The treatments for non-Hodgkin lymphoma are effective and improving.  People can live long, productive lives with correct treatment.

Treatment for non-Hodgkin lymphoma has improved significantly in the last decade.  Data from the National Cancer Institute shows that five-year survival rates for the disease jumped from just over 50 percent in the early 1990s to almost 67 percent in 2004.  The Centers for Disease Control (CDC), in a report published in October 2007, says that though the total numbers of cases of NHL are still rising, the rate of increase has slowed down in the last 10 years.  They further state many more patients are experiencing long-term remissions and even cures – the number of deaths due to NHL has actually started to fall. 

There's no recipe for treatment success for each subtype of NHL.  Instead, after doctors zero in on the subtype, growth rate and stage, they work with the patient to formulate a goal of therapy.  Other factors come into play, such as the patient's age and overall health, costs, side effects and quality of life.   

In general, the goal of therapy for a curable form of lymphoma is to aggressively go for the cure, despite the probability of toxicity from treatment in the short term.  The goal for the chronic, indolent forms of lymphoma are more often to control the disease so the patient can live as close to a normal life as possible. 

Watchful waiting may be entirely appropriate for patients if their cancer is slow to progress and they have no symptoms.  This is especially true if the patient is older or has other conditions that are more concerning than the NHL.   

For those who are treated, chemotherapy (usually combination regimens using several drugs) or a mixture of chemotherapy and radiation is the first line of defense.  Widespread (systemic) disease requires chemotherapy.  Radiation is generally used for early stage, localized NHL.

Newer biological treatments for people with certain types of NHL have recently come on the scene.  Rituximab, a monoclonal antibody drug, was approved for use in 1997.  It locks onto lymphoma cells by binding to a protein known as the CD20 antigen on the surface of B-cell tumors.  Because it's so targeted, it produces fewer side effects than standard chemotherapy drugs.  That means doctors can be more aggressive and prescribe this antibody in combination with chemotherapy.  This drug has made a big impact in improving the outcome of patients with lymphoma.  Two newer monoclonal antibody drugs – Bexxar and Zevalin – carry radioactive particles to tumors (called radioimmunotherapy). More new monoclonal antibodies are being developed that go after different targets or that work in different ways.  Monoclonal antibody drugs can be combined with chemotherapy and radiation.   

Stem cell transplantation may be used for advanced and hard-to-treat (refractory) lymphomas as well as for relapse.  They provide a way for doctors to give very high doses of chemotherapy, which kill blood cells and bone marrow and inhibit the body from making new blood cells.  Doctors collect stem cells from the patient or a donor and store them.  After a patient undergoes high-dose chemotherapy, the stem cells are transfused into the bloodstream to replace those that have were damaged or destroyed.

Treatments for NHL are changing fast.  Doctors have a lot to keep up with.  For that reason, most experts recommend that lymphoma patients make every effort to go to a cancer center with an emphasis on treating NHL.    

Learn more about non-Hodgkin lymphoma:

Key Point 1:  Lymphoma is a cancer of the lymph glands.  Classification tells you what kind you have.  Staging tells you where it is.  Early diagnosis, classification and staging affect treatment and prognosis.