Primary mediastinal large B-cell lymphoma (PMBCL)

The symptoms of PMBCL are usually caused by the lymphoma pressing on other structures in the chest. This can cause:

• a cough
• aching in the chest
• breathlessness
• a hoarse voice
• swelling in the neck, arm or face or swollen veins in these areas
• dizziness
• headaches that are worse when bending forward.

Some of these symptoms can be caused by pressure on a large vein in the chest. This vein is called the superior vena cava (SVC). Pressure on the SVC can slow blood flow. This is called superior vena cava obstruction (SVCO).

PMBCL may also cause the following 3 symptoms:

• drenching night sweats
• unexplained high temperatures
• unexplained weight loss.

These are called B symptoms. Along with staging and grading (below), B symptoms can help your cancer team understand:

• how the lymphoma might develop
• which treatments might help.

A change in how you feel or how your body works can be caused by conditions other than PMBCL. But always ask your GP to check any ongoing, new or unexplained symptoms. We are also here if you need someone to talk to. You can:

• call the Macmillan Support Line for free on 0808 808 00 00, 7 days a week, 8am to 8pm.
• chat to our specialists online.

If you have symptoms that worry you, you should begin by going to your GP. They will examine you. If they think cancer may be causing your symptoms, they will refer you to a specialist doctor at a hospital.

The most important test for diagnosing lymphoma is a biopsy. This means testing a small piece of tissue or a sample of cells from an affected area of your body.

Find out more about having a biopsy and other tests in our general lymphoma information.

Waiting for test results

Waiting for test results can be a difficult time. It may take up to 2 weeks for the results to be ready.

You may find it helpful to talk with your partner, your family or a close friend. Your specialist nurse can also provide support.

You can talk to one of our cancer support specialists for free on 0808 808 00 00, 7 days a week, 8am to 8pm.

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

After the MDT meeting, you will usually meet with your cancer doctor and specialist nurse. They will explain the different treatment options and possible side effects. They will also talk to you about things to consider when making treatment decisions.

Your treatment options will depend on:

• the stage of the lymphoma
• your general health
• your preferences.

PMBCL is fast-growing and needs to be treated quickly. The aim of treatment is to get rid of all signs of the lymphoma and to cure you.

You may only need one type of treatment. Or you may need a combination of treatments.

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

The most common treatments for PMBCL are:

People often have many different feelings during and after PMBCL treatment. If you have finished treatment, you may feel relieved it has ended but worried about what might happen in the future.

It is important to know where to get support or information if you need it. People often need support even some time after PMBCL treatment. But sometimes it is difficult to know who to ask for help.

You can:

• ask your GP or someone from your cancer team for advice about support in your area
• find cancer support services near you
• call the Macmillan Support Line for free on 0808 808 00 00.
• chat to our cancer information specialists online.
• visit our non-Hodgkin lymphoma forum to talk to people who have been affected by lymphoma, share your experience, and ask your questions.

You may also find the HOPE programme helpful. The programme is a free 6 week self-management course designed to help you develop techniques and strategies when living with or after cancer. Topics include goal setting, fatigue management, and wellbeing.

You can sign up for the online HOPE programme. Or to find out more about face to face programmes in your area, email ServiceOpsSupport@macmillan.org.uk

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

• Lymphoma Action provides high quality information and support for people affected by lymphoma. It provides helpline services and a range of peer support including online support meetings, educational events and webinars. Its website includes TrialsLink, a database of lymphoma clinical trials.

We know cancer can affect you physically, emotionally and financially. We have information and advice about different ways cancer might impact you, such as help with:

• eating problems and your appetite
• fertility
• how you're feeling
• improving your sexual well-being
• managing pain and discomfort
• money and work
• tiredness (fatigue)
• trouble sleeping
• uncertainty
• walking and mobility problems.