Patient information from BMJ

Non-Hodgkin lymphoma

Last published:Jun 24, 2025

Non-Hodgkin’s lymphoma is a type of cancer. It’s worrying to learn that you have any type of cancer. But there are good treatments for non-Hodgkin lymphoma, which can often lead to a cure.

This information is about the most common type of non-Hodgkin lymphoma, called diffuse large B-cell lymphoma. You can use this information to talk to your doctor and decide which treatments are best for you. 

What is non-Hodgkin lymphoma?

Non-Hodgkin lymphoma is a type of cancer that affects cells in your immune system.

When your body's cells are healthy, they divide, grow, and are replaced in an orderly way. When cells become cancerous, they grow too fast and do not develop properly. Abnormal cells form a lump called a tumor, which gets bigger over time.

Lymphocytes are a type of white blood cell, which help your body fight infection. In non-Hodgkin lymphoma, the lymphocyte cells become abnormal and may start to build up in lymph nodes. Lymph nodes are small glands that occur naturally throughout your body. They are an important part of your immune system.

Sometimes the tumors in non-Hodgkin lymphoma grow outside the lymph nodes. For example, they can grow in the stomach, bowels, and brain.

It’s not clear why some people get non-Hodgkin lymphoma. However, we do know that it's more common in:

• people over the age of 50

• males

• people who have a parent or sibling who had this cancer

• people who have problems with their immune system (e.g., in people with HIV, or in people who have had an organ transplant)

• people who have had a previous viral or bacterial infection (e.g., Epstein-Barr virus or Helicobacter pylori).

There are more than 30 types of non-Hodgkin lymphoma. The information here is for adults with diffuse large B-cell lymphoma. If you are unsure what type of lymphoma you have, ask your doctor.

What are the symptoms of non-Hodgkin lymphoma?

The most common symptom is being able to feel one or more lumps in your neck, armpit, groin, or abdomen, or in your testicles if you're a man.

Some lumps get very big and grow fast, but others grow more slowly.

Some people get more general symptoms. These include:

• feeling very tired

• having a fever that makes you sweat badly at night

• losing your appetite, and

• losing weight.

Lymphomas can also cause other symptoms depending on where they grow. For example:

• if a lymphoma blocks your bowel, this can cause pain, nausea, and vomiting

• a lymphoma in the lungs can cause difficulty breathing

• if a lymphoma develops in your brain, you could get seizures or become forgetful and confused. 

If your symptoms suggest that you might have non-Hodgkin lymphoma, your doctor will carry out some tests. These will include blood tests, scans (normally a PET-CT scan), and a biopsy.

A biopsy is where a surgeon removes a piece of tissue from the affected area to test it for cancer cells. People often have a lymph node (or part of a lymph node) removed for testing.

Your doctor might discuss with you what "stage" your cancer is at. This means how far your cancer has spread. For example, stage 1 and 2 cancers might only be in a small area, while stage 3 and 4 cancers are likely to have spread further. Later-stage cancers are harder to treat. 

What are the treatment options for non-Hodgkin lymphoma?

Chemotherapy is the main treatment for diffuse large B-cell non-Hodgkin lymphoma. You might also have radiation therapy.

You will be treated by a specialist cancer doctor.

Chemotherapy

Chemotherapy is a treatment that kills cancer cells. The type of chemotherapy most often used for diffuse large B-cell lymphoma is a combination of medicines, called R-CHOP. It is a combination of five medicines.

If you have stage 3 or 4 cancer, you may be given a different type of chemotherapy combination. 

You have chemotherapy in cycles, which usually last for 21 days. For each cycle you will have treatment, followed by a rest period with no treatment. This gives your body time to recover.

You will have between 2 and 4 cycles to begin with. Depending on how you respond to the treatment, you might have a further 4-6 cycles. The exact number and duration of these cycles will depend on the nature of your cancer and what other treatments you have (e.g., you may have fewer cycles if you also have radiation therapy). 

Chemotherapy will probably shrink your tumor and can cure it. Even if your cancer does not go away completely, chemotherapy can help you live longer.

You are likely to get some temporary side effects from these treatments, but you probably won't get all of them. The most common side effects from chemotherapy include:

• losing some or all of your hair

• nausea and vomiting

• feeling tired

• having low levels of blood cells that help fight infections

• having discomfort when you pass urine.

Most of these side effects can be treated.

It's important that you tell your doctor if you have symptoms of a possible infection, such as a fever, chills, stomach pain, pain when urinating, or a cough.

Chemotherapy can also sometimes cause bleeding. You should let your doctor know if you have black stools (which suggests there is blood in your stools), or bleeding from your rectum, nose, gums, or (if you are a woman) vagina.

Additional medicines

Sometimes doctors recommend taking other medicines along with chemotherapy. These are usually offered to prevent possible problems either from your cancer or from the chemotherapy. Not everyone will need these treatments. You and your doctor will discuss what's right for you. 

• Most people treated with R-CHOP will also have a treatment called a growth factor. R-CHOP kills cancer cells, but it also kills some of your normal cells that help fight infections. Growth factors help your body to make more of these cells. 

• If you end up very low on cells that fight infections, your doctor may recommend taking antibiotics for a while to help prevent infections caused by bacteria.

• Your doctor may also recommend other treatments, including medicines to lower the chance of lymphoma coming back in your brain and spinal cord.

Radiation therapy

Sometimes people have radiation therapy after chemotherapy. Your doctor may recommend this treatment if:

• you have lymphoma in a single area

• the lymphoma is large, or

• some lymphoma may still be remaining at the end of chemotherapy.

Radiation therapy uses high-energy x-rays to kill cancer cells. Each treatment lasts only a few minutes, and you won't feel anything during treatment. Most people need treatment five days a week for several weeks.

Adding radiation therapy to chemotherapy may help get rid of your lymphoma and help you live longer than having chemotherapy alone. But not everyone needs radiation therapy.

The most common short-term side effects include having itchy skin where you have been treated, and feeling tired.

Radiation therapy can also sometimes cause long-term problems. But these aren't common and they depend on the part of your body treated. Your doctor will discuss possible side effects with you.

What happens next?

Cancer affects everyone differently. Statistics show that:[1]

• 8 out of 10 people with stage 1 diffuse large B-cell lymphoma are still living after 5 years

• 6 out of 10 people with stage 4 diffuse large B-cell lymphoma are still living after 5 years

​​Your doctor or nurse may use the word "remission." Being in remission means that treatment has worked and doctors can no longer detect your cancer. You can think of yourself as cured when you have been in remission for five years. 

Like many other cancers, non-Hodgkin lymphoma can come back after treatment. When a cancer comes back it's called having a relapse. No-one can tell you for certain if your lymphoma will come back. 

If your cancer does come back, you can have more treatment. You may need a different type of chemotherapy, or more intense chemotherapy.

You might also need a stem cell or bone marrow transplant, which can help your body recover from intense chemotherapy. Many people who have a relapse can still be cured.