Stage 4 lymphoma is a cancer that begins in the lymph nodes (tissues that contain white blood cells). It can also affect other body organs outside the lymphatic system, such as the lungs or bones.
The most common types of non-Hodgkin lymphoma are diffuse large B-cell lymphoma and T cell lymphoma. These cancers can be very aggressive, but they often respond to treatment.
Usually, your doctor will stage the type of lymphoma you have using a system called the Lugano classification. This is based on your age, symptoms and test results. It’s important to know the differences between stages so you can understand your treatment options.
1. Acute lymphoblastic leukemia/lymphoma
Acute lymphoblastic leukemia (ALL) is an unusual form of cancer that begins in a type of white blood cell, called lymphocytes. These leukemia cells are found in the bone marrow and spleen, and in other parts of the body. It can spread to other parts of the body and cause symptoms such as pain, weight loss, or tiredness.
2. Hodgkin lymphoma
Hodgkin lymphoma is a rare type of cancer that occurs in the white blood cells (called lymphocytes) that help fight infection. It can occur in any part of the body, but it most commonly affects the lymph nodes in the neck, chest and abdomen.
3. Infiltrating lymphoma
Infiltrating lymphoma is a type of non-Hodgkin lymphoma that starts in the lymph nodes and then spreads to other parts of the body. It can also spread to other organs such as the lungs or liver.
4. Recurrent lymphoma
Recurrent lymphoma is a type of NHL that has come back after treatment. This can happen a short time after the first treatment, or years later.
5. Adjuvant chemotherapy
After diagnosis, your doctor will probably recommend a combination of drugs to treat the lymphoma. These drugs work by destroying or killing the cancer cells. They may be given to you through your bloodstream, or they may be given directly to the cancer in a small amount.
Your doctor will also tell you about side effects, which are usually temporary and go away after the chemotherapy treatment is over. They can include fatigue, lowered blood counts, risk of infection, nausea and vomiting, hair loss, and loss of appetite.
6. R-CHOP Chemotherapy
For most types of lymphoma, your doctor will prescribe a combination of chemotherapy drugs, known as an R-CHOP regimen. These drugs, which include cyclophosphamide, doxorubicin, vincristine, and prednisone, are given in six cycles. The drug rituximab, a monoclonal antibody, is also often prescribed along with the other drugs.
7. Stem cell transplant
For some people with relapsed or aggressive lymphomas, a stem cell transplant might be the best way to stop the disease from growing. This treatment might be performed by a bone marrow or stem cell transplant specialist.
8. Treatment with a new drug or combination of drugs
Your doctor will talk to you about the different types of medication that are available and what might be right for you. They will also help you decide which drugs are safe and effective for you. They will help you choose the most appropriate dosage for each drug, and they will provide you with regular check-ups to make sure that your medication is working well.
