Staging and prognosis for non-Hodgkin lymphoma
Tests help show how far non-Hodgkin lymphoma has spread. This process is called staging and it helps your health care team recommend the best treatment for you.
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Staging is a way of describing how far non-Hodgkin lymphoma has spread throughout the body.
Knowing the stage helps your doctor work out the best treatment for you. Your doctor can explain your stage to you.
As well as a number, each stage is given a letter according to whether you are experiencing specific symptoms:
- “A” means you feel well, with none of the B symptoms of non-Hodgkin lymphoma.
- “B” means you have some or all of these symptoms – unexplained fevers, unexplained weight loss or drenching night sweats.
Stages of non-Hodgkin lymphoma
|stage I||One lymph node area is affected. This is either above or below the diaphragm.|
|stage II||Two or more lymph node areas are affected on the same side of the diaphragm.|
|stage III||Lymph node areas both above and below the diaphragm are affected.|
|stage IV||Lymphoma is in multiple lymph nodes and has spread to other parts of the body (e.g. bone marrow, liver, lungs).|
Doctors also give non-Hodgkin lymphoma a grade, which describes how quickly the lymphoma is likely to grow and spread. The two grades of non-Hodgkin lymphoma are low-grade and high-grade, and they are treated in slightly different ways.
Grades of non-Hodgkin lymphoma
|Doctors may call this indolent lymphoma. It may cause few symptoms in the beginning because there is little change in the cancer over time. It often doesn’t need to be treated straightaway. Follicular lymphoma is the most common type of low-grade lymphoma.|
grade and high-grade (fast-growing)
|Doctors may also call this aggressive lymphoma. It grows much faster than low-grade non-Hodgkin lymphoma and needs to be treated as soon as possible to have the best chance of destroying the cancer and causing remission. Diffuse large B-cell lymphoma is a common high-grade lymphoma.|
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Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your haematologist (or medical oncologist if they are your main treating specialist).
However, it is not possible for anyone to predict the exact course of your disease. Instead, your doctor can give you an idea about common issues that affect people with your type of non-Hodgkin lymphoma.
Important factors in assessing your prognosis include:
- your test results
- the type of non-Hodgkin lymphoma you have
- the stage
- the rate and depth of tumour growth
- the likelihood of response to treatment
- other factors such as your age, level of fitness and medical history.
You will also have tests throughout your treatment that show how well the treatment is working.
Most people who are treated for non-Hodgkin lymphoma go into remission after treatment. Remission means the symptoms of cancer have decreased or disappeared and there is no evidence of disease on physical examination or imaging tests. During remission, you will need regular check-ups to ensure that you are still healthy and the cancer hasn’t returned.
People may experience multiple episodes (recurrences) of the disease during their lifetime, meaning they go in and out of remission.
For more on treatment for recurrence see If Non-Hodgkin Lymphoma Returns.
Download a PDF booklet on this topic.
Dr Ian Bilmon, Haematologist, Westmead and Sydney Adventist Hospitals; Dr Anne Capp, Radiation Oncologist, Calvary Mater Newcastle; Rachelle Frith, Clinical Nurse Consultant Haematology, Prince of Wales Hospital; Jason Gardner, Consumer; A/Prof Angela Hong, Radiation Oncologist, Chris O’Brien Lifehouse, and Clinical Professor, The University of Sydney; Yvonne King, 13 11 20 Consultant, Cancer Council NSW; Samantha Rennie, Social Worker, Cancer Services, St George Hospital. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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