What Does It Mean to Have Advanced-Stage Lymphoma?

When lymphocytes are in your lymph nodes, your doctor will call them “nodal.” When they’re in other parts of your body, they’re called “extranodal.” You can have them in both places.

When Your Cancer is Advanced

Doctors classify non-Hodgkin lymphomas as early stage or advanced stage. In early stage lymphomas — stage I or II — the cancer is only in only one group of lymph nodes or one organ, or it’s all on the same side (either above or below) of your diaphragm — the divider that separates your chest from your abdomen.

Advanced stage — stage III or IV — means you have lymphoma in more than one area. In stage III, the lymphoma is both above and below your diaphragm. Or, the cancer could be above your diaphragm but also in your spleen. In stage IV, the cancer is above and below the diaphragm and has spread to at least one organ outside of your lymph nodes, such as your liver, lung, or bone marrow.

How Your Stage Affects Your Outlook

It’s natural to wonder, once you learn your cancer stage, what that means for your prognosis. An advanced-stage cancer can sound frightening.

The later the stage of your cancer, the more challenging it can be to treat, just because it is more widespread. So typically, the prognosis will be different as the stage increases. For example, for early-stage diffuse large B-cell lymphoma, the 5-year relative survival rate (how likely you are to still be alive five years after your diagnosis compared with someone who doesn’t have this cancer) is 73%. At stage IV, the 5-year relative survival rate is 55%.

Of course, these percentages are based on research done on large numbers of people. Your situation may not follow the statistics. It is possible for people to live for many years, and even be cured with an advanced-stage non-Hodgkin lymphoma.

Also, your stage isn’t the only thing that affects your outlook. Your doctors may use other factors, such as your age, the location of your lymphoma, and certain markers in your blood, to help assess your outlook.

Treatments by Stage

Your doctor will tailor your treatment to the stage of your cancer, as well as other factors, such as how aggressive it is. Chemotherapy is generally part of the treatment at every stage. But in the early stages, radiation may be added, because stage I and II lymphomas tend to respond well to radiation.

In advanced-stage disease, you won’t typically get radiation unless you have areas with very high concentrations of cancer cells, Dr. Schuster says. Instead, you’ll get the same combination of chemotherapy drugs and the targeted drug rituximab (Rituxan), but you may have more treatments than you would if you had an early-stage cancer. Generally, it takes more than four months of therapy to treat later-stage lymphomas, he adds.

Understand Your Stage, and Your Options

The diagnosis phase can be a very confusing time. You’ll be learning a lot about your cancer, probably in a very short period of time. And you’ll have to use your brand new knowledge to make important decisions about your treatment.

Don’t be afraid or embarrassed to ask questions if there’s anything you don’t fully understand. Non-Hodgkin lymphoma is a very complex cancer that has many different types and components. No one, including your doctor, expects you to wrap your head around it immediately. Talk through your diagnosis with your medical team and make sure you understand all the treatment options that are available for your stage of cancer.

 

 

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