What Increases Your Risk

No one knows exactly what increases your risk of getting non-Hodgkin's lymphoma (NHL). Experts do agree that the disease is not caused by injury and is not contagious. The following risk factors may increase your chances of having the disease. But most people with these risk factors do not ever have non-Hodgkin's lymphoma. And many people who have non-Hodgkin's lymphoma do not have any of these risk factors.¹

• Being male. NHL is more common in men than in women.
• Age. The likelihood of getting NHL increases as you get older.
• Impaired immune system. NHL is most common among those who have an impaired immune system, an autoimmune disease, or HIV or AIDS. It also occurs among those who take immunosuppressant medicines, such as medicines following an organ transplant.
• Viral infection. A viral infection, such as Epstein-Barr virus, increases the risk of developing NHL.
• Bacterial infection. Infection with Helicobacter pylori increases the risk of lymphoma involving the stomach.
• Environmental exposure. Exposure to agricultural pesticides or fertilizers, solvents, and other chemicals may increase the risk of developing NHL.

When To Call a Doctor

Call your doctor to schedule an appointment if you have had any symptoms for longer than 2 weeks, such as:

• Painless swelling in the lymph nodes in the neck, underarm, or groin.
• Unexplained fever.
• Drenching night sweats.
• Extreme fatigue.
• Unexplained weight loss in the past 6 months.
• Itchy skin.
• Cough or shortness of breath.
• Pain in the abdomen or back.

Watchful Waiting

Watchful waiting (surveillance) is a period after the diagnosis of some types of non-Hodgkin's lymphoma (NHL) when you are not receiving treatment but are still being watched closely by your doctor. Watchful waiting is not appropriate for aggressive or high-grade lymphoma. Watchful waiting does not mean that your doctor is giving up or refusing to give you treatment. During this time you will:

• Have regularly scheduled appointments with your doctor.
• Receive periodic medical tests, including scans and blood tests.
• Be told which symptoms to report to your doctor immediately.

Watchful waiting may be as effective as immediate aggressive treatment for some types of NHL. But watchful waiting ends when one of the following occurs:

• Symptoms develop.
• Lymphoma tumor size increases.
• Organs do not function normally.

Who To See

Doctors who can help diagnose non-Hodgkin's lymphoma (NHL) include:

• Family medicine doctor.
• Internist.
• Surgeon.
• Nurse practitioner.

When NHL is suspected, a tissue sample (biopsy) is needed to make a diagnosis. A biopsy for non-Hodgkin's lymphoma is usually taken from a lymph node. But other tissues may be sampled as well. A surgeon will remove a sample of tissue so that a pathologist can examine it under a microscope to check for cancer cells.

Non-Hodgkin's lymphoma is usually treated by a medical oncologist or a hematologist. If you require radiation therapy, you will also see a radiation oncologist.

To prepare for your appointment, see the topic Making the Most of Your Appointment.