Follicular Lymphoma: Causes, Symptoms, Treatment, and More

Follicular lymphoma is a cancer that affects white blood cells called lymphocytes. They help your body fight infections. MenuMedicalReferenceFeaturesVideoNewsArchiveNewsReferenceSlideshowsMedicationsFindanOncologistOverview&FactsRisks&PreventionSymptoms&SignsCancerTypesDiagnosis&TestsYourCancerCareTeamCancerTreatmentCutting-EdgeTreatmentsLiving&ManagingRemission&RecurrenceSupport&ResourcesAllGuideTopicsLymphomaHodgkin'sLymphomaNon-Hodgkin'sLymphomaLeukemiaChildhoodLeukemiaPolycythemiaVeraChronicMyeloidLeukemiaMyelodysplasticSyndromeAcuteLymphoblasticLeukemiaBook:TakeControlofYourCancerRiskChronicLymphocyticLeukemiaMultipleMyelomaRadiationTherapyChemotherapyFindaHematologistCancerHealthCenterCancerA-ZGuideCancerLeukemia&LymphomaMenuWhatIsFollicularLymphoma?CausesSymptomsGettingaDiagnosisQuestionsforYourDoctorTreatmentTakingCareofYourselfWhattoExpectGettingSupportMoreWhatIsFollicularLymphoma?Follicularlymphomaisacancerthataffectswhitebloodcellscalledlymphocytes.Theyhelpyourbodyfightinfections.Therearetwotypesoflymphomas:Hodgkin'sandnon-Hodgkin's,basedonthekindofwhitebloodcelltheyaffect.Follicularlymphomaisanon-Hodgkin'slymphoma.Whenyouhavefollicularlymphoma,thesickbloodcellscantraveltomanypartsofyourbody,suchasyourorgans,bonemarrow,andlymphnodes(pea-sizedglandsinyourneck,groin,andunderyourarmsthatarepartofyourimmunesystem).Thebloodcellscanformtumorsintheseplaces.Althoughfollicularlymphomausuallycan'tbecured,youcanlivelongandwellwithit.Thiscancergrowsslowly.Youmaynotneedtreatmentformanyyears,orever.Butifyoudo,itusuallyworkswell.Manypeoplelivedisease-freeafterward.CausesDoctorsdon'tknowwhatcausesfollicularandothernon-Hodgkin'slymphomas.Unlikesomecancers,theyarenotpasseddowninfamilies.Insomecases,radiationorcancer-causingchemicals,orcertaininfections,maybeacause.Butothertimesthereisnoknowncause.Youaremorelikelytogetfollicularlymphomaasyouage.Peopleare60yearsold,onaverage,whendiagnosed.You'realsommaybeatanincreasedrisk togetthediseaseifyouhaveHIV,rheumatoidarthritis,lupus,orceliacdisease,whichareallimmunesystemdisorders.SymptomsYoumayhavenosymptomsoffollicularlymphoma.Ifyoudohavesymptoms,youmayhave:Painlessswellingofthelymphnodesinyourneck,groin,stomach,orarmpitsShortnessofbreathFatigueNightsweatsWeightlossGettingaDiagnosisFirst,yourdoctorwilldoaphysicalexamandaskyouquestionslike:Haveyouhadalumpinyourneck,groin,stomach,orarmpits?Wasitpainful?Diditgoawayandcomeback?Haveyoueverbeendiagnosedwithcancer?Howwasittreated?Haveyoubeenexposedtoanycancer-causingchemicalsonthejob?HaveyoubeendiagnosedwithHIV,rheumatoidarthritis,lupus,orceliacdisease?Haveyouhadanorgantransplant?Ifyourdoctornoticesthatyouhaveenlargedlymphnodes,itdoesn'tmeanyouhavecancer.They'remostoftencausedbyinfectionsorotherproblems.Ifyoudohaveone,yourdoctormaygiveyouanantibiotictoseeifitshrinksinafewweeks.Ifyouhaveotherlymphomasymptomsorthelymphnodeisverylarge,orifitdoesn'tshrinkwithantibiotics,yourdoctorwilldoabiopsy.Todothat,they'llremoveeitherthewholelymphnodeorpartofit.Ifanodeishardtoreach,theymayuseaverythinneedletoremovealittlebitoflymphnodetissuethroughyourskin.Doctorscallthisafine-needleaspirationbiopsy.Thisisusuallyan"outpatient"procedure,whichmeansyoudon'tneedtostayovernightinahospital.Sometimesyourdoctormaynumbtheareafirst,butthat'snotalwaysneeded.Usingamicroscope,expertswillcheckthetissuefromthebiopsy.Ifitshowsthatyouhavefollicularlymphoma,yourdoctorwillwanttodoothertests.Thesemayincludebloodtestsand:Bonemarrowtest.Yourdoctorwilltakesamplesofyourbonemarrow,usuallyfromthebackofyourhipbone.Forthistest,youliedownonatableandgetashotthatwillnumbthearea.Thenyourdoctorusesaneedletoremoveasmallamountofliquidbonemarrow.Yourdoctorwilllookatthesampleunderamicroscopeandcheckforsickcellstoseeifthediseasehasspread.CTscan,orcomputedtomography.It'sapowerfulX-raythatmakesdetailedpicturesinsideyourbody.PETscan.Thiscreates3-Dimagesbyusingaradioactivechemicalthatcollectswhereyourcellsareveryactive.Theresultswillhelpyourdoctorcheckwhichpartsofyourbodyareaffectedandthestageofthelymphoma.Basedonthatinformation,youandyourdoctorcandecideifyouneedtreatmentandwhatkind.Youmaywanttogetasecondopinionbeforeyoutakeaction.QuestionsforYourDoctorArethereanyothertestsIshouldhavebeforewedecideontreatment?Whatisthestageofmyfollicularlymphomaandwhatdoesitmean?Doesitneedtobetreatedrightaway?Whattreatmentdoyourecommend?Why?Whatarethesideeffectsofthistreatment?Howwillitaffectmydailylife?Howlikelyismyfollicularlymphomatocomebackafterthistreatment?Whatwillwedoifitdoescomeback?Youmaywanttoaskyourdoctorifyoucantakepartinaclinicaltrial.Thesetestnewdrugstoseeiftheyaresafeandiftheywork.Theyoftenareawayforpeopletotrynewmedicinethatisn'tyetavailabletoeveryone.Yourdoctorcantellyouifoneofthesetrialsmightbeagoodfitforyou.TreatmentIfyouhavenosymptoms,yourdoctormaydecidejusttowatchyouclosely.Thisiscalled"watchfulwaiting."Studiesshowitworksaswellasearlytreatment.Yourdoctormayadvisestartingtreatmentif:YourlymphnodeskeepgettinglargerYouhaveafeverornightsweatsYouarelosingweightYouhavelowbloodcountsAftertreatment,manypeoplestaydisease-freeforyears,althoughthecancerusuallyreturns.Overtime,30%to40%offollicularlymphomasbehavelikeorturnintootherformsoflymphomathatgrowfasterandneedintensivetreatment.Ifyoudoneedtreatment,itmayincludeoneormoreofthefollowing:Radiation.Itkillscancercells.Theradiationcomesfromahigh-energybeam,similartoanX-ray,orfrommaterialputinsideyourbodyinornearthecancer.Follicularlymphomarespondswelltoradiation.Insomecases,itcancurethecancer.Ifyoursisatanearlystage,youmayonlyneedradiation.Ifit'sadvanced,youmaygetothertreatmentsaswell.Monoclonalantibodies.Thesearedrugsthatactlikeyourbody'sdisease-fightingcells.Formostpeople,rituximab(Rituxan)andobinutuzumab(Gazyva)workswelltokilllymphomacellswhiledoinglittledamagetonormalbodytissues.Italsohasfewersideeffectsthanchemotherapy.Youmayalsotakerituximabasmaintenancetherapy,toslowthegrowthoflymphoma.YougetitbyIVinyourdoctor'sofficeorataninfusioncenter.Yourdosingschedulewilldependonyourparticularcase.Becauseitmustbegivenslowly,expectittotakeseveralhoursatfirst.Chemotherapy.Usually,yougetthistreatmentbyIVorasapill.Becauseitentersthebloodstreamandreachesmostpartsofthebody,itworksverywellforlymphoma.Tazemetostatmaybeanoptionforpatientsthathavefailedorareresistanttotreatments&canbeusedforFLwithspecifictypesofmutations.Radioimmunotherapy.Yougetthismedication--Y90ibritumomabtiuxetan(Zevalin)--throughanIV.Itdeliversradiationstraighttoaproteinoncancercells.Yourdoctormayrecommenditifyourlymphomacomesbackordoesn'trespondtochemotherapy.Kineseinhibitors.Takenonceaday, umbralisib(Ukoniq)isaKineseinhiitor.Itworkstoblockthe phosphoinositide3-kinase (PI3K)enzymethatcausesthecancertogrow,Stemcelltransplant.Thisisusedmainlywhenfollicularlymphomareturns.Thesearen'tthe"embryonic"stemcellsthatyoumayhaveheardabout.Theycomefromeitheryourownstemcellsoradonor'sbonemarrow.Closerelatives,suchasyourbrotherorsister,arethebestchanceforagoodmatch.Ifthatdoesn'tworkout,youneedtogetonalistofpotentialdonorsfromstrangers.Sometimesthebestchancefortherightstemcellsforyouwillbefromsomeonewhoisinthesameracialorethnicbackgroundasyou.Beforethetransplantyouwilllikelyneedtogettreatedwithhighdosesofchemoforaboutaweekortwo.Thiscanbeatoughprocessbecauseyoumaygetsideeffectslikenauseaandmouthsores.Whenthehigh-dosechemoisdone,you'llstartthetransplant.ThenewstemcellsaregiventoyouthroughanIV.Youwon'tfeelanypainfromthis,andyou'reawakewhileit’shappening.Afteryourtransplant,itcouldtake2to6weeksforthestemcellstomultiplyandstartmakingnewbloodcells.Duringthistimeyoumaybeinthehospital,orattheveryleast,willneedtomakevisitseverydaytogetcheckedbyyourtransplantteam.Itcantake6monthstoayearuntilthenumberofnormalbloodcellsinyourbodygetsbacktowhatitshouldbe.TakingCareofYourselfIt'snormaltohavemixedfeelings:happythatyou'renothavingsymptomsoraredisease-freeaftertreatment,butworriedaboutwhatmighthappeninthefuture.Despitetheuncertainty,youcanhaveafulllife.Thesetipsmayhelp:Don'ttrytoignorewhateverfearsyouhave.Letyourselffeelthemandthenpracticelettingthemgo.Talkingaboutthemtoafriendorcounseloroftenhelps.Focusonwhatyoucandotobehealthynow.Exercise,eatabalanceddiet,andmakeanyotherchangesthatwouldhelptakebettercareofyourself.Thishelpsyoufeelbetterandhavemoresenseofcontrol.Spendsomepeacefultimeeveryday.Thiscanbehelpfulevenifit'sjustforafewminutes.Whenyouarestressedout,summonupthatfeeling.WhattoExpectWithfollicularlymphoma,timeisonyourside.Itgrowsslowly,andnewandbettertreatmentsarehelpingpeoplelivedisease-freeforlongerperiodsoftime.Mostpeoplerespondwelltotreatment--notjustthefirsttime,butifitcomesback.Stayinformedandtalktoyourdoctoraboutallyourtreatmentoptionsandtheclinicaltrialsthatmightbehelpfulforyou.GettingSupportTheLymphomaResearchFoundationoffersmanyresourcesontreatments,researchadvances,clinicaltrials,andwaystocopewithfollicularlymphoma.Theseincludeone-on-onepeersupportandfinancialaidprograms.DealingWithChemoNauseaChemo:3ThingsYouNeedtoKnowComplementaryTreatmentsforCancerInformationAboutNHLClinicalTrialsWatchfulWaiting:IsThistheChoiceforYou?TreatingNon-Hodgkin'sLymphoma:YourOptionsLymphoma:Symptoms,Causes,Diagnosis,TreatmentRheumatoidArthritisandLymphomaNon-Hodgkin’slymphomaandHIVBurkittLymphoma:Diagnosis,Prognosis,Symptoms,andTreatmentsAnaplasticLarge-CellLymphoma:Causes,Symptoms,andTreatmentsFollicularLymphomaSmallLymphocyticLymphomaLymphomaTopicsStemCellTransplantsWhataretheyandwhydoweneedthem?LungCancerSeeitinpictures,plusreadthefacts.TopCancer-fightingFoodsFightcanceroneplateatatime.OvarianCancerDoyouknowthesymptoms?VitaminD:Nutrition’sNewestStarTreatmentsforNon-Hodgkin'sLymphomaFeelingDown?TipstoGetYourFightingSpiritBackHowPetsCanHelpYourHealthWhatAreStemCellTransplants?Non-Hodgkin'sLymphomaSymptomsChronicMyelogenousLeukemiaPhasesandTreatmentGettoKnowYourLymphNodesCancerHealthCheckDealingwithChemoNauseaCancerandSleepProblemsWhat’sYourCancerIQ?ComplementaryMedicineQuizHandlingtheStressofCancerHealthSolutionsPenisCurvedWhenErect?CouldIhaveCAD?TreatBentFingersTreatHR+,HER2-MBCTiredofDandruff?BenefitsofCBDRethinkMSTreatmentAFib-RelatedStrokesRiskofaFutureDVT/PEIsMyPenisNormal?RelapsingMSOptionsLiverTransplantsSaveLivesFinancePlasticSurgeryBentFingerCausesLivingWithPsoriasis?MissingTeeth?MorefromWebMD5TipstoHelpWithRelapsingMSHowtoThriveWithNarcolepsyReliefforBlockedHairFolliclesPsoriaticArthritisandYourSleepWhatPsoriasisFeelsLikeFirstPsoriaticArthritisFlareTalkingtoYourDoctorAboutRACrohn's:A'Full-Body'DiseaseAvoidingCrohn’sFlaresHealthBenefitsofHempSeedOilLiveBetterWithPsoriaticDiseaseTypesofB-CellTherapyforMS5HealthBenefitsofHempWhyProstateCancerSpreadsLivingwithAdvancedBreastCancerWhereBreastCancerSpreads