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Treatment for non-Hodgkin lymphoma

The treatment options for non-Hodgkin lymphoma varies and is dependent on three things:

  • the exact type of B or T-cell lymphoma you have;
  • where it has spread in your body; and
  • how fast it is likely to grow.

Usually, the treatment for lymphomas includes chemotherapy or radiotherapy and surgery. Peripheral blood stem cell transplantation, steroid therapy and biotherapies may also be used.

Low-grade lymphomas (indolent)

Some types of lymphoma are slow growing, relatively symptom free and do not require urgent treatment. These types of lymphoma are known as low-grade (or indolent) lymphomas.

For low-grade lymphomas, your doctor may recommend regular check-ups to carefully monitor your health. If your lymphoma is confined to a small group of lymph nodes, radiotherapy alone may be able to cure some low-grade lymphomas or keep them under control for a long time.

If a low-grade lymphoma is more widespread, the decision to start treatment or not depends on where the lymphoma has spread to. In some instances, chemotherapy is given, either in tablet form or intravenously, which is usually highly effective.

Intermediate and high-grade lymphomas

Intermediate-grade and high-grade lymphomas are fast growing and require treatment upon diagnosis. Chemotherapy is the main form of treatment and is usually combined with rituximab in B-cell lymphomas to give the best results. If the lymphoma responds well to chemotherapy, they can sometimes be cured.

Chemotherapy uses drugs to kill or slow the growth of cancer cells while doing the least possible damage to healthy cells. Chemotherapy is given through a liquid drip into a vein (intravenously), an injection into a muscle or as tablets. You will probably have chemotherapy as a course of several sessions (cycles) over approximately 6 months. Your cancer specialist will explain your treatment schedule.

Improved results in treating non-Hodgkin lymphoma have been achieved by combining chemotherapy with monoclonal antibody therapy which is specifically designed to target lymphoma cells. Once antibodies bind to these cells, a patient’s own immune system is then able to recognise lymphoma cells as foreign and kill them.

Side effects of chemotherapy

People react to chemotherapy differently – some people have few side effects, while others have many. The side effects depend on the drugs used and the dose. Your cancer specialist or nurse will discuss the likely side effects with you, including how they can be prevented or controlled with medicine.

Common side effects include fatigue; changes in appetite, taste and smell; constipation or diarrhoea; mouth sores and ulcers; and hair loss.

Keep a record of the doses and names of your chemotherapy drugs handy. This will save time if you become ill and need to visit the emergency department.

During chemotherapy, you will have a higher risk of getting an infection or bleeding. If you have a temperature over 38°C, contact your doctor or go to the emergency department. Tell your doctor if you feel more tired than usual, or if you bruise or bleed easily.

Download our booklet ‘Understanding Chemotherapy’

Download our fact sheet ‘Understanding Targeted Therapy’

Also known as radiotherapy, this treatment uses a controlled dose of radiation, such as focused x-ray beams, to kill or damage cancer cells.   The treatment is carefully planned to do as little harm as possible to your normal body tissue near the cancer.

Radiation therapy is usually given in small doses (also known as fractions) over a few weeks in the radiotherapy department of a hospital.

During treatment, you will lie on a treatment table under a machine called a linear accelerator. Each treatment takes only a few minutes, but a session may last 10–20 minutes because of the time it takes to set up the machine.

Side effects of radiation therapy

The side effects of radiation therapy vary. Most are temporary and disappear a few weeks or months after treatment.

Common side effects include fatigue; skin reaction (redness, dry or itchy) in the treatment area; mouth problems and local hair loss. Radiation therapy can cause the skin or internal tissue to become less stretchy and harden (fibrosis).

Download our booklet ‘Understanding Radiation Therapy’

This information is reviewed by

This information was written and last reviewed in September 2020 by Cancer Council SA's experienced information team with support from national Cancer Council publications.