Lymphoma treatment

How treatment is planned

When planning your treatment, your doctor will consider the type of lymphoma you have, the stage and grade, your age and general health, and your preferences.

The aim of treatment is to make the signs and symptoms of lymphoma reduce or disappear. This is called remission. Remission can last for a long period of time. Sometimes lymphoma becomes active again and further treatment is required. This is called a relapse.

While Hodgkin and non-Hodgkin lymphomas are both types of cancer that start in the lymphatic system, they are often treated in different ways because some treatments work better for one type than the other. However, some treatments are used for both lymphomas – these include chemotherapy, steroid therapy and immunotherapy.

This section describes the types of treatments you may have. The table below shows what treatments can be used for Hodgkin lymphoma and non-Hodgkin lymphoma.

Watchful waiting

If you are diagnosed with low-grade non-Hodgkin lymphoma, you may not need treatment straightaway. Instead, you may have regular check-ups to monitor the lymphoma. This approach is called watchful waiting (or watch and wait). It is rarely used with Hodgkin lymphoma.

Watchful waiting does not mean that nothing is done. You will still see the doctor regularly to check for signs the lymphoma is progressing.

Having treatment earlier than necessary can cause side effects. Many people who have no treatment for low-grade non-Hodgkin lymphoma continue their usual daily activities for many years. Some people find watchful waiting hard to accept and prefer to have treatment immediately. If waiting for treatment makes you feel anxious, speak with your treatment team.

Treatment options

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells or slow their growth. It can be used in various ways depending on the grade and type of lymphoma.

• a main treatment for Hodgkin Lymphoma, often combined with radiation therapy
• a main treatment for non-Hodgkin Lymphoma, often combined with other drug therapies

Radiation therapy

Radiation therapy (also known as radiotherapy) uses radiation to kill or damage cancer cells so they cannot grow, multiply or spread. 

• a main treatment for Hodgkin Lymphoma often combined with chemotherapy
• can be used for low-grade non-Hodgkin Lymphoma, and sometimes after chemotherapy

Steroid therapy

Steroid therapy uses artificially produced steroids to reduce inflammation in the body, such as redness, swelling or pain.

• often used with chemotherapy for both Hodgkin or non-Hodgkin lymphoma

Targeted therapy

Targeted therapy drugs attack specific features of cancer cells to stop the cancer growing or to reduce its size. 

• used sometimes for Hodgkin Lymphoma
• used for some types of non-Hodgkin Lymphoma

Immunotherapy

Immunotherapy uses the body’s own immune system to fight cancer. There are 2 main types of immunotherapies used to treat lymphoma – checkpoint inhibitors and CAR T-cell therapy.

• checkpoint inhibitors may be used for Hogkin Lymphoma
• may be used for some types of non-Hodgkin Lymphoma

CAR T-Cell therapy

Chimeric antigen receptor (CAR) T-cell therapy is a type of immunotherapy used to treat some types of non-Hodgkin lymphoma. This therapy works by boosting the ability of T-cells to fight cancer.

• rarely used for Hodgkin Lymphoma
• used for some B-cell lymphomas (non-Hodgkin) that have come back or not responded to other treatment

Stem cell transplant

If lymphoma returns (relapses) or does not respond to initial treatment (refractory disease), you may have a stem cell transplant. 

• can be used for Hodgkin or non-Hodgkin Lymphoma if cancer comes back or does not respond to treatment

Late effects of treatment

Some side effects from treatment may not show up until many months or years later. These are called late effects. Your treatment will be carefully planned to reduce the risk of any of these late effects.

With improved staging and treatment of lymphoma, late effects are less likely than in the past. Your doctor will talk to you about any possible late effects before treatment starts.

When treatment finishes, talk to your doctors about your risk of developing late effects from treatment and how this will be monitored. Ask for a written summary of your treatments so you have this on hand if needed. It is important that you talk to your doctors about any symptoms that appear, even many years after treatment.

Palliative treatment

Palliative treatment helps to improve people’s quality of life by managing the symptoms of cancer without trying to cure the disease. It is best thought of as supportive care.

Many people think that palliative treatment is for people at the end of their life; however, it can help people at any stage of advanced lymphoma to improve quality of life – it does not mean giving up hope. Palliative treatment can help some people with advanced lymphoma live well and with few symptoms for many months or years.

As well as slowing the spread of cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include short courses of radiation therapy, chemotherapy, targeted therapy or other medicines. If you are experiencing ongoing symptoms, ask for a referral to the symptom management or palliative care team.

Palliative treatment is one aspect of palliative care, in which a team of health professionals aims to meet your physical, emotional, cultural, spiritual and social needs. The team also supports families and carers. Your care may be led by a specialist palliative care team or by your GP and a community nurse.

See Palliative care or Living with advanced cancer or listen to Cancer Council's The Thing About Advanced Cancer podcast series.