Table of ContentsView AllTable of ContentsTypesDiagnosing StagesSymptomsTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Types
Diagnosing Stages
Symptoms
Treatment
Prognosis
A diagnosis of stage 4lymphomameans that cancer has spread outside of the lymphatic system and into one or more organs. With treatment, stage 4 lymphoma survival rate (for five years) is 74%.
As with most cancers, lymphoma’s progression is categorized into stages 1 through 4, with 4 being the most advanced. Staging helps provide a treatment roadmap for your healthcare provider.
This article will discuss the main types of lymphoma and the symptoms associated with stage 4. It will also cover the treatments you can expect, and the estimated stage 4 lymphoma survival rate.
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Types of Lymphoma
There are many types and subtypes of this disease. The two main forms are Hodgkin and non-Hodgkin lymphoma. Non-Hodgkin lymphoma is the more common kind.
Hodgkin Lymphoma
The lymphatic system contains B lymphocytes and T lymphocytes.Hodgkin lymphomatypically, though not always, starts in B lymphocytes. Hodgkin lymphoma can appear anywhere in the lymphatic system but usually starts above the diaphragm in the neck, armpits, or chest.
If you have stage 4 Hodgkin lymphoma, the cancer has spread outside of the lymph system into organs such as the liver, lungs, or bone marrow.
There are several subtypes of Hodgkin lymphoma. Classic Hodgkin lymphoma is the most common form of this disease. Of people with Hodgkin lymphoma, 95% have classic Hodgkin lymphoma and 5% have nodular lymphocyte-predominant B-cell lymphoma (NLPBL) which is a rare condition and in the near future is not going to be diagnosed as Hodgkin lymphoma.
Non-Hodgkin Lymphoma
Non-Hodgkin lymphoma can start in either B lymphocytes or T lymphocytes. B-cell lymphomas are more common than T-cell lymphomas.The two mostcommon subtypesof non-Hodgkin lymphoma are diffuse large B-cell lymphoma and follicular lymphoma.
If you have non-Hodgkin lymphoma, the cancerous cells may be classified as indolent (slow-growing), or aggressive (fast-growing). Indolent lymphomas spread (metastasize) slowly. The most common form of indolent lymphoma isfollicular lymphoma.
Aggressive lymphomas metastasize rapidly. The most common form of aggressive lymphoma is diffuse large B-cell lymphoma.
If you have stage 4 non-Hodgkin lymphoma, the cancer may have spread outside the lymphatic system into organs such as the liver, lungs, or bone marrow.
Diagnosing Stages of Lymphoma
There are several diagnostic tests used to determine the lymphoma stage. Testing can also help determine how you’re responding to your current treatment for this disease. These tests vary, based on your symptoms.
Swollen or enlarged lymph nodeswill be biopsied (sampled) to confirm a diagnosis of Hodgkin’s or non-Hodgkin’s lymphoma. In many instances, the entirelymph nodewill be removed for laboratory testing. This ensures that enough tissue is available for analysis and diagnosis.
Abone marrow aspiration and biopsywill be done to determine if cancer has spread to the bones. Usually, the bone marrow is taken from the hip bone for this test.
Aspinal tap (lumbar puncture)to remove and test cerebrospinal fluid may be done if your doctor suspects that lymphoma has spread to the brain.
Sampling of pleural fluid (fluid accumulating in the space between the lungs and ribs)or peritoneal fluid (fluid accumulating in the abdominal cavity) may be done to check for spread into the chest or stomach. Lymphoma can cause fluid buildup in these and other areas of the body. These tests use fluid extracted from the abdomen or chest to look for cancer cells.
Imaging tests will be done to identify enlarged lymph nodes and organs where cancer may have spread. They include:
Blood tests can be helpful for determining the amount of spread you have, as well as issues with organ function. Blood tests include:
Symptoms of Stage 4 Lymphoma
The most common symptom of Hodgkin’s and non-Hodgkin’s lymphoma is swollen lymph nodes, which are usually painless. You may not notice you have swollen lymph nodes until you’re in the later stages of the disease.
Lymphoma and AlcoholIf you have Hodgkin’s lymphoma, drinking alcohol may make swollen lymph nodes painful.The specific reason for alcohol-related pain is unknown, but it may be more common among women with a type of Hodgkin’s lymphoma known asnodular sclerosis.
Lymphoma and Alcohol
If you have Hodgkin’s lymphoma, drinking alcohol may make swollen lymph nodes painful.The specific reason for alcohol-related pain is unknown, but it may be more common among women with a type of Hodgkin’s lymphoma known asnodular sclerosis.
If you’re in stage 4 lymphoma, your symptoms may vary, based on where the cancer has spread.For example, if cancer has traveled to the brain, you may have headaches or seizures.
If it has spread to the chest, you may have chest pain or trouble breathing. If it is affecting your stomach, you may have nausea or pain in that area. You may also feel full after eating very little food.
A group of symptoms known asB symptomsmay be diagnosed in stages 2, 3, or 4. These include:
Other symptoms of Stage 4 lymphoma include:
Recommended treatments will be based on several factors, including the type or subtype of lymphoma you have. They also include the goals of treatment, your age, overall health, and personal preferences.
Treatments during stage 4 are typically designed to shrink or eradicate (destroy completely) tumors. Treatment at this stage may includepalliative care(reduces the discomfort of symptoms but is not curative).
An intensechemotherapyregimen is typically the first-line treatment for stage 4 Hodgkin’s or non-Hodgkin’s lymphoma.Chemotherapy kills cancer cells throughout the body and can be beneficial for attacking tumors wherever lymphoma spreads. Your response to treatment will be monitored throughout with imaging tests.
There are many different types of chemotherapy drugs. If you don’t respond well to treatment, your chemo drugs may be swapped out for other types.Radiation therapymay also be given as a follow-up to chemotherapy.
Immunotherapymay be administered, with or without chemotherapy. These medications boost your immune system, enabling it to better kill or slow down the growth of lymphoma cells.
Several types of chimeric antigen receptor (CAR) T-cell therapy are currently approved for the treatment of non-Hodgkin lymphomas. These include Breyanzi (lisocabtagene maraleucel), Kymriah (tisagenlecleucel), Yescarta (axicabtagene ciloleucel), and Tecartus (brexucabtagene autoleucel). In this type of therapy, a person’s immune cells are harvested and modified in the lab to recognize lymphoma cells. They are reinfused and target the lymphoma cells.
Targeted therapymay be used when the cancerous cells have certain characteristics. Targeted therapy drugs hone in on the proteins on cancer cells that control their growth and spread. This treatment works differently than chemo. It may be effective when chemotherapy does not produce good results.
If you don’t respond well to treatment or your cancer comes back, your doctor may suggest astem cell (bone marrow) transplant. Stem cell transplants help your bone marrow produce healthy cells.
Since chemo can destroy bone marrow cells, a stem cell transplantmakes it possible for you to get stronger doses of chemotherapy and then have your bone marrow restored with a transplant.You may also have whole-body radiation done in conjunction with chemotherapy and a stem cell transplant and chemotherapy.
In addition to being used as an adjunct (add-on) treatment, radiation may be used during palliative care to reduce pain and ease the symptoms of stage 4 lymphoma.
Stage 4 Lymphoma Survival Rate
Lymphoma is not a cookie-cutter disease. Many factors may have an impact on your potential prognosis. Your response to treatment, age, and overall health all play a role. The number of lymph node areas or organs affected may also have an impact.
The data used to compute the five-year relative survival rate for stage 4 lymphoma are based on the experiences of people who were diagnosed five or more years ago. Since treatments are always improving, this data may not take into account new treatments and, so, may not be able to predict what will happen in your case.
The more advanced your cancer is, the more challenging your odds may become. However, stage 4 lymphoma is treatable and many people live for many years after getting this diagnosis.
Factors that Affect Your Prognosis
Age, stage of the disease, and your overall health are among the issues that can affect how well you recover or survive with stage 4 lymphoma.
Specific factors include
Summary
The two main types of lymphoma are Hodgkin’s and non-Hodgkin’s lymphoma. A diagnosis of stage 4 lymphoma for either type means that cancer has spread outside of the lymphatic system into other areas of the body.
Stage 4 lymphoma is treatable. Aggressive rounds of chemotherapy are often given as a first-line treatment for lymphoma at this stage.
The five-year relative survival rate for stage 4 lymphoma varies and ranges from 57% to 86% based on the type you have. These figures are estimates and not necessarily predictions of what will happen in your case.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Survival rates and factors that affect prognosis (outlook) for non-Hodgkin lymphoma.
Moffitt Cancer Center.Hodgkin vs. non-Hodgkin lymphoma.
Thompson Cancer Survival Center.Hodgkin lymphoma.
Leukemia and Lymphoma Society.Hodgkin lymphoma subtypes.
American Cancer Society.Types of B-cell lymphoma.
American Cancer Society.Tests for non-Hodgkin lymphoma.
American Society of Clinical Oncology.Understanding your lab test results.
William BM, Bongu NR, Bast M, et al.The utility of lactate dehydrogenase in the follow up of patients with diffuse large B-cell lymphoma.Rev Bras Hematol Hemoter. 2013;35(3):189-191. doi:10.5581/1516-8484.20130055
American Cancer Society.Signs & symptoms of Hodgkin lymphoma.
American Cancer Society.Signs and symptoms of non-Hodgkin lymphoma.
American Cancer Society.Chemotherapy for non-Hodgkin lymphoma.
American Cancer Society.Chemotherapy for Hodgkin lymphoma.
American Cancer Society.Immunotherapy for non-Hodgkin lymphoma.
American Society of Clinical Oncology.Treating non-Hodgkin Lymphoma.
American Cancer Society.Survival rates for Hodgkin lymphoma.
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