Understanding your diagnosis
Your test results provide a lot of information about your non-Hodgkin lymphoma.
This may include:
- the cells it started in (cancer type)
- whether it has spread from where it started (cancer stage)
- whether it is likely to grow quickly or slowly (cancer grade).
Your specialist uses this information to explain how the cancer could affect you in the future (your prognosis), and what your treatment options are. Your specialist may arrange further tests if more information is required.
What you need to know
Blood cells are formed through a process called haematopoiesis. This usually occurs in the bone marrow, which is a sponge-like tissue found inside many bones in the body. It may also occur in other tissues, like the spleen, liver, thymus (a gland behind the breastbone), and lymph nodes.
During this process, immature cells called haematopoietic stem cells develop into different types of blood cells.
The three main types of blood cells are:
- red blood cells
- white blood cells
Blood cancers start when a part of haematopoiesis goes wrong, and one or more cells become abnormal and start growing and dividing rapidly.
These immature abnormal blood cells crowd out normal blood cells in the bone marrow. They can also enter into the blood or lymphatic circulation and travel around the body.
The main types of blood cancer are:
Lymphoma is cancer of white blood cells known as lymphocytes, which are found in lymph nodes. They are important in protecting the body against infection.
There are 2 main groups of lymphoma:
- Hodgkin lymphoma
- non-Hodgkin lymphoma.
Non-Hodgkin lymphoma is further split into over 30 different sub types based on the appearance of the cells under the microscope. These include:
- diffuse large B cell lymphoma (DLBCL)
- follicular lymphoma (FL)
- mantle cell lymphoma (MCL)
- Burkitt's lymphoma (BL)
- cutaneous T cell lymphoma (CTCL)
- T cell lymphoma.
Knowing the type of non-Hodgkin lymphoma helps the haematologist decide the most suitable treatment.
Staging means how much lymphoma is found in the body. Doctors use staging to help work out the most suitable treatment for you.
The systems used to describe the stages of lymphoma are the Lugano classification or the Ann Arbor system.
There are 4 numbered stages:
- Stage 1 – one lymph node, or one group of lymph nodes, is involved
- Stage 2 – two groups of lymph nodes, that are on the same side of the diaphragm, are involved
- Stage 3 – lymph nodes on both sides of the diaphragm are involved
- Stage – multiple lymph nodes are involved and the lymphoma involves other parts of the body, e.g., liver, bone marrow, or spleen. This is called advanced stage disease.
The grade of lymphomas is based on the appearance of the cells (histology) and how fast the cells are growing. They are classed as:
- bulky disease.
What to ask or talk about
Talking about prognosis
Prognosis means what is likely to happen to you in the future because of your cancer. You may find it hard to talk about prognosis but it can help you make decisions about the treatment and care you want.
Everyone’s cancer is different, and everyone responds differently to treatment. Because of this, doctors can’t tell you exactly what will happen to you. Instead, they can give you the best information they have about what to expect.
Doctors work out prognosis based on statistics. These show what happens in large groups of people with cancer. They cannot predict what will happen to you or any other individual person.
Your specialist will share information about you and your cancer with a multidisciplinary team (MDT) to decide the best treatment options for you.
You may need more than one type of treatment or have a choice of treatments. You may also need to see other specialists during treatment planning.
Dealing with your diagnosis
Getting a cancer diagnosis is very distressing for the person with cancer, and their carers, family and friends. Different people react in different ways. They can be upset and angry or just in shock. Many people find it difficult to take in all the information and understand what it will mean for them.
The situation can be especially difficult for people who get a diagnosis of advanced cancer.
If you need to speak to someone about your diagnosis, you can call the Cancer Council on 13 11 20.