National Cancer Institute

What You Need 

To Know About TM

Non-Hodgkin

Lymphoma

U.S. DEPARTMENT OF 

HEALTH AND HUMAN SERVICES

National Institutes of Health

U.S. DEPARTMENT OF

HEALTH AND HUMAN SERVICES

National Institutes of Health

National Cancer Institute

Contents

About This Booklet 1

What Is Non-Hodgkin Lymphoma? 2

Risk Factors 4

Symptoms 6

Diagnosis 6

Staging 9

Treatment 12

Second Opinion 22

Supportive Care 24

Nutrition and Physical Activity 24

Follow-up Care 25

Sources of Support 26

Taking Part in Cancer Research 28

Dictionary 30

National Cancer Institute Information Resources 45

National Cancer Institute Publications 46
About This Booklet

This National Cancer Institute (NCI) booklet is

about non-Hodgkin lymphoma,* a cancer that starts in

the immune system. Non-Hodgkin lymphoma is also

called NHL. Each year, more than 63,000 Americans

learn they have non-Hodgkin lymphoma. 

This booklet tells about diagnosis, treatment, and

supportive care. Learning about the medical care for

people with lymphoma can help you take an active part

in making choices about your own care.

This booklet has lists of questions to ask your

doctor. Many people find it helpful to take a list of

questions to a doctor visit. To help remember what

your doctor says, you can take notes or ask whether

you may use a tape recorder. You may also want to

have a family member or friend go with you when you

talk with the doctor—to take part in the discussion, to

take notes, or just to listen. 

1

*Words in italics are in the Dictionary on page 30. The Dictionary

explains these terms. It also shows how to pronounce them.

This booklet is only about non-Hodgkin

lymphoma. It is not about Hodgkin lymphoma

(also called Hodgkin disease). 

People with Hodgkin lymphoma have different

treatment options. Instead of this booklet, they

may want to read What You Need To Know

AboutTM Hodgkin Lymphoma. Page 46 tells how

to get NCI booklets.
For the latest information about lymphoma,

please visit our Web site at http://www.cancer.gov/

cancertopics/types/non-hodgkin. Or, contact our

Cancer Information Service. We can answer your

questions about cancer. We can send you NCI booklets

and fact sheets. Call 1-800-4-CANCER

(1-800-422-6237) or instant message us through the

LiveHelp service at http://www.cancer.gov/help. 

What Is Non-Hodgkin Lymphoma? 

Non-Hodgkin lymphoma is cancer that begins in

cells of the immune system. The immune system fights

infections and other diseases.

The lymphatic system is part of the immune system.

The lymphatic system includes the following:

• Lymph vessels: The lymphatic system has a network

of lymph vessels. Lymph vessels branch into all the

tissues of the body.

• Lymph: The lymph vessels carry clear fluid called

lymph. Lymph contains white blood cells, especially

lymphocytes such as B cells and T cells. 

• Lymph nodes: Lymph vessels are connected to

small, round masses of tissue called lymph nodes.

Groups of lymph nodes are found in the neck,

underarms, chest, abdomen, and groin. Lymph

nodes store white blood cells. They trap and remove

bacteria or other harmful substances that may be in

the lymph.

• Other parts of the lymphatic system: Other parts

of the lymphatic system include the tonsils, thymus,

and spleen. Lymphatic tissue is also found in other

parts of the body including the stomach, skin, and

small intestine. 

2
3

This picture shows lymph nodes above and below the

diaphragm. It also shows the lymph vessels, tonsils,

thymus, and spleen.

Tonsil

Diaphragm

Lymph

nodes

Lymph

vessels

Spleen

Thymus

Because lymphatic tissue is in many parts of the

body, lymphoma can start almost anywhere. Usually,

it’s first found in a lymph node.
Non-Hodgkin Lymphoma Cells

Non-Hodgkin lymphoma begins when a lymphocyte

(usually a B cell) becomes abnormal. The abnormal

cell divides to make copies of itself. The new cells

divide again and again, making more and more

abnormal cells. The abnormal cells don’t die when they

should. They don’t protect the body from infections or

other diseases. The buildup of extra cells often forms a

mass of tissue called a growth or tumor.

See the Staging section on page 9 for information

about lymphoma that has spread.

Risk Factors

Doctors seldom know why one person develops

non-Hodgkin lymphoma and another does not. But

research shows that certain risk factors increase the

chance that a person will develop this disease. 

In general, the risk factors for non-Hodgkin

lymphoma include the following: 

• Weakened immune system: The risk of developing

lymphoma may be increased by having a weakened

immune system (such as from an inherited condition

or certain drugs used after an organ transplant). 

• Certain infections: Having certain types of

infections increases the risk of developing

lymphoma. However, lymphoma is not contagious.

You cannot catch lymphoma from another person.

The following are the main types of infection that

can increase the risk of lymphoma:

—Human immunodeficiency virus (HIV): HIV is

the virus that causes AIDS. People who have HIV

infection are at much greater risk of some types

of non-Hodgkin lymphoma.

4
—Epstein-Barr virus (EBV): Infection with EBV

has been linked to an increased risk of

lymphoma. In Africa, EBV infection is linked to

Burkitt lymphoma.

—Helicobacter pylori: H. pylori are bacteria that

can cause stomach ulcers. They also increase a

person’s risk of lymphoma in the stomach lining.

—Human T-cell leukemia/lymphoma virus 

(HTLV-1): Infection with HTLV-1 increases a

person’s risk of lymphoma and leukemia. 

—Hepatitis C virus: Some studies have found an

increased risk of lymphoma in people with

hepatitis C virus. More research is needed to

understand the role of hepatitis C virus.

• Age: Although non-Hodgkin lymphoma can

occur in young people, the chance of developing

this disease goes up with age. Most people with

non-Hodgkin lymphoma are older than 60.

(For information about this disease in children,

call the Cancer Information Service at

1–800–4–CANCER.) 

Researchers are studying obesity and other possible

risk factors for non-Hodgkin lymphoma. People who

work with herbicides or certain other chemicals may

be at increased risk of this disease. Researchers are

also looking at a possible link between using hair dyes

before 1980 and non-Hodgkin lymphoma. 

Having one or more risk factors does not mean that

a person will develop non-Hodgkin lymphoma. Most

people who have risk factors never develop cancer. 

5
Symptoms

Non-Hodgkin lymphoma can cause many

symptoms: 

• Swollen, painless lymph nodes in the neck, armpits,

or groin

• Unexplained weight loss

• Fever

• Soaking night sweats

• Coughing, trouble breathing, or chest pain

• Weakness and tiredness that don’t go away

• Pain, swelling, or a feeling of fullness in the

abdomen

Most often, these symptoms are not due to cancer.

Infections or other health problems may also cause

these symptoms. Anyone with symptoms that do not go

away within 2 weeks should see a doctor so that

problems can be diagnosed and treated.

Diagnosis

If you have swollen lymph nodes or another

symptom that suggests non-Hodgkin lymphoma, your

doctor will try to find out what’s causing the problem.

Your doctor may ask about your personal and family

medical history. 

You may have some of the following exams and

tests:

• Physical exam: Your doctor checks for swollen

lymph nodes in your neck, underarms, and groin.

Your doctor also checks for a swollen spleen or

liver.

6
• Blood tests: The lab does a complete blood count to

check the number of white blood cells. The lab also

checks for other cells and substances, such as lactate

dehydrogenase (LDH). Lymphoma may cause a

high level of LDH.

• Chest x-rays: You may have x-rays to check for

swollen lymph nodes or other signs of disease in

your chest.

• Biopsy: A biopsy is the only sure way to diagnose

lymphoma. Your doctor may remove an entire

lymph node (excisional biopsy) or only part of a

lymph node (incisional biopsy). A thin needle (fine

needle aspiration) usually cannot remove a large

enough sample for the pathologist to diagnose

lymphoma. Removing an entire lymph node is best.

The pathologist uses a microscope to check the

tissue for lymphoma cells. 

7

You may want to ask the doctor these

questions before having a biopsy:

• How will the biopsy be done? 

• Where will I have my biopsy? 

• Will I have to do anything to prepare for it?

• How long will it take? Will I be awake? Will it

hurt?

• Are there any risks? What are the chances of

swelling, infection, or bleeding after the

biopsy?

• How long will it take me to recover? 

• How soon will I know the results? Who will

explain them to me?

• If I do have cancer, who will talk to me about

the next steps? When?
Types of Non-Hodgkin Lymphoma 

When lymphoma is found, the pathologist reports

the type. There are many types of lymphoma. The most

common types are diffuse large B-cell lymphoma and

follicular lymphoma.

Lymphomas may be grouped by how quickly they

are likely to grow: 

• Indolent (also called low-grade) lymphomas grow

slowly. They tend to cause few symptoms. 

• Aggressive (also called intermediate-grade and

high-grade) lymphomas grow and spread more

quickly. They tend to cause severe symptoms. Over

time, many indolent lymphomas become aggressive

lymphomas. 

8
It’s a good idea to get a second opinion about the

type of lymphoma that you have. The treatment plan

varies by the type of lymphoma. A pathologist at a

major referral center can review your biopsy. See the

Second Opinion section on page 22 for more

information.

Staging

Your doctor needs to know the extent (stage) of nonHodgkin lymphoma to plan the best treatment. Staging

is a careful attempt to find out what parts of the body

are affected by the disease.

Lymphoma usually starts in a lymph node. It can

spread to nearly any other part of the body. For

example, it can spread to the liver, lungs, bone, and

bone marrow. 

Staging may involve some of these tests: 

• Bone marrow biopsy: The doctor uses a thick

needle to remove a small sample of bone and bone

marrow from your hipbone or another large bone.

Local anesthesia can help control pain. A

pathologist looks for lymphoma cells in the sample.

• CT scan: An x-ray machine linked to a computer

takes a series of detailed pictures of your head, neck,

chest, abdomen, or pelvis. You may receive an

injection of contrast material. Also, you may be

asked to drink another type of contrast material. The

contrast material makes it easier for the doctor to see

swollen lymph nodes and other abnormal areas on

the x-ray.

9
• MRI: Your doctor may order MRI pictures of your

spinal cord, bone marrow, or brain. MRI uses a

powerful magnet linked to a computer. It makes

detailed pictures of tissue on a computer screen or

film. 

• Ultrasound: An ultrasound device sends out sound

waves that you cannot hear. A small hand-held

device is held against your body. The waves bounce

off nearby tissues, and a computer uses the echoes

to create a picture. Tumors may produce echoes that

are different from the echoes made by healthy

tissues. The picture can show possible tumors. 

• Spinal tap: The doctor uses a long, thin needle to

remove fluid from the spinal column. Local

anesthesia can help control pain. You must lie flat

for a few hours afterward so that you don’t get a

headache. The lab checks the fluid for lymphoma

cells or other problems. 

• PET scan: You receive an injection of a small

amount of radioactive sugar. A machine makes

computerized pictures of the sugar being used by

cells in your body. Lymphoma cells use sugar faster

than normal cells, and areas with lymphoma look

brighter on the pictures. 

The stage is based on where lymphoma cells are

found (in the lymph nodes or in other organs or

tissues). The stage also depends on how many areas are

affected. The stages of non-Hodgkin lymphoma are as

follows:

• Stage I: The lymphoma cells are in one lymph node

group (such as in the neck or underarm). Or, if the

abnormal cells are not in the lymph nodes, they are

in only one part of a tissue or organ (such as the

lung, but not the liver or bone marrow).

10
• Stage II: The lymphoma cells are in at least two

lymph node groups on the same side of (either

above or below) the diaphragm. (See the picture of

the diaphragm on page 3.) Or, the lymphoma cells

are in one part of an organ and the lymph nodes

near that organ (on the same side of the diaphragm).

There may be lymphoma cells in other lymph node

groups on the same side of the diaphragm. 

• Stage III: The lymphoma is in lymph nodes above

and below the diaphragm. It also may be found in

one part of a tissue or an organ near these lymph

node groups.

• Stage IV: Lymphoma cells are found in several

parts of one or more organs or tissues (in addition to

the lymph nodes). Or, it is in the liver, blood, or

bone marrow.

• Recurrent: The disease returns after treatment.

In addition to these stage numbers, your doctor may

also describe the stage as A or B:

• A: You have not had weight loss, drenching night

sweats, or fevers.

• B: You have had weight loss, drenching night

sweats, or fevers. 

11
Treatment

Your doctor can describe your treatment choices and

the expected results. You and your doctor can work

together to develop a treatment plan that meets your

needs. 

Your doctor may refer you to a specialist, or you

may ask for a referral. Specialists who treat nonHodgkin lymphoma include hematologists, medical

oncologists, and radiation oncologists. Your doctor

may suggest that you choose an oncologist who

specializes in the treatment of lymphoma. Often, such

doctors are associated with major academic centers.

Your health care team may also include an oncology

nurse and a registered dietitian.

The choice of treatment depends mainly on the

following:

• The type of non-Hodgkin lymphoma (for example,

follicular lymphoma)

• Its stage (where the lymphoma is found) 

• How quickly the cancer is growing (whether it is

indolent or aggressive lymphoma)

• Your age

• Whether you have other health problems 

If you have indolent non-Hodgkin lymphoma

without symptoms, you may not need treatment for the

cancer right away. The doctor watches your health

closely so that treatment can start when you begin to

have symptoms. Not getting cancer treatment right

away is called watchful waiting. 

If you have indolent lymphoma with symptoms, you

will probably receive chemotherapy and biological

therapy. Radiation therapy may be used for people

with Stage I or Stage II lymphoma.

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If you have aggressive lymphoma, the treatment is

usually chemotherapy and biological therapy.

Radiation therapy also may be used. 

If non-Hodgkin lymphoma comes back after

treatment, doctors call this a relapse or recurrence.

People whose lymphoma comes back after treatment

may receive high doses of chemotherapy, radiation

therapy, or both, followed by stem cell transplantation.

You may want to know about side effects and how

treatment may change your normal activities. Because

chemotherapy and radiation therapy often damage

healthy cells and tissues, side effects are common. Side

effects may not be the same for each person, and they

may change from one treatment session to the next.

Before treatment starts, your health care team will

explain possible side effects and suggest ways to help

you manage them. 

At any stage of the disease, you can have supportive

care. Supportive care is treatment to control pain and

other symptoms, to relieve the side effects of therapy,

and to help you cope with the feelings that a diagnosis

of cancer can bring. See the Supportive Care section on

page 24. 

You may want to talk to your doctor about taking

part in a clinical trial, a research study of new

treatment methods. See the Taking Part in Cancer

Research section on page 28.

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14

You may want to ask the doctor these

questions before you begin treatment:

• What type of lymphoma do I have? May I

have a copy of the report from the pathologist?

• What is the stage of my disease? Where are the

tumors?

• What are my treatment choices? Which do you

recommend for me? Why?

• Will I have more than one kind of treatment?

• What are the expected benefits of each kind of

treatment? How will we know the treatment is

working? What tests will be used to check its

effectiveness? How often will I get these tests?

• What are the risks and possible side effects of

each treatment? What can we do to control the

side effects?

• How long will treatment last?

• Will I have to stay in the hospital? If so, for

how long?

• What can I do to take care of myself during

treatment?

• What is the treatment likely to cost? Will my

insurance cover the cost?

• How will treatment affect my normal

activities? 

• Would a clinical trial be right for me?

• How often will I need checkups?
Watchful Waiting 

People who choose watchful waiting put off having

cancer treatment until they have symptoms. Doctors

sometimes suggest watchful waiting for people with

indolent lymphoma. People with indolent lymphoma

may not have problems that require cancer treatment

for a long time. Sometimes the tumor may even shrink

for a while without therapy. By putting off treatment,

they can avoid the side effects of chemotherapy or

radiation therapy.

If you and your doctor agree that watchful waiting is

a good idea, the doctor will check you regularly (every

3 months). You will receive treatment if symptoms

occur or get worse. 

Some people do not choose watchful waiting

because they don’t want to worry about having cancer

that is not treated. Those who choose watchful waiting

but later become worried should discuss their feelings

with the doctor. 

15

You may want to ask the doctor these

questions before choosing watchful waiting:

• If I choose watchful waiting, can I change my

mind later on?

• Will the disease be harder to treat later?

• How often will I have checkups?

• Between checkups, what problems should I

report?
Chemotherapy

Chemotherapy for lymphoma uses drugs to kill

lymphoma cells. It is called systemic therapy because

the drugs travel through the bloodstream. The drugs

can reach lymphoma cells in almost all parts of the

body. 

You may receive chemotherapy by mouth, through a

vein, or in the space around the spinal cord. Treatment

is usually in an outpatient part of the hospital, at the

doctor’s office, or at home. Some people need to stay

in the hospital during treatment. 

Chemotherapy is given in cycles. You have a

treatment period followed by a rest period. The length

of the rest period and the number of cycles depend on

the stage of your disease and on the anticancer drugs

used.

If you have lymphoma in the stomach caused by 

H. pylori infection, your doctor may treat this

lymphoma with antibiotics. After the drug cures the

infection, the lymphoma also may go away. 

The side effects of chemotherapy depend mainly on

which drugs are given and how much. The drugs can

harm normal cells that divide rapidly: 

• Blood cells: When chemotherapy lowers your levels

of healthy blood cells, you are more likely to get

infections, bruise or bleed easily, and feel very weak

and tired. Your health care team gives you blood

tests to check for low levels of blood cells. If levels

are low, there are medicines that can help your body

make new blood cells.

• Cells in hair roots: Chemotherapy may cause hair

loss. If you lose your hair, it will grow back, but it

may be somewhat different in color and texture.

16
• Cells that line the digestive tract: Chemotherapy

can cause poor appetite, nausea and vomiting,

diarrhea, trouble swallowing, or mouth and lip sores.

Ask your health care team about medicines or other

treatments that help with these problems.

The drugs used for non-Hodgkin lymphoma also

may cause skin rashes or blisters, and headaches or

other aches. Your skin may become darker. Your nails

may develop ridges or dark bands.

Your doctor can suggest ways to control many of

these side effects. You may find it helpful to read

NCI’s booklet Chemotherapy and You. Page 46 tells

how to get NCI booklets.

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You may want to ask the doctor these

questions before having chemotherapy:

• Which drug or drugs will I have?

• When will treatment start? When will it end?

How often will I have treatments?

• What side effects should I tell you about? Can

I prevent or treat any of these side effects?

• Will there be lasting side effects?

Biological Therapy

People with certain types of non-Hodgkin lymphoma

may have biological therapy. This type of treatment

helps the immune system fight cancer. 
Monoclonal antibodies are the type of biological

therapy used for lymphoma. They are proteins made in

the lab that can bind to cancer cells. They help the

immune system kill lymphoma cells. People receive

this treatment through a vein at the doctor’s office,

clinic, or hospital. 

Flu-like symptoms such as fever, chills, headache,

weakness, and nausea may occur. Most side effects are

easy to treat. Rarely, a person may have more serious

side effects, such as breathing problems, low blood

pressure, or severe skin rashes. Your doctor or nurse

can tell you about the side effects that you can expect

and how to manage them.

You may find it helpful to read NCI’s booklet

Biological Therapy. Page 46 tells how to get NCI

booklets.

18

You may want to ask the doctor these

questions before having biological therapy:

• What will the treatment do?

• Will I have to stay in the hospital?

• How will we know if the treatment is working?

• How long will I be on biological therapy?

• Will I have side effects during treatment? How

long will they last? What can we do about

them?
Radiation Therapy

Radiation therapy (also called radiotherapy) uses

high-energy rays to kill non-Hodgkin lymphoma cells.

It can shrink tumors and help control pain. 

Two types of radiation therapy are used for people

with lymphoma:

• External radiation: A large machine aims the rays

at the part of the body where lymphoma cells have

collected. This is local therapy because it affects

cells in the treated area only. Most people go to a

hospital or clinic for treatment 5 days a week for

several weeks.

• Systemic radiation: Some people with lymphoma

receive an injection of radioactive material that

travels throughout the body. The radioactive

material is bound to monoclonal antibodies that seek

out lymphoma cells. The radiation destroys the

lymphoma cells. 

The side effects of radiation therapy depend mainly

on the type of radiation therapy, the dose of radiation,

and the part of the body that is treated. For example,

external radiation to your abdomen can cause nausea,

vomiting, and diarrhea. When your chest and neck are

treated, you may have a dry, sore throat and some

trouble swallowing. In addition, your skin in the

treated area may become red, dry, and tender. You also

may lose your hair in the treated area.

You are likely to become very tired during external

radiation therapy, especially in the later weeks of

treatment. Resting is important, but doctors usually

advise people to try to stay as active as they can. 

19
People who get systemic radiation also may feel

very tired. They may be more likely to get infections. 

If you have radiation therapy and chemotherapy at

the same time, your side effects may be worse. The

side effects can be distressing. You can talk with your

doctor about ways to relieve them.

You may find it helpful to read NCI’s booklet

Radiation Therapy and You. Page 46 tells how to get

NCI booklets.

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You may want to ask the doctor these

questions before starting radiation therapy:

• Why do I need this treatment?

• When will the treatments begin? When will

they end?

• What are the risks and side effects of this

treatment? What can we do about them?

• How will I feel during treatment?

• How will treatment affect my normal

activities?

• Are there any lasting effects?
Stem Cell Transplantation

If lymphoma returns after treatment, you may

receive stem cell transplantation. A transplant of bloodforming stem cells allows you to receive high doses of

chemotherapy, radiation therapy, or both. The high

doses destroy both lymphoma cells and healthy blood

cells in your bone marrow. 

Stem cell transplants take place in the hospital. After

you receive high-dose treatment, healthy bloodforming stem cells are given to you through a flexible

tube placed in a large vein in your neck or chest area.

New blood cells develop from the transplanted stem

cells.

The stem cells may come from your own body or

from a donor:

• Autologous stem cell transplantation: This type of

transplant uses your own stem cells. Your stem cells

are removed before high-dose treatment. The cells

may be treated to kill lymphoma cells that may be

present. The stem cells are frozen and stored. After

you receive high-dose treatment, the stored stem

cells are thawed and returned to you. 

• Allogeneic stem cell transplantation: Sometimes

healthy stem cells from a donor are available. Your

brother, sister, or parent may be the donor. Or the

stem cells may come from an unrelated donor.

Doctors use blood tests to be sure the donor’s cells

match your cells. 

• Syngeneic stem cell transplantation: This type of

transplant uses stem cells from a patient’s healthy

identical twin.

You may find it helpful to read NCI’s fact sheet

Bone Marrow Transplantation and Peripheral Blood

Stem Cell Transplantation: Questions and Answers.

Page 46 tells how to get NCI fact sheets.

21
Second Opinion

Before starting treatment, you might want a second

opinion about your diagnosis and your treatment plan.

Many insurance companies cover a second opinion if

you or your doctor requests it. 

It may take some time and effort to gather your

medical records and see another doctor. In most cases,

a brief delay in starting treatment will not make

treatment less effective. To make sure, you should

discuss this delay with your doctor. Sometimes people

with non-Hodgkin lymphoma need treatment right

away. 

22

You may want to ask the doctor these

questions before having a stem cell transplant:

• What are the possible benefits and risks of

different types of transplants? 

• What kind of stem cell transplant will I have?

If I need a donor, how will we find one?

• How long will I need to be in the hospital?

Will I need special care? How will I be

protected from germs?

• How will we know if the treatment is working?

• What can we do about side effects?

• How will treatment affect my normal

activities?

• What is my chance of a full recovery?
There are many ways to find a doctor for a second

opinion. You can ask your doctor, a local or state

medical society, a nearby hospital, or a medical school

for names of specialists. Other sources can be found in

the NCI fact sheet How To Find a Doctor or Treatment

Facility If You Have Cancer. 

Nonprofit groups with an interest in lymphoma may

be of help. Many such groups are listed in the NCI fact

sheet National Organizations That Offer Services to

People With Cancer and Their Families. Page 46 tells

how to get NCI fact sheets.

23
Supportive Care

Non-Hodgkin lymphoma and its treatment can lead

to other health problems. You may receive supportive

care to prevent or control these problems and to

improve your comfort and quality of life during

treatment.

You may receive antibiotics and other drugs to help

protect you from infections. Your health care team may

advise you to stay away from crowds and from people

with colds and other contagious diseases. If an

infection develops, it can be serious, and you will need

treatment right away. 

Non-Hodgkin lymphoma and its treatment also can

lead to anemia, which may make you feel very tired.

Drugs or blood transfusions can help with this

problem. 

You can get information about supportive care

on NCI’s Web site at http://www.cancer.gov/

cancerinfo/coping and from NCI’s Cancer Information

Service at 1–800–4–CANCER. 

Nutrition and Physical Activity

It’s important for you to take care of yourself by

eating well and staying as active as you can. 

You need the right amount of calories to maintain a

good weight. You also need enough protein to keep up

your strength. Eating well may help you feel better and

have more energy.

24
Sometimes, especially during or soon after

treatment, you may not feel like eating. You may be

uncomfortable or tired. You may find that foods do not

taste as good as they used to. In addition, the side

effects of treatment (such as poor appetite, nausea,

vomiting, or mouth sores) can make it hard to eat well.

Your doctor, a registered dietitian, or another health

care provider can suggest ways to deal with these

problems. Also, the NCI booklet Eating Hints for

Cancer Patients has many useful ideas and recipes.

Page 46 tells how to get NCI booklets.

Many people find they feel better when they stay

active. Walking, yoga, swimming, and other activities

can keep you strong and increase your energy. Exercise

may reduce nausea and pain and make treatment easier

to handle. It also can help relieve stress. Whatever

physical activity you choose, be sure to talk to your

doctor before you start. Also, if your activity causes

you pain or other problems, be sure to let your doctor

or nurse know about it.

Follow-up Care

You’ll need regular checkups after treatment for

non-Hodgkin lymphoma. Your doctor will watch your

recovery closely and check for recurrence of the

lymphoma. Checkups help make sure that any changes

in your health are noted and treated as needed.

Checkups may include a physical exam, lab tests, chest

x-rays, and other procedures. Between scheduled visits,

you should contact the doctor right away if you have

any health problems.

25
You may want to read the NCI booklet Facing

Forward: Life After Cancer Treatment. It answers

questions about follow-up care and other concerns.

Page 46 tells how to get NCI booklets.

26

You may want to ask your doctor these

questions after you have finished treatment:

• How often will I need checkups?

• Which follow-up tests do you suggest for me? 

• Between checkups, what health problems or

symptoms should I tell you about?

Sources of Support

Learning you have non-Hodgkin lymphoma can

change your life and the lives of those close to you.

These changes can be hard to handle. It’s normal for

you, your family, and your friends to have many

different and sometimes confusing feelings. 

Concerns about treatments and managing side

effects, hospital stays, and medical bills are common.

You also may worry about caring for your family,

keeping your job, or continuing daily activities. 

Here’s where you can go for support:

• Doctors, nurses, and other members of your health

care team can answer many of your questions about

treatment, working, or other activities. 

• Social workers, counselors, or members of the clergy

can be helpful if you want to talk about your feelings

or concerns. Often, social workers can suggest

resources for financial aid, transportation, home care,

or emotional support.
• Support groups can also help. In these groups,

patients or their family members meet with other

patients or their families to share what they have

learned about coping with the disease and the effects

of treatment. Groups may offer support in person,

over the telephone, or on the Internet. You may want

to talk with a member of your health care team

about finding a support group. 

• Information specialists at 1–800–4–CANCER and

at LiveHelp (http://www.cancer.gov/help) can help

you locate programs, services, and publications.

They can give you names of national organizations

that offer services to people with cancer and their

families.

For tips on coping, you may want to read the NCI

booklet Taking Time: Support for People With Cancer.

Page 46 tells how to get NCI booklets.

27
Taking Part in Cancer Research

Doctors all over the country are studying new ways

to treat lymphoma. Clinical trials (research studies in

which people volunteer to take part) find out whether

promising approaches to treatment are safe and

effective. Research already has led to advances.

Researchers are studying many types of treatments

for lymphoma: 

• Chemotherapy: Doctors are testing new drugs that

kill cancer cells. They are working with many drugs

and drug combinations. They also are looking at

ways of combining drugs with other treatments,

such as biological therapy.

• Radiation therapy: Doctors are testing radiation

treatment alone and with chemotherapy.

• Biological therapy: New types of biological therapy

are under study. For example, researchers are

making cancer vaccines that may help the immune

system kill lymphoma cells. Also, doctors are

studying a type of biological therapy that delivers

radiation directly to cancer cells.

• Stem cell transplantation: Doctors are studying

stem cell transplantation in people with newly

diagnosed lymphoma and those who have already

been treated.

People who join clinical trials may be among the

first to benefit if a new approach is effective. And even

if participants do not benefit directly, they still help

doctors learn more about lymphoma and how to

control it. Although clinical trials may pose some risks,

researchers do all they can to protect their patients.

28
If you are interested in being part of a clinical trial,

you should talk with your doctor. You may want to

read the NCI booklet Taking Part in Cancer Treatment

Research Studies. It describes how treatment studies

are carried out and explains their possible benefits and

risks. Page 46 tells how to get NCI booklets.

NCI’s Web site includes a section on clinical trials at

http://www.cancer.gov/clinicaltrials. It has general

information about clinical trials as well as detailed

information about specific ongoing studies of new

treatments for non-Hodgkin lymphoma. Information

specialists at 1–800–4–CANCER or at LiveHelp can

answer questions and provide information about

clinical trials. 

29
Dictionary

Definitions of thousands of terms are on the NCI

Web site in the NCI Dictionary of Cancer Terms. You

can access it at http://www.cancer.gov/dictionary. 

Abdomen (AB-doh-men): The area of the body that

contains the pancreas, stomach, intestines, liver,

gallbladder, and other organs.

Aggressive lymphoma: A type of lymphoma that grows

and spreads quickly, and has severe symptoms. It is

seen frequently in patients who are HIV-positive

(AIDS-related lymphoma). Also called intermediategrade lymphoma or high-grade lymphoma.

AIDS: Acquired immunodeficiency syndrome

(uh-KWY-erd IH-myoo-noh-dih-FIH-shun-see

SIN-drome). A disease caused by human

immunodeficiency virus (HIV). People with AIDS are

at an increased risk for developing certain cancers and

for infections that usually occur only in individuals

with a weak immune system.

Allogeneic stem cell transplantation (A-loh-jehNAY-ik stem sel tranz-plan-TAY-shun): A procedure in

which a person receives blood-forming stem cells

(cells from which all blood cells develop) from a

genetically similar, but not identical, donor. This is

often a sister or brother, but could be an unrelated

donor.

Anemia (a-NEE-mee-a): A condition in which the

number of red blood cells is below normal.

Antibiotic (an-tih-by-AH-tik): A drug used to treat

infections caused by bacteria and other

microorganisms.

30
Autologous stem cell transplantation (aw-TAHluh-gus stem sel tranz-plan-TAY-shun): A procedure in

which blood-forming stem cells (cells from which all

blood cells develop) are removed, stored, and later

given back to the same person.

B cell: A white blood cell that comes from bone

marrow. As part of the immune system, B cells make

antibodies and help fight infections. Also called 

B lymphocyte.

Bacteria (bak-TEER-ee-uh): A large group of singlecell microorganisms. Some cause infections and

disease in animals and humans. The singular of

bacteria is bacterium.

Biological therapy (BY-oh-LAH-jih-kul THAYRuh-pee): Treatment to boost or restore the ability of the

immune system to fight cancer, infections, and other

diseases. Also used to lessen certain side effects that

may be caused by some cancer treatments. Agents used

in biological therapy include monoclonal antibodies,

growth factors, and vaccines. These agents may also

have a direct antitumor effect. Also called

immunotherapy, biotherapy, biological response

modifier therapy, and BRM therapy.

Biopsy (BY-op-see): The removal of cells or tissues for

examination by a pathologist. The pathologist may

study the tissue under a microscope or perform other

tests on the cells or tissue. When only a sample of

tissue is removed, the procedure is called an incisional

biopsy. When an entire lump or suspicious area is

removed, the procedure is called an excisional biopsy.

When a sample of tissue or fluid is removed with a

needle, the procedure is called a needle biopsy, core

biopsy, or fine-needle aspiration.

Blood transfusion: The administration of blood or

blood products into a blood vessel.

31
Bone marrow (MAYR-oh): The soft, sponge-like

tissue in the center of most bones. It produces white

blood cells, red blood cells, and platelets.

Bone marrow biopsy (MAYR-oh BY-op-see): The

removal of a sample of tissue from the bone marrow

with a needle for examination under a microscope.

Burkitt lymphoma (BER-kit lim-FOH-muh): An

aggressive (fast-growing) type of B-cell non-Hodgkin

lymphoma that occurs most often in children and

young adults. The disease may affect the jaw, central

nervous system, bowel, kidneys, ovaries, or other

organs. There are three main types of Burkitt

lymphoma (sporadic, endemic, and immunodeficiency

related). Sporadic Burkitt lymphoma occurs throughout

the world, and endemic Burkitt lymphoma occurs in

Africa. Immunodeficiency-related Burkitt lymphoma is

most often seen in AIDS patients.

Cancer (KAN-ser): A term for diseases in which

abnormal cells divide without control. Cancer cells can

invade nearby tissues and can spread to other parts of

the body through the blood and lymph systems.

Cell (sel): The individual unit that makes up the tissues

of the body. All living things are made up of one or

more cells. 

Chemotherapy (KEE-moh-THAYR-uh-pee):

Treatment with drugs that kill cancer cells. 

Clinical trial: A type of research study that tests how

well new medical approaches work in people. These

studies test new methods of screening, prevention,

diagnosis, or treatment of a disease. Also called a

clinical study.

32
Complete blood count: CBC. A test to check the

number of red blood cells, white blood cells, and

platelets in a sample of blood. Also called blood cell

count.

Contiguous lymphoma (kun-TIG-yoo-us lim-FOHmuh): Lymphoma in which the lymph nodes

containing cancer are next to each other.

Contrast material: A dye or other substance that helps

to show abnormal areas inside the body. It is given by

injection into a vein, by enema, or by mouth. Contrast

material may be used with x-rays, CT scans, MRI, or

other imaging tests.

CT scan: Computed tomography scan (kum-PYOO-ted

tuh-MAH-gruh-fee skan). A series of detailed pictures

of areas inside the body taken from different angles;

the pictures are created by a computer linked to an 

x-ray machine. Also called computerized tomography

and computerized axial tomography (CAT) scan.

Diaphragm (DY-uh-fram): The thin muscle below the

lungs and heart that separates the chest from the

abdomen. 

Diffuse large B-cell lymphoma (lim-FOH-muh): A

type of B-cell non-Hodgkin lymphoma (cancer of the

immune system) that is usually aggressive (fastgrowing). It is the most common type of non-Hodgkin

lymphoma, and is marked by rapidly growing tumors

in the lymph nodes, spleen, liver, bone marrow, or

other organs. Other symptoms include fever, night

sweats, and weight loss. There are several subtypes of

diffuse large B-cell lymphoma.

Digestive tract (dy-JES-tiv): The organs through which

food and liquids pass when they are swallowed,

digested, and eliminated. These organs are the mouth,

esophagus, stomach, small and large intestines, and

rectum and anus.

33
Epstein-Barr virus (ep-stine-BAR VY-rus): EBV.

A common virus that remains dormant in most people.

It causes infectious mononucleosis and has been

associated with certain cancers, including Burkitt

lymphoma, immunoblastic lymphoma, and

nasopharyngeal carcinoma. 

Excisional biopsy (ek-SIH-zhun-al BY-op-see):

A surgical procedure in which an entire lump or

suspicious area is removed for diagnosis. The tissue is

then examined under a microscope.

External radiation therapy (RAY-dee-AY-shun

THAYR-uh-pee): A type of radiation therapy that uses

a machine to aim high-energy rays at the cancer from

outside of the body. Also called external beam

radiation therapy.

Fine needle aspiration (as-per-AY-shun): The removal

of tissue or fluid with a needle for examination under a

microscope. Also called needle biopsy.

Follicular lymphoma (fuh-LIH-kyoo-ler limFOH-muh): A type of B-cell non-Hodgkin lymphoma

(cancer of the immune system) that is usually indolent

(slow-growing). The tumor cells grow as groups to

form nodules. There are several subtypes of follicular

lymphoma.

Groin: The area where the thigh meets the abdomen.

Helicobacter pylori (HEEL-ih-koh-BAK-ter

py-LOR-ee): H. pylori. A type of bacterium that causes

inflammation and ulcers in the stomach or small

intestine. People with H. pylori infections may be more

likely to develop cancer in the stomach, including

MALT (mucosa-associated lymphoid tissue)

lymphoma.

Hematologist (HEE-muh-TAH-loh-jist): A doctor who

specializes in treating blood disorders.

34
Hepatitis C virus (HEH-puh-TY-tis SEE VY-rus): A

virus that causes hepatitis (inflammation of the liver).

It is carried and passed to others through blood or

sexual contact. Also, infants born to infected mothers

may become infected with the virus.

Herbicide: A chemical that kills plants.

High-grade lymphoma (lim-FOH-muh): A type of

lymphoma that grows and spreads quickly, and has

severe symptoms. It is seen frequently in patients who

are HIV-positive (AIDS-related lymphoma). Also

called aggressive lymphoma or intermediate-grade

lymphoma.

Hodgkin lymphoma (HOJ-kin lim-FOH-muh): A

cancer of the immune system that is marked by the

presence of a type of cell called the Reed-Sternberg

cell. Symptoms include the painless enlargement of

lymph nodes, spleen, or other immune tissue. Other

symptoms include fever, weight loss, fatigue, or night

sweats. Also called Hodgkin disease.

Human immunodeficiency virus (HYOO-mun

ih-MYOO-noh-dih-FIH-shun-see VY-rus): HIV. The

cause of acquired immunodeficiency syndrome

(AIDS).

Human T-cell leukemia/lymphoma virus type 1

(HYOO-mun TEE-sel loo-KEE-mee-uh lim-FOH-muh

VY-rus): HTLV-1. A type of virus that infects T cells 

(a type of white blood cell) and can cause leukemia

and lymphoma. HTLV-1 is spread by sharing syringes

or needles, through blood transfusions or sexual

contact, and from mother to child during birth or

breast-feeding. 

Immune system (ih-MYOON): The complex group of

organs and cells that defends the body against

infections and other diseases. 

35
Incisional biopsy (in-SIH-zhun-al BY-op-see): A

surgical procedure in which a portion of a lump or

suspicious area is removed for diagnosis. The tissue is

then examined under a microscope.

Indolent lymphoma (IN-doh-lent lim-FOH-muh): A

type of lymphoma that tends to grow and spread

slowly, and has few symptoms. Also called low-grade

lymphoma.

Infection: Invasion and multiplication of germs in the

body. Infections can occur in any part of the body and

can spread throughout the body. The germs may be

bacteria, viruses, yeast, or fungi. They can cause a

fever and other problems, depending on where the

infection occurs. When the body’s natural defense

system is strong, it can often fight the germs and

prevent infection. Some cancer treatments can weaken

the natural defense system.

Inherited (in-HAYR-it-ed): Transmitted through genes

that have been passed from parents to their offspring

(children). 

Injection: Use of a syringe and needle to push fluids or

drugs into the body; often called a “shot.”

Intermediate-grade lymphoma: A type of lymphoma

that grows and spreads quickly, and has severe

symptoms. It is seen frequently in patients who are

HIV-positive (AIDS-related lymphoma). Also called

aggressive lymphoma or high-grade lymphoma. 

Lactate dehydrogenase (LAK-tayt dee-hy-DRAHjeh-nayz): LDH. One of a group of enzymes found in

the blood and other body tissues, and involved in

energy production in cells. An increased amount of

LDH in the blood may be a sign of tissue damage and

some types of cancer or other diseases. Also called

lactic acid dehydrogenase.

36
Leukemia (loo-KEE-mee-uh): Cancer that starts in

blood-forming tissue such as the bone marrow and

causes large numbers of blood cells to be produced and

enter the bloodstream.

Local anesthesia (A-nes-THEE-zhuh ): Drugs that

cause a temporary loss of feeling in one part of the

body. The patient remains awake but has no feeling in

the part of the body treated with the anesthetic.

Local therapy (THAYR-uh-pee): Treatment that affects

cells in the tumor and the area close to it. 

Low-grade lymphoma: A type of lymphoma that tends

to grow and spread slowly, and has few symptoms.

Also called indolent lymphoma. 

Lymph (limf): The clear fluid that travels through the

lymphatic system and carries cells that help fight

infections and other diseases. Also called lymphatic

fluid.

Lymph node (limf node): A rounded mass of lymphatic

tissue that is surrounded by a capsule of connective

tissue. Lymph nodes filter lymph (lymphatic fluid), and

they store lymphocytes (white blood cells). They are

located along lymphatic vessels. Also called a lymph

gland.

Lymph vessel (limf): A thin tube that carries lymph

(lymphatic fluid) and white blood cells through the

lymphatic system. Also called lymphatic vessel. 

Lymphatic system (lim-FA-tik SIS-tem): The tissues

and organs that produce, store, and carry white blood

cells that fight infections and other diseases. This

system includes the spleen, thymus, lymph nodes, and

lymphatic vessels (a network of thin tubes that carry

lymph and white blood cells). Lymphatic vessels

branch, like blood vessels, into all the tissues of the

body.

37
Lymphocyte (LIM-foh-site): A type of white blood cell.

Lymphocytes have a number of roles in the immune

system, including the production of antibodies and

other substances that fight infections and other

diseases. 

Lymphoma (lim-FOH-muh): Cancer that begins in

cells of the immune system. There are two basic

categories of lymphomas. One kind is Hodgkin

lymphoma, which is marked by the presence of a type

of cell called the Reed-Sternberg cell. The other

category is non-Hodgkin lymphomas, which includes a

large, diverse group of cancers of immune system

cells. Non-Hodgkin lymphomas can be further divided

into cancers that have an indolent (slow-growing)

course and those that have an aggressive (fast-growing)

course. These subtypes behave and respond to

treatment differently. Both Hodgkin and non-Hodgkin

lymphomas can occur in children and adults, and

prognosis and treatment depend on the stage and the

type of cancer.

Medical oncologist (MEH-dih-kul on-KAH-loh-jist):

A doctor who specializes in diagnosing and treating

cancer using chemotherapy, hormonal therapy, and

biological therapy. A medical oncologist often is the

main health care provider for someone who has cancer.

A medical oncologist also gives supportive care and

may coordinate treatment given by other specialists. 

Monoclonal antibody (MAH-noh-KLOH-nul AN-tihBAH-dee): A type of protein made in the laboratory

that can locate and bind to substances in the body and

on the surface of cancer cells. There are many kinds of

monoclonal antibodies; each one is made to find a

different substance. Monoclonal antibodies are being

used to treat some types of cancer and are being

studied in the treatment of other types. They can be

used alone or to carry drugs, toxins, or radioactive

materials directly to a tumor.

38
MRI: Magnetic resonance imaging (mag-NEH-tik

REH-zuh-nunts IH-muh-jing). A procedure in which

radio waves and a powerful magnet linked to a

computer are used to create detailed pictures of areas

inside the body. These pictures can show the difference

between normal and diseased tissue. MRI makes better

images of organs and soft tissue than other scanning

techniques, such as computed tomography (CT) or 

x-ray. MRI is especially useful for imaging the brain,

the spine, the soft tissue of joints, and the inside of

bones. Also called nuclear magnetic resonance imaging

(NMRI).

Noncontiguous lymphoma (non-kun-TIG-yoo-us

lim-FOH-muh): Lymphoma in which the lymph nodes

containing cancer are not next to each other, but are on

the same side of the diaphragm (the thin muscle below

the lungs that helps breathing and separates the chest

from the abdomen).

Non-Hodgkin lymphoma (non-HOJ-kin lim-FOHmuh): NHL. Any of a large group of cancers of the

immune system. NHLs can occur at any age and are

often marked by enlarged lymph nodes, fever, and

weight loss. There are many different types of NHL,

which can be divided into aggressive (fast-growing)

and indolent (slow-growing) types and can be

classified as either B-cell or T-cell NHL. B-cell NHLs

include Burkitt lymphoma, diffuse large B-cell

lymphoma, follicular lymphoma, immunoblastic large

cell lymphoma, precursor B-lymphoblastic lymphoma,

and mantle cell lymphoma. T-cell NHLs include

mycosis fungoides, anaplastic large cell lymphoma,

and precursor T-lymphoblastic lymphoma. Lymphomas

related to lymphoproliferative disorders following bone

marrow or stem cell transplantation are usually B-cell

NHLs. Prognosis and treatment depend on the stage

and type of disease.

39
Obesity (oh-BEE-sih-tee): A condition marked by

having an abnormally high, unhealthy amount of body

fat.

Oncology nurse (on-KAH-loh-jee): A nurse who

specializes in treating and caring for people who have

cancer.

Pathologist (puh-THAH-loh-jist): A doctor who

identifies diseases by studying cells and tissues under a

microscope.

Pelvis: The lower part of the abdomen, located

between the hip bones.

PET scan: Positron emission tomography scan

(PAH-zih-tron ee-MIH-shun toh-MAH-gruh-fee skan).

A procedure in which a small amount of radioactive

glucose (sugar) is injected into a vein, and a scanner is

used to make detailed, computerized pictures of areas

inside the body where the glucose is used. Because

cancer cells often use more glucose than normal cells,

the pictures can be used to find cancer cells in the

body.

Radiation oncologist (RAY-dee-AY-shun on-KAHloh-jist): A doctor who specializes in using radiation to

treat cancer.

Radiation therapy (RAY-dee-AY-shun THAYRuh-pee): The use of high-energy radiation from x-rays,

gamma rays, neutrons, and other sources to kill cancer

cells and shrink tumors. Radiation may come from a

machine outside the body (external beam radiation

therapy), or it may come from radioactive material

placed in the body near cancer cells (internal radiation

therapy). Systemic radiation therapy uses a radioactive

substance, such as a radiolabeled monoclonal antibody,

that circulates throughout the body. Also called

radiotherapy and irradiation. 

Radioactive (RAY-dee-oh-AK-tiv): Giving off

radiation.

40
Recurrence: Cancer that has returned after a period of

time during which the cancer could not be detected.

The cancer may come back to the same place as the

original (primary) tumor or to another place in the

body. Also called recurrent cancer.

Registered dietitian (dy-eh-TIH-shun): A health

professional with special training in the use of diet and

nutrition to keep the body healthy. A registered

dietitian may help the medical team improve the

nutritional health of a patient.

Relapse: The return of signs and symptoms of cancer

after a period of improvement.

Risk factor: Something that may increase the chance of

developing a disease. Some examples of risk factors

for cancer include age, a family history of certain

cancers, use of tobacco products, certain eating habits,

obesity, lack of exercise, exposure to radiation or other

cancer-causing agents, and certain genetic changes. 

Side effect: A problem that occurs when treatment

affects healthy tissues or organs. Some common side

effects of cancer treatment are fatigue, pain, nausea,

vomiting, decreased blood cell counts, hair loss, and

mouth sores.

Spinal cord: A column of nerve tissue that runs from

the base of the skull down the back. It is surrounded by

three protective membranes, and is enclosed within the

vertebrae (back bones). The spinal cord and the brain

make up the central nervous system, and spinal cord

nerves carry most messages between the brain and the

rest of the body.

Spinal tap: A procedure in which a needle is put into

the lower part of the spinal column to collect

cerebrospinal fluid or to give drugs. Also called a

lumbar puncture.

41
Spleen: An organ that is part of the lymphatic system.

The spleen produces lymphocytes, filters the blood,

stores blood cells, and destroys old blood cells. It is

located on the left side of the abdomen near the

stomach. 

Stem cell: A cell from which other types of cells can

develop. Blood cells develop from blood-forming stem

cells.

Stem cell transplantation: A method of replacing

immature blood-forming cells that were destroyed by

cancer treatment. The stem cells are given to the

person after treatment to help the bone marrow recover

and continue producing healthy blood cells.

Supportive care: Care given to improve the quality of

life of patients who have a serious or life-threatening

disease. The goal of supportive care is to prevent or

treat as early as possible the symptoms of the disease,

side effects caused by treatment of the disease, and

psychological, social, and spiritual problems related to

the disease or its treatment. Also called palliative care,

comfort care, and symptom management.

Syngeneic stem cell transplantation (SIN-juhNAY-ik): A procedure in which a patient receives

blood-forming stem cells (cells from which all blood

cells develop) donated by his or her healthy identical

twin.

Systemic radiation therapy (sis-TEH-mik RAY-deeAY-shun THAYR-uh-pee): A type of radiation therapy

in which a radioactive substance, such as radioactive

iodine or a radioactively labeled monoclonal antibody,

is swallowed or injected into the body and travels

through the bloodstream, locating and killing tumor

cells.

42
Systemic therapy (sis-TEH-mik THAYR-uh-pee):

Treatment using substances that travel through the

bloodstream, reaching and affecting cells all over the

body.

T cell: One type of white blood cell that attacks virusinfected cells, foreign cells, and cancer cells. T cells

also produce a number of substances that regulate the

immune response. Also called T lymphocyte.

Thymus: An organ that is part of the lymphatic system,

in which T lymphocytes grow and multiply. The

thymus is in the chest behind the breastbone. 

Tissue (TISH-oo): A group or layer of cells that work

together to perform a specific function. 

Tonsil: One of two small masses of lymphoid tissue on

either side of the throat.

Tumor (TOO-mer): An abnormal mass of tissue that

results when cells divide more than they should or do

not die when they should. Tumors may be benign (not

cancerous), or malignant (cancerous). Also called

neoplasm.

Ultrasound (UL-truh-SOWND): A procedure in which

high-energy sound waves (ultrasound) are bounced off

internal tissues or organs and make echoes. The echo

patterns are shown on the screen of an ultrasound

machine, forming a picture of body tissues called a

sonogram. Also called ultrasonography. 

Vaccine: A substance or group of substances meant to

cause the immune system to respond to a tumor or to

microorganisms, such as bacteria or viruses. A vaccine

can help the body recognize and destroy cancer cells or

microorganisms. 

Virus (VY-rus): A microorganism that can infect cells

and cause disease.

43
Watchful waiting: Closely monitoring a patient’s

condition but withholding treatment until symptoms

appear or change. Also called observation. 

White blood cell: WBC. Refers to a blood cell that

does not contain hemoglobin. White blood cells

include lymphocytes, neutrophils, eosinophils,

macrophages, and mast cells. These cells are made by

bone marrow and help the body fight infections and

other diseases.

X-ray: A type of high-energy radiation. In low doses,

x-rays are used to diagnose diseases by making

pictures of the inside of the body. In high doses, x-rays

are used to treat cancer.

44
National Cancer Institute Information

Resources

You may want more information for yourself, your

family, and your doctor. The following NCI services

are available to help you.

Telephone

NCI’s Cancer Information Service (CIS) provides

accurate, up-to-date information on cancer to patients

and their families, health professionals, and the general

public. Information specialists translate the latest

scientific information into plain language and respond

in English or Spanish. Calls to the CIS are confidential

and free.

Telephone: 1–800–4–CANCER (1–800–422–6237)

TTY: 1–800–332–8615 

Internet

NCI’s Web site provides information from numerous

NCI sources. It offers current information about cancer

prevention, screening, diagnosis, treatment, genetics,

supportive care, and ongoing clinical trials. It has

information about NCI’s research programs, funding

opportunities, and cancer statistics. 

Web site: http://www.cancer.gov

Spanish Web site: http://www.cancer.gov/espanol

If you’re unable to find what you need on the Web

site, contact NCI staff. Use the online contact form at

http://www.cancer.gov/contact or send an email to

cancergovstaff@mail.nih.gov.

Also, information specialists provide live,

online assistance through LiveHelp at

http://www.cancer.gov/help. 

45
National Cancer Institute Publications

NCI provides publications about cancer, including

the booklets and fact sheets mentioned in this booklet.

Many are available in both English and Spanish. 

You can order these publications by telephone, on

the Internet, or by mail. You may also read them online

and print your own copy.

• By telephone: People in the United States and its

territories may order these and other NCI

publications by calling the NCI’s Cancer

Information Service at 1–800–4–CANCER. 

• On the Internet: Many NCI publications can be

viewed, downloaded, and ordered from

http://www.cancer.gov/publications on the

Internet. People in the United States and its

territories may use this Web site to order printed

copies. This Web site also explains how people

outside the United States can mail or fax their

requests for NCI booklets.

• By mail: NCI publications can be ordered by

writing to the address below: 

Publications Ordering Service

National Cancer Institute

Suite 3035A

6116 Executive Boulevard, MSC 8322

Bethesda, MD 20892–8322

Cancer Treatment

• Chemotherapy and You (also available in Spanish:

La quimioterapia y usted)

• Radiation Therapy and You (also available in

Spanish: La radioterapia y usted)

46
• Biological Therapy: Treatments That Use Your

Immune System to Fight Cancer 

• Bone Marrow Transplantation and Peripheral Blood

Stem Cell Transplantation: Questions and Answers

(also available in Spanish: El trasplante de médula

ósea y el trasplante de células madre de sangre

periférica: preguntas y respuestas)

• How To Find a Doctor or Treatment Facility If You

Have Cancer (also available in Spanish: Cómo

encontrar a un doctor o un establecimiento de

tratamiento si usted tiene cáncer) 

Clinical Trials

• Taking Part in Cancer Treatment Research Studies

Living With Cancer

• Eating Hints for Cancer Patients (also available in

Spanish: Consejos de alimentación para pacientes

con cáncer: Antes, durante y después del

tratamiento)

• Pain Control (also available in Spanish: Control del

dolor)

• Coping With Advanced Cancer

• Facing Forward: Life After Cancer Treatment (also

available in Spanish: Siga adelante: la vida después

del tratamiento del cáncer)

• Facing Forward: Ways You Can Make a Difference

in Cancer

• Taking Time: Support for People with Cancer 

• When Cancer Returns

47
• National Organizations That Offer Services to

People With Cancer and Their Families (also

available in Spanish: Organizaciones nacionales que

brindan servicios a las personas con cáncer y a sus

familias) 

• Cancer Support Groups: Questions and Answers

• Follow-up Care After Cancer Treatment: Questions

and Answers

Complementary Medicine

• Thinking about Complementary & Alternative

Medicine: A guide for people with cancer

Caregivers

• When Someone You Love Is Being Treated for

Cancer: Support for Caregivers

• When Someone You Love Has Advanced Cancer:

Support for Caregivers

• Facing Forward: When Someone You Love Has

Completed Cancer Treatment

• Caring for the Caregiver: Support for Cancer

Caregivers

48
¿Necesita información en español?

Llame al Servicio de Información sobre el

Cáncer y hable en español con un especialista en

información de cáncer. El número es

1–800–422–6237.

O visite el sitio de Internet del Instituto

Nacional del Cáncer en

http://www.cancer.gov/espanol. 

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NIH Publication No. 07-1567

Revised September 2007

Printed September 2007