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Should I see a specialist in non Hodgkin lymphoma?

Men and women discussing non Hodgkin's lymphoma

This page tells you about the guidelines that GPs in the UK have to help them decide who needs to see a specialist for suspected non Hodgkin lymphoma (NHL). You can find the following information

 

A quick guide to what's on this page

Should I see a specialist in non Hodgkin lymphoma?

The symptoms of lymphoma are very similar to many other medical conditions. It can be very difficult for GPs to decide who may have a lymphoma and who may have something much more minor. There are guidelines for GPs to help them decide which patients need to be seen urgently by a specialist.

Guidelines for urgent referral

You should get an appointment within 2 weeks for an urgent referral. You should have an urgent referral to a specialist (usually a haematologist) if you have 

  • Swollen lymph nodes or an enlarged spleen that isn’t getting better and your doctor can't explain the cause. Your GP should also take into account any other symptoms you might be having such as a high temperature, night sweats, shortness of breath, very itchy skin or weight loss.

If you are a child (0-15) or young person (16-24) the guidelines say you should be referred to a specialist within 2 days if you have

  • Swollen lymph nodes or an enlarged spleen and your doctor can't explain the cause. Your GP will also take into account any other symptoms you might have such as high temperature (fever), night sweats, shortness of breath, very itchy skin or weight loss.

CR PDF Icon You can view and print the quick guides for all the pages in the About NHL section.

 

 

How common is non Hodgkin lymphoma?

There are more than 12,700 cases of non Hodgkin lymphoma diagnosed in the UK each year. It is the 5th most common cancer in the UK. 4 out of every 100 cancers diagnosed in the UK (4%) are non Hodgkin lymphoma.

 

About UK referral guidelines

The symptoms of lymphoma are very similar to many other medical conditions. It can be very difficult for GPs to decide who may have a lymphoma and who may have something much less serious that will go away on its own. With many symptoms, it is perfectly right that your GP should ask you to wait to see if they get better, or respond to simple treatments. If GPs referred everyone who came to see them to a specialist immediately, the system would get jammed and people needing urgent appointments wouldn't be able to get them.

Seeing a specialist

There are particular symptoms that mean your GP should refer you to a specialist straight away. The National Institute for Health and Care Excellence (NICE) and the Scottish Government have produced guidelines for GPs to help them decide which patients need to be seen urgently by a specialist. While reading these guidelines, it is important to remember that

  • About 70 out of every 100 people (70%) diagnosed with non Hodgkin lymphoma are over 60, but you can be diagnosed at any age
  • The most common symptoms are weight loss, tiredness, night sweats, a lump in a lymph gland (often in the armpit or neck) and an enlarged liver or spleen
  • Between 35 and 45 out of every 100 people diagnosed (35 to 45%) have NHL somewhere else in the body other than in the lymph glands
 

Guidelines for urgent referral

You should get an appointment within 2 weeks for an urgent referral. You should have an urgent referral to see a blood disorder specialist (a haematologist) if you have 

  • Swollen lymph nodes or an enlarged spleen and your doctor can't explain the cause. Your GP should also take into account any other symptoms you might have, such as a high temperature, night sweats, shortness of breath, very itchy skin or weight loss. 

If you are a child (0-15) or young person (16-24) the guidelines say you should be referred to a specialist within 2 days if you have

  • Swollen lymph nodes or an enlarged spleen and your doctor can't explain the cause. Your GP should also take into account any other symptoms you might have, such as a high temperature (fever), night sweats, shortness of breath, very itchy skin or weight loss.

Do bear in mind that many of these symptoms can be caused by other, less serious, medical conditions and do not necessarily mean that you have non Hodgkin lymphoma.

 

What to do if you are still worried

If you are concerned that your GP is not taking your symptoms as seriously as you think they should, you could print this page and take it along to an appointment. Ask your GP to talk it through with you. Then you can decide together whether you need to see a specialist and if so, how soon.

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Updated: 2 July 2015