Q&A: What is Non-Hodgkin’s Lymphoma?

In the United States, an estimated 79,320 new cases of Non-Hodgkin’s Lymphoma (NHL) will be diagnosed in 2026. While that number is alarming, there is still reason for hope after diagnosis: the five-year relative survival rate for NHL overall is 74.3%. Even more encouragingly, some slower moving forms of NHL have excellent long-term survival, while many aggressive types can be highly treatable—and, in some cases, curable—with modern therapies.

But what is NHL? And how is it different from Hodgkin’s Lymphoma? This September, in recognition of Blood Cancer Awareness Month, Sung Ho Lee, MD, board-certified physician in medical oncology and hematology at Highland Medical - Hematology Oncology Associates of Rockland, along with his Clinical Research Coordinators, Sharyar Khan and Jessica Szlaz , M.Sc., share important information about Non-Hodgkin’s Lymphoma.

Q: What’s the difference between Hodgkins Lymphoma vs. Non-Hodgkins Lymphoma?

A: To understand the difference between NHL and Hodgkin’s Lymphoma, you need to know what Lymphoma is: it’s a type of cancer that affects your lymphatic system, specifically in infection-fighting white blood cells called lymphocytes.

Hodgkin’s Lymphoma is marked by the presence of giant, abnormal lymphocytes called Reed-Sternberg cells. These typically start in the upper body lymph nodes (neck, chest, armpits) and spread in an orderly, predictable path.

NHL, on the other hand, does not have Reed Sternberg cells and it involved a more diverse group of B-cells, T-cells, or NK (natural killer) cells. These cells can originate in lymph nodes anywhere in the body, and tend to spread in a non-predictable path, where in some cases, it can involve tissue outside the lymphatic cells, such as the bone marrow, or stomach.

Q: Who is getting diagnosed?

A: Statistically, NHL has been more prevalent in men than women, with the median age at first diagnosis at 67 years old. In terms of race, doctors have seen a higher diagnosis in white/non-Hispanic people, followed by black/African Americans.

In terms of location, New York reports a large number of cases for several reasons. Our population of 20 million naturally increases the incidence rate, along with having an older populous state of 65+.

Q: What are the symptoms?

A: When it comes to identifying symptoms, there are few to look for when diagnosing NHL which include but are not limited to: swollen lymph nodes, unexplained fatigue, night sweats, easily bruising or bleeding, and back and bone pain. But keep in mind: simply having one or more of these symptoms does not automatically mean it’s NHL. Always consult with a medical professional to be properly evaluated.

Q: What causes NHL?

A: While there is no single cause of NHL, there are clinical trials in place to explore possible triggers. However, it is known that some environmental factors that play a role such as long-term exposure to pesticides, industrial chemicals, and previous radiation exposure can affect a person’s risk. Genetic changes during someone’s lifetime (not inherited) and immune system factors play some role in it.

Q: What are the treatment options?

A: Treatment for NHL depends on the type of lymphoma, its stage, and the patient's overall health. Common treatment options include chemotherapy, immunotherapy, targeted therapy, radiation therapy, and, in some cases, CAR T-cell therapy or a stem cell transplant. Some slow-growing forms of NHL may not require immediate treatment and can be safely monitored through a watch-and-wait approach. Thanks to advances in cancer research, today's treatments are more personalized than ever, and many people with NHL achieve long-term remission or, in some cases, are cured.

Q: Is it preventable?

A: Unlike some cancers, there is no guaranteed way to prevent NHL and in most cases, doctors don't know exactly why it develops. However, adopting healthy lifestyle habits, like eating nutritious foods, limiting alcohol consumption, and having an exercise routine is always recommended to keep your overall immune system healthy, and may help reduce your risk of several types of cancer.

For more information, visit www.highlandmedical.co/hematology-oncology or call 845-480-7440.