oncology (2020).

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Rajnish Gupta, Macmillan Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Reviewed: 01 March 2021
Reviewed: 01/03/2021
Next review: 01 March 2024
Next review: 01/03/2024