Non-Hodgkin’s lymphoma (sometimes called NHL, or simply lymphoma) is a group of diseases that actually includes more than 20 different disorders. How common is non-Hodgkin’s lymphoma? Non-Hodgkin’s lymphoma is currently the seventh most common cancer in men and women in the United States. (1)
In the U.S. alone more than 66,000 new cases of NHL are diagnosed every year, and this number only keeps rising. Non-Hodgkin’s lymphoma is much more common than the other primary type of lymphoma, Hodgkin’s lymphoma.
People who are most likely to develop non-Hodgkin’s lymphoma are older/elderly people and those with low-functioning immune systems, due to having other illnesses or even taking certain medications. Fortunately, many people with non-Hodgkin’s lymphoma survive the disease and go on to live many years. But lymphoma can make it hard to keep up with work, school, family obligations, hobbies or other day-to-day activities. A healthy lifestyle — including eating a nutrient-dense diet, getting enough sleep and exercising — can all help prevent non-Hodgkin’s lymphoma and also manage symptoms.
What Is Non-Hodgkin’s Lymphoma?
Lymphomas are cancers of the lymphocytes, which are white blood cells made by the immune system (specifically the lymphatic system) that are stored in lymph nodes and blood-forming organs. Lymphocytes normally help to fight off infections and produce antibodies, so they are very important for supporting the immune system’s defense mechanisms. They travel throughout the whole body via the blood and lymphatic vessels, essentially always “on patrol” for invaders that might cause illnesses or infections.
Non-Hodgkin’s lymphoma is the term for a group of cancers that develop in B or T lymphocytes. The majority of NHL cases are caused by abnormalities of B lymphocytes (an estimated 80–85 percent), with only about 15–20 percent of cases being due to T cell abnormalities. Is NHL a type of blood cancer? Yes, most doctors consider lymphoma to be a form of blood cancer. According to the American Society of Hematology, “About half of the blood cancers that occur each year are lymphomas, or cancers of the lymphatic system.” (2) One of the first signs of non-Hodgkin’s lymphoma is rapid swelling and enlargement of the lymph nodes. NHL can be contained to only one lymph node or potentially spread to other lymph nodes throughout the body.
How many different types of lymphomas are there? There are more than 20 subtypes of lymphoma, some more common than others. The two main types of lymphomas are Hodgkin’s lymphoma (which used to be called Hodgkin’s disease) and non-Hodgkin’s lymphoma.
Non-Hodgkin’s vs. Hodgkin’s Lymphoma:
- What is the difference between non-Hodgkin’s lymphoma and Hodgkin’s lymphoma? Lymphomas that do not start in white blood cells are called non-Hodgkin’s lymphoma. They start inside bone marrow, the spleen, the thymus or the lymph nodes and then spread to other parts of the body. (3) Hodgkin’s lymphoma/disease is also characterized by the presence of a particular type of cancer cell called a Reed Sternberg cell.
- Each year in the U.S about 8,000 new cases of Hodgkin’s lymphoma are diagnosed, which makes it about eight times less common than non-Hodgkin’s lymphoma.
- Hodgkin’s lymphoma is more common in men than in women and usually occurs after the age of 10, typically between the ages of 15–40 (although people over 40 can also develop the disease).
- The cause of Hodgkin’s lymphoma is currently not known, but most people will be able to be cured with treatment such as radiation or chemotherapy.
- Hodgkin’s lymphoma causes the lymph nodes to become enlarged, but this usually isn’t painful like it is with non-Hodgkin’s. Other symptoms can include:
- muscle weakness
- shortness of breath
- night sweats
- weight loss
- temporary pain due to swelling
Other Types of Lymphoma:
- Other types of lymphomas include: Diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, mantle cell lymphoma, small lymphocytic lymphoma, primary mediastinal large B-cell lymphoma, splenic marginal zone B-cell lymphoma, extranodal marginal zone B-cell lymphoma of MALT.
- Mycosis fungoides (or Sézary Syndrome or Alibert-Bazin syndrome) is a type of cutaneous T-cell lymphoma that mostly affects the skin and causes rashes, tumors, skin lesions, and itchy skin. (4)
- Burkitt’s lymphoma affects B-cell lymphocytes and can be life-threatening, leading to impaired immunity and complications. (5) This type of lymphoma is most common in parts of Africa, but rare in the U.S. with only about 1,200 new cases diagnosed each year. Burkitt’s accounts for only about 1–2 percent of adult lymphoma cases worldwide, but up to 40 percent of pediatric lymphoma cases in nations like the U.S. and those located in Western Europe. (6)
- Mucosa-associated lymphoid tissue (MALT) lymphoma is another type of gastric (stomach) lymphoma that is commonly a result of chronic untreated infection with the H. pylori bacterium, which is tied to development of stomach ulcers.
All types of lymphoma have this in common: They are caused by abnormalities of the lymphatic system (or lymph system), which is part of the immune system and responsible for protecting the body from pathogens like germs or viruses that can cause infections and some other illnesses. The lymphatic system has many roles, including helping to move waste and excess fluids from the body and helping to clean the blood.
Lymph nodes are found all around the body, with the most prominent locations being the throat, groin, armpits, chest and abdomen. They collect lymphocytes and are scattered throughout the network of lymphatic vessels. Inside the lymph nodes important immune cells — white blood cells, or lymphocytes — are created, which are critical for fighting infections and healing wounds.
Signs and Symptoms of Non-Hodgkin’s Lymphoma
Symptoms of non-Hodgkin’s lymphoma are due to the many changes that take place in the body when the lymph nodes become swollen and stop working properly. Certain symptoms are due to the infiltration of lymphoma cells into the bone marrow, blood, intestines, skin, brain and spinal cord. Red blood cells can also become destroyed, leading to symptoms of anemia. Bleeding and swelling can occur in the digestive tract, leading to many digestive changes and difficulty properly absorbing nutrients. Antibody production can be halted, increasing susceptibility to other diseases and bone marrow can also become destroyed.
Some of the most common non-Hodgkin’s lymphoma symptoms include:
- Enlargement of the lymph nodes, especially in the neck, under the armpits, and/or in the groin.
- Pain and swelling surrounding the lymph nodes and vital organs, including the liver, stomach, kidneys and spleen.
- Swelling of the face.
- Shortness of breath, chest pain, difficulty breathing and coughs due to enlargement and swelling of the lymph nodes in the chest.
- Loss of appetite, diarrhea and, potentially, weight loss.
- Abdominal pain, distention, bloating and constipation.
- Malabsorption of nutrients.
- Night sweats.
- Thickened, dark, sometimes itchy areas of skin.
- Progressive swelling of the legs and difficulty moving/walking normally.
- Sometimes symptoms related to having too few red or white blood cells, including anemia, fatigue, weakness, increased bruising and bleeding, and pale skin.
- Increased risk for infections and common illnesses due to decreased white blood cells.
- When NHL advances, persistent fever and changes to the skin and nervous system.
- In children, lymphoma can cause anemia, rashes, neurological changes, weakness and abnormal sensations.
Non-Hodgkin’s Lymphoma Causes & Risk Factors
It’s not exactly known what causes each subtype of non-Hodgkin’s lymphoma, although experts believe that viruses play a role in the development of certain rarer types. For most patients with lymphoma a clear cause for their disease will not be found; however, certain people have a higher risk for developing lymphoma than others.
Risk factors for non-Hodgkin’s lymphoma include: (7)
- Being an older adult over the age of 60.
- Having another disease that causes a suppressed or low-functioning immune system, or taking medications that interfere with normal functioning of the immune system. Examples of diseases that have been linked with higher NHL risk include autoimmune diseases such as rheumatoid arthritis, lupus), Sjogren (Sjögren) disease, celiac disease, or other types of cancer.
- Having had a virus linked to NHL including Epstein-Barr virus (EBV), Human herpes virus 8 (HHV-8), or human T-cell lymphotropic virus (HTLV-1).
- Having HIV.
- History of infections including hepatitis C or those caused by bacteria such as Helicobacter pylori, Chlamydia psittaci, or Campylobacter jejuni.
- Having had an organ transplant.
- Exposure to chemicals/toxins including benzene, certain herbicides and insecticides.
- Having had chemotherapy or radiation treatment in the past.
- Obesity and eating a poor diet.
- Being a male, since NHL is generally more common in men than in women.
- Being from the United States or Europe, which have some of the highest rates of NHL.
- Being of Caucasian/white descent, since whites are more likely than African Americans and Asian Americans to develop NHL.
As described above, the underlying cause of non-Hodgkin’s lymphoma is abnormal lymphocytes. There are two main types of lymphocytes (white blood cells): B cells and T cells. B cells normally help protect the body against germs (bacteria or viruses) by making proteins called antibodies, while T cells destroy germs or abnormal cells and help control activity of other immune system cells. Non-Hodgkin B-cell lymphomas are much more common than T-cell lymphomas.
Conventional Treatments for Non-Hodgkin’s Lymphoma
Treatments for NHL will depend on how severe the patient’s disease is, plus what specific type of lymphoma they have. Patients with NHL are usually treated by a team of medical professionals including: (8)
- Hematologist (specialized in disorders of the blood)
- Oncologist (specializes in treating cancer)
- Radiation oncologist
- Physician assistants (PAs)
- Nurse practitioners (NPs)
- Nutrition specialists
- Therapists or social workers
Non-Hodgkin’s lymphomas can either be more or less proliferative depending on how severe the disease is. Each individual case of NHL will depend on how mature the cells are when they become cancerous; how much the cancer spreads; how healthy the patient is otherwise; the patient’s age and their family and medical history.
Doctors split different types of NHLs into different grades: low grade, intermediate grade, or high grade lymphoma. Lymphomas are also classified as either “indolent lymphomas,” which spread slowly and don’t always require treatment right away, or “aggressive lymphomas,” which spread rapidly and need to be treated immediately to control the disease.
Conventional treatments for non-Hodgkin’s lymphoma typically one or more of these treatment approaches:
- Radiation therapy
- Immunotherapy and targeted therapy drugs (which can include cytokine therapies, histone deacetylase inhibitors, kinase inhibitors and/or proteasome inhibitors)
- Proton therapy
- Stem cell transplants
- Surgery (rarely)
- Bone marrow stimulants
- And use of monoclonal antibody rituximab (Rituxan)
Diffuse large B-cell lymphomas (or DLBCL) typically progress quickly and therefore are usually treated with chemotherapy and three to six cycles of drugs known as CHOPs (cyclophosphamide, doxorubicin, vincristine, and prednisone), plus rituximab (Rituxan). Chemo injections and radiation may also need to be used in more severe cases. Follicular lymphoma, which spreads slowly but can return and be hard to treat, is usually treated with radiation therapy and sometimes Rituxan and/or chemotherapy.
Prevention & 5 Natural Ways to Manage Lymphoma Symptoms
1. Limit Your Risk for Infections and Viruses
- Eat an anti-inflammatory diet to boost your defense against common pathogens and germs.
- Exercise regularly, aiming for 30 minutes or more every day.
- Get enough sleep and control stress, which in high amounts can lead to flare-ups and lower immune system function.
- Limit alcohol consumption to about one drink per day, not exceeding about two drinks daily for men (or about seven–14 drinks weekly at most).
- Reduce your risk for acquiring sexually transmitted diseases, including HPV or AIDS/HIV, by avoiding unprotected sex (especially with many partners) and all use of intravenous drugs.
- Avoid potentially dangerous germs by practicing good hygiene. You can do this by washing your hands regularly, keeping your home clean, and avoiding close contact with people who you know are sick.
- Avoid taking any unnecessary medications or drugs, especially if they cause side effects and can be replaced with other less risky treatments.
- Keep skin clean and moisturized to prevent infections.
- Stretch daily in order to keep lymph fluids moving and to prevent swelling and stiffness.
- Visit your doctor every year for regular check ups; this way you can treat illnesses early on before they progress. Report any signs of infection, viruses or other concerns so you can identify what’s causing them.
2. Maintain a Healthy, Strong Immune System
Not every type of cancer or lymphoma may be preventable, but you can do your part to lower your risk as much as possible. The World Cancer Research Fund estimates that about 20 percent of all cancers diagnosed in the U.S. are related to preventable lifestyle risk factors, including: amount of body fat, physical inactivity, excess alcohol consumption, and/or poor nutrition. (9) Other preventable factors also come into play, such as exposure to chemicals and medication use. It’s estimated that only about 5–10 percent of all cancers are inherited (passed from one blood relative to another), which means you do have a lot of control over your health. (10)
A good deal of evidence shows that you can decrease your risk for many types of cancers — including lymphomas — by making healthy dietary choices; exercising and staying active; reducing carcinogen/toxin exposure; and not smoking or using drugs. All of these lifestyle habits have a big impact on your immune system and ability to fight off illnesses including cancer.
Other natural immune system boosters include: probiotics, echinacea, elderberry, medicinal mushrooms, adaptogen herbs, colloidal silver, ginger, astragalus and oregano.
3. Eat an Anti-Inflammatory Diet & Maintain a Healthy Weight
According to the American Cancer Society, “Some studies have suggested that being overweight or obese may increase your risk of non-Hodgkin lymphoma. Other studies have suggested that a diet high in fat and meats may raise your risk.” (11)
- Eat a diet high in plant foods and antioxidants.
- Try to fill half your plate at every meal with fresh veggies and/or fruits. Replace some of the meat and dairy in your diet (especially pork, beef, lamb, deer and buffalo) with plant-based proteins in order to get more fiber into your diet.
- Some of the best cancer-fighting foods include:
- leafy green veggies
- sea vegetables
- cruciferous veggies and other non-starchy veggies
- wild-caught fish like salmon
- nuts and seeds like chia and flax
- whole grains
- Avoid foods known to cause weight gain, inflammation and other health problems, especially: processed meats (like cold cuts, deli meats, salami, etc.), added sugar, sweetened beverages, refined grains, trans-fats and hydrogenated fats, fried foods and fast food.
- Take steps to stay at a healthy weight as you get older. If you begin to gain weight, try to make changes early on before the situation becomes more difficult.
- Find ways to stay physically active on a regular basis, ideally by doing different types of exercises to strengthen your whole body. Try sitting less throughout the day and also adding high intensity interval training or strength-training to your weekly workout routine.
4. Limit Exposure to Carcinogens, Toxins & Chemicals
Purchase organic foods as much as possible in order to limit your exposure to pesticides and insecticides. Recently, concerns have grown over the use of chemical weed killers (such as Roundup, produced by Monsanto), especially those containing the active ingredient glyphosate. According to the World Health Organization (WHO), glyphosate is probably carcinogenic to humans and may contribute to an increased cancer risk. Experts believe that pesticides/insecticides may cause changes to cells’ DNA and impact the immune system in other ways. If you work on a farm or in agriculture, then it’s worth doing your research and talking to your doctor about your risk for related problems.
Quit smoking and using tobacco if you currently do, perhaps by getting support from a treatment group or behavioral therapist.
Talk to your doctor about medications you take regularly and whether these might increase your risk for certain diseases.
Also, some sun exposure can be beneficial (such as for preventing vitamin D deficiency), but too much can cause dangerous changes to cells.
5. Manage Symptoms Like Soreness, Pain & Indigestion
Some tips to help you manage symptoms like constipation, swelling and pain associated with NHL include:
- Use essential oils like lemon, myrrh, oregano, cypress and frankincense oil to help with lymphatic drainage, reducing swelling and improving circulation.
- Eat smaller meals throughout the day, rather than one to three big meals. Drink lots of water and eat more fiber by increasing unprocessed plant foods in your diet. Magnesium supplements may also help to reduce constipation.
- Get plenty of sleep, at least 7–8 hours each night. Rest enough and take time to yourself to do things you enjoy in order to prevent stress and burn-out from causing flare-ups in symptoms.
- Work with a nutritionist if you have any nutrient deficiencies, and consider taking supplements that might help.
- Try yoga to help with circulation and flexibility or meditation to control muscular tension and anxiety.
- If you experience lymphedema, swelling and heaviness in your limbs, then keep them elevated, use compression garments, and stretch.
- Consider trying infrared sauna treatments for dealing with chronic pain, chronic fatigue syndrome and even depression.
- Visit an acupuncturist or specialist in massage therapy (especially one trained in manual lymphatic drainage) for help with reducing stiffness, soreness, aches, stress and fatigue.
Precautions When Treating Non-Hodgkin’s Lymphoma
Treatment for non-Hodgkin’s lymphoma isn’t always necessary, but this doesn’t mean that you should delay visiting a doctor for help. When it comes to cancer, always get help from a professional and consider getting a second opinion regarding your treatment options. If you have a family history of lymphoma or are in a high-risk group, then be sure to stay current on routine doctor’s visits and tests. If you feel overwhelmed by your diagnosis, consider speaking with a therapist to manage stress, or joining a support group.
Key Points about Non-Hodgkin’s Lymphoma
- Lymphomas are cancers of the lymphocytes, which are white blood cells made by the immune system (specifically the lymphatic system) that are stored in lymph nodes and blood-forming organs.
- Lymphomas that do not start in white blood cells are called non-Hodgkin’s lymphomas. There are 20 different types of non-Hodgkin’s lymphomas. They start inside bone marrow, the spleen, the thymus or the lymph nodes and then spread to other parts of the body.
- Symptom of NHL can include: swelling and enlargement of lymph nodes, pain, fever, shortness of breath, skin changes, abdominal pains and constipation, and weight loss.
- NHL is treated with a combination of lifestyle changes, chemotherapy, radiation, immunotherapy, targeted drug therapies and other approaches.
5 Natural Ways to Manage Non-Hodgkin’s Lymphoma Symptoms
- Participate in preventive care by making healthier lifestyle choices, including practicing good hygiene, limiting alcohol and following safe sex guidelines to minimize your risk for viruses and infections.
- Maintain a healthy, strong immune system.
- Eat an anti-inflammatory diet and maintain a healthy weight.
- Limit exposure to carcinogens, toxins & chemicals.
- Use health practices such as gentle exercise, essential oils, massage, and rest among others to help manage symptoms like pain, soreness and indigestion.