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. “Stage IV” does not have the same implications in NHL as it does for many other cancers.
|Stage||Number and Location of Affected Lymph Nodes and Organs|
|Stage I||Involvement of one lymph node or a group of adjacent nodes|
|Stage II||Involvement of two or more lymph node regions on the same side of the diaphragm|
|Stage III||Involvement of two or more lymph node regions above and below the diaphragm (for example, neck, chest and abdomen)|
|Stage IV||Involvement of lymph node regions on both sides of the diaphragm and involvement of organs such as the lungs, liver or bones|
Categories A, B, X and E
The four stages of NHL can be divided into categories:
- A Category: No symptoms
- B Category: Presence of fever, drenching sweats, loss of more than 10 percent of body weight over the previous six months (without dieting)
- X Category: Bulky disease. This is a nodal mass whose greatest size is usually more than 10 cm or more than onethird of the chest diameter by x-ray
- E Category: Involvement of organs or tissues beyond the lymph system
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/or weight loss (any one of these symptoms).
When all the diagnostic and staging tests are completed, the doctor will evaluate the information, identify the NHL subtype, determine which areas of the body are involved and begin to discuss treatment options with the patient.