No parent wants their child to be sick. Recovery can be possible with an early diagnosis and the many effective therapies available, even though cancer is a diagnosis that no one wants.

“If your child was recently diagnosed with non-Hodgkin’s lymphoma, you may have questions about the treatments that are prescribed and how well they work.”

Pediatric non-Hodgkin’s lymphoma (NHL) is a condition that impacts your child’s lymph nodes. While symptoms can appear gradually, the disease can also spread quickly. Keep in mind that symptoms can vary depending on where the cancer first begins to develop.

For example, if the cancer begins in the spine, you might also notice that your child has difficulty walking, weakness in their legs, or may even struggle with incontinence.

Symptoms in babies

Symptoms in children & teens

One of the best ways to detect NHL early is to be aware symptoms and to take action if you suspect something is wrong with your child. Because it’s not a common childhood cancer, there aren’t widely recommended screening tests to detect NHL.

The diagnosis will usually begin with a medical history and physical exam. Sometimes NHL is diagnosed through a process of elimination. The swollen lysy is the biggest symptom of NHL, but several diseases and illnesses can also cause this symptom to appear.

Biopsy

“Doctors often start by treating the swollen nodes with antibiotics. Infections are the most common reason for swollen lymph nodes in children. If the swollen nodes don’t respond to treatment, more tests may be recommended, including a biopsy to determine the cause.”

The speed of diagnosis will also depend on how quickly the nodes are growing. Similarly, if a child’s health seems to be getting worse, doctors will move through the diagnosis process faster. Also, the type of biopsy performed will depend on where the swollen lymph nodes are located. But the most common methods are surgical biopsy and bone marrow biopsy.

Additional Testing

While biopsies are an essential part of the diagnosis process, other tests may be performed. This can include several tests to find potential hidden areas of abnormal growth, such as:

Additionally, your child might undergo an EKG-Echo (electrocardiogram and echocardiogram) and a pulmonary function test to determine heart and lung function before starting treatment.

How common is non-Hodgkin’s lymphoma in children?

NHL isn’t a common cancer in children or teens. However, some risk factors might increase a child’s chances of being diagnosed with it, such as:

  • Prior to the treatment.
  • undergoing an organ transplant procedure
  • HIV infections
  • A deficiency in the immune system.

Determining the right course of treatment is dependent upon the type of NHL that a child has. This is why biopsies are important so that the type can be accurately identified. The type of NHL depends on the type of lymphocyte (white blood cell) where the cancer first begins to grow.

Adult NHL is usually quite different from childhood NHL. Childhood lymphoma is more aggressive because it can grow and spread very quickly.

There are four main types of childhood NHL:

Stages

With cancer, the stage refers to how advanced or how much cancer growths are detected when the disease was first diagnosed. NHL is divided into four stages with one being the lowest and four being the most advanced. Stage one and two lymphomas are referred to as limited-stage while three and four are considered advanced-stage.

  • Stage I: The lymphoma is only in one place such as either one tumor, or located within one part of the body, and isn’t present in the chest or abdomen.
  • Stage II: The lymphoma is in one area outside the lymph nodes and in nearby lymph nodes, or it can be in two or more areas above or below the diaphragm along with spreading to nearby lymph nodes. Additionally, there might be a tumor in the digestive tract that can be removed with surgery.
  • Stage III: The lymphoma may have started in the chest. The tumor may have started in the abdomen but spread too much to be easily removed through surgery. The tumor may be near the spine or there may be more than one tumor present outside of the lymph nodes. Additionally, the tumor may have spread widely to groups of lymph nodes both above and below the diaphragm. Or, the tumor is present in the bone and potentially a nearby area.
  • Stage IV: The lymphoma has spread to the central nervous system — either in the brain or spinal cord — or the bone marrow.

Keep in mind that treatment can vary based on the type and stage of NHL that your child has.

However, chemotherapy is usually the main treatment. Some children may also be prescribed a combination of not only chemotherapy but also drugs and steroids. If drugs or steroids are recommended, the prescription will depend on the type and stage of cancer that your child has.

Sometimes surgery may also be used to remove tumors, and in some rare cases, a child might undergo radiotherapy. Additionally, if a child has recurrent lymphoma, they may require more intensive chemotherapy and even have a stem cell transplant.

Treatment timelines vary widely depending on the type and stage of the cancer. Sometimes, clinical trials are also recommended when treating recurrent NHL, to allow your child to benefit from the most cutting-edge treatments available.

While the thought of childhood cancer is scary, know that NHL has a high prognosis rate for children. Oncologists usually don’t speak in terms of general success rates but rather the 5-year survival rate. This means that a child has survived 5 years after completing treatment.

Although individual prognoses will depend on the type and stage of cancer your child has, the success rates for treatment are roughly 80 to 90 percent across all types. Stage I and II NHL have the highest success rates at greater than 90 percent, while stage III and IV NHL range from 80 to 90 percent.

Cancer is a traumatic experience both for the patient and their family. But for parents, having a child with cancer can be especially difficult — especially if they’re young. Along with trying to keep them informed in an age-appropriate way, parents must also manage the emotional rollercoaster associated with the entire process from diagnosis to treatment.

It is important to have a strong support group because children take their cues from their parents. Check out some of the organizations for more resources.

You should be prepared for the side effects of the treatment. Hair loss, weight loss, pain from medications, and loss of appetite are some of the things that can be related. If your child experiences any of the side effects, you should talk to them about it before it happens.

“Take time to have fun with your child. Taking a moment to relax can help to distract from the treatment. Don’t be afraid to seek therapy for yourself and your child.”

Ongoing clinical trials

Clinical trials are a common option for treating NHL.

The National Cancer Institute offers an active database for ongoing clinical trials with filters that allow you to adjust for the specific type of NHL your child has and their age.

“Before you add a trial to your child’s plan, talk to the doctor or team about it.”

“When a child is diagnosed with cancer, it is even more frightening. There are proven treatment options that offer a promising outcome with survival rates as high as 90 percent, even in more advanced stages of non-Hodgkin’s lymphoma.”

The best course of action is to take a proactive approach to getting your child diagnosed. You should have a support group around you and your family as you navigate the process.