Your doctor will determine the extent of your disease's progression by staging. Staging helps your doctor predict the disease's progression and develop a treatment plan.
NHL doesn't always begin in stage I and spread to more advanced stages. More than half of all patients with intermediate or aggressive disease and more than 80 percent of all patients with indolent disease are diagnosed with stage III or IV NHL. And if someone is diagnosed in stage IV, it doesn't mean that the disease is incurable - it may be highly curable depending on the subtype.
Number and Location of Affected Lymph Nodes and Organs
Involvement of one lymph node group
Involvement of two or more lymph node groups on the same side of the diaphragm (a thin muscle below the lungs)
Involvement of lymph node groups on both sides of the diaphragm
Involvement of one or more organs other than the lymph nodes and possible involvement of the lymph nodes
Categories A, B, X and E
The four stages of NHL can be divided into categories:
- A Category: No fever, no exaggerated sweating and no weight loss are present.
- B Category: Fever, excessive sweating and weight loss are present.
- X Category: Bulky disease (large masses of lymphocytes) is present.
- E Category: The lymphoma has spread to areas or organs outside of the lymph nodes, or to tissues beyond, but near, the major lymphatic areas.
For example, stage IIB indicates that the patient has
- Two lymph node sites near each other with disease involvement (for example, enlarged lymph nodes in the neck and near the collarbone, or in the neck and the armpit)
- Fever, excessive sweating and weight loss.
Your treatment depends on your stage and category. Patients who fall into the B category usually need more aggressive treatment than A category patients do.