Non-Hodgkins Lymphoma
What is Non-Hodgkin Lymphoma (NHL)?
Non-Hodgkin lymphoma is what I was diagnosed with in my 20’s. Like most people, I’d never heard of it until it was the word a doctor used about me.
Non-Hodgkin lymphoma (NHL) is a type of blood cancer that starts in the lymphatic system. It happens when lymphocytes grow out of control. Lymphocytes are white blood cells that normally fight infection. As they build up, they cause a swollen lymph node. You might feel it as a lump, and sizes vary a lot – from pea-sized up to golf-ball sized or larger. This usually happens in the neck, armpit or groin.
It’s different from Hodgkin lymphoma. Hodgkin lymphoma contains a specific abnormal cell called a Reed-Sternberg cell – NHL doesn’t. There are over 60 subtypes of NHL, which is part of why it can look different from person to person.
Types of Non-Hodgkin Lymphoma (NHL)
Doctors group NHL by how it behaves:
High-grade (fast-growing): grows and spreads quickly, and treatment usually starts soon after diagnosis. The most common type is diffuse large B-cell lymphoma (DLBCL). Most young people with NHL have a high-grade type. Despite growing fast, high-grade NHL often responds very well to treatment and has a good chance of long-term remission.
Low-grade (slow-growing): develops gradually and is often described as a more chronic condition. Follicular lymphoma is the most common low-grade type. Some people with low-grade NHL don’t need treatment straight away. Instead, they’re monitored closely and this is called “watch and wait.” It can feel strange not to treat cancer straight away, but it’s a recognised, evidence-based approach.
Who Gets Non-Hodgkin Lymphoma?
Around 13,700 people are diagnosed with NHL each year in the UK (Cancer Research UK), that’s roughly 38 people every day. It can develop at any age, and while it’s more common in older adults, it’s still one of the more common cancers diagnosed in young people.
What are the Symptoms of Non-Hodgkin Lymphoma?
The most common first sign is a swollen lymph node- often felt as a painless lump – in the neck, armpit or groin. Other symptoms can include night sweats, fatigue, unexplained weight loss, fever, and itching. Symptoms depend on where in the body the lymphoma develops. – head to our signs & symptoms page to get clued up!
How is Non-Hodgkin Lymphoma Staged?
Staging tells your medical team how much of your body is affected, which helps decide the right treatment. It runs from 1 to 4 – lower numbers mean more localised disease, higher numbers mean it’s spread further. Staging is a planning tool, not a verdict on how serious your case is.
Stage 1 Non-Hodgkins Lymphoma
Lymphoma is in only one group of lymph nodes, anywhere in the body, either above or below the diaphragm.
Stage 1E Non-Hodgkins Lymphoma
The lymphoma started in a single organ outside the lymphatic system, and is only in that organ. This is called extranodal lymphoma. Extranodal sites include the lungs, liver, bone marrow, kidneys, brain and spinal cord.
Stage 2 Non-Hodgkins Lymphoma
Lymphoma is in two or more groups of lymph nodes, all on the same side of the diaphragm.
Stage 2E Non-Hodgkins Lymphoma
The lymphoma started in one organ outside the lymphatic system and is also in one or more groups of lymph nodes, these must all be on the same side of the diaphragm.
Stage 3 Non-Hodgkins Lymphoma
Lymphoma is present on both sides of the diaphragm – above and below.
Stage 4 Non-Hodgkins Lymphoma
The most advanced stage. Lymphoma has spread from the lymph nodes into at least one organ outside the lymphatic system, such as the lungs, liver, kidneys, bone marrow or bones.
A and B – What Do Those Letters Mean?
Your doctor might add a letter A or B to your stage. B means you have one or more of: drenching night sweats, unintentional weight loss, or fevers that come and go. A means you don’t. B symptoms may mean more intensive treatment, it isn’t a worse prognosis, just more information for your team.
How is Non-Hodgkin Lymphoma Treated?
Treatment depends on your specific subtype, stage, and overall health. It usually involves one or a combination of:
Watch and wait – active monitoring without immediate treatment, common for low-grade NHL
Chemotherapy – often combined with other drugs; R-CHOP is a standard regimen for many NHL subtypes
Immunotherapy – including monoclonal antibodies like rituximab, which target lymphoma cells specifically
Radiotherapy – targeted radiation, often for localised disease
CAR-T cell therapy – a newer treatment for some relapsed or hard-to-treat NHL, where your own immune cells are modified to attack the cancer
Stem cell transplant – more commonly used for relapsed or treatment-resistant disease
Your haematologist will explain what’s right for you, and why.
Worried About Your Symptoms?
If something on this page sounds familiar, don’t sit on it. Going to the GP isn’t wasting anyone’s time.
Check the full list of lymphoma symptoms
Use our Know Your Nodes checker
Read stories from young people who’ve been diagnosed
Not sure what to say? Read our guide on talking to your GP
