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Surgery for non Hodgkin lymphoma

Men and women discussing non Hodgkin's lymphoma

This page tells you about surgery for non Hodgkin lymphoma. You can find the following information

 

A quick guide to what's on this page

Surgery for non Hodgkin lymphoma

Surgery is not often used as a treatment for NHL. This is because other treatments such as chemotherapy, biological therapies or radiotherapy usually work well and are the main treatments. But you may have an operation to remove a lymph node for testing (biopsy).

For a lymph node biopsy your doctor may remove a whole lymph node while you are under anaesthetic. They send the lymph node to the laboratory. This is a very small operation. Sometimes doctors use ultrasound or a CT scan to help guide a needle into the lymph node to take a sample of tissue. You usually have this under local anaesthetic.

Removing your spleen or an abdominal tumour

If you have a very rare type of NHL called splenic marginal zone lymphoma, doctors may remove the spleen. But this type of operation is not very common. Occasionally the spleen may also be removed in other types of NHL. You will be more at risk of infection without a spleen. You will need to take antibiotics for the rest of your life to help stop infection. You should carry a card saying you have no spleen in case of medical emergencies.

Surgery is sometimes used to remove lymphoma in the abdomen. You usually go home a few days after surgery to remove the spleen or an abdominal tumour.
 

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

 

 

Surgery for NHL

Surgery is not often used as a treatment for non Hodgkin lymphoma. This is because other treatments such as chemotherapy, biological therapy or radiotherapy usually work well and are the main treatments.

We have included some information about surgery because you may have an operation for the following reasons

  • To make sure of the diagnosis by removing a lymph node for testing (biopsy)
  • To remove limited disease from an affected organ, for example the stomach or small bowel
  • To remove the spleen (splenectomy) in a rare type of lymphoma called splenic marginal zone lymphoma

We have information about the different types of operation.

 

Lymph node biopsy

Your doctor removes part or all of a swollen lymph node under local or general anaesthetic and sends it to the laboratory. A pathologist looks at it under the microscope to see if it contains non Hodgkin lymphoma cells. They can also find out what type of NHL it is by looking at proteins on the surface of the cells and using special chemical stains.

Having the whole lymph node taken out (excision biopsy) is a very small operation. You will have a few stitches and possibly some bruising and stiffness. You usually have your stitches taken out 7 to 10 days after the surgery.

Doctors sometimes use an ultrasound scan or a CT scan to help guide a needle into the lymph node to take a sample of tissue. You usually have this under local anaesthetic.

You can read detailed information about having a lymph node biopsy.

 

Surgery to remove a tumour

If there is a large area of lymphoma in the tummy (abdomen), your surgeon may take it out during an operation. This is called debulking. You may have chemotherapy or radiotherapy once you have recovered from the surgery.

 

Removing the spleen (splenectomy)

If you have a very rare type of lymphoma called splenic marginal zone lymphoma, the doctors may decide to remove the spleen. Although not very common, your spleen may also be taken out in other types of lymphoma if it is swollen and contains lymphoma cells. Or you may have this type of operation to diagnose a lymphoma which appears to be only in the spleen.

You may be able to have the spleen taken out by keyhole surgery. This means the spleen is removed through a small wound using a laparoscope. Doctors call this operation a laparoscopic splenectomy. A laparoscope is a flexible tube with a light and a camera at one end, and an eyepiece at the other. A surgeon uses specialised surgical instruments through the laparoscope to remove the spleen safely.

You are likely to be in hospital for a shorter time if you have keyhole surgery than if you have open surgery. And you will probably recover more quickly too. With any keyhole surgery, there is a risk of complications and you may end up having open surgery after all. Your surgeon will explain all this to you when you sign the form agreeing to the operation.

After having your spleen removed, you are more at risk of infection. You will have some vaccinations before your spleen is taken out (or just after). And you will need to take antibiotics for the rest of your life to help stop you getting infections.

You should carry a card saying that you have no spleen, in case of medical emergencies. Before you go abroad, talk to your doctor. You may need extra vaccinations because you have no spleen.

 

After surgery to remove a tumour or the spleen

When you wake up after surgery to remove a tumour or the spleen, you will probably have a few tubes in place. These are

  • An intravenous infusion (drip) to give you liquid
  • Drainage tubes from the wound to help it heal

Your nurse will take your drip out as soon as you can start eating and drinking again. This may take a couple of days. Your doctor will listen to your abdomen with a stethoscope. As soon as the doctor can hear your bowel working again, you will be able to start taking sips of water. Gradually you will work up to eating and drinking normally.

The drainage tubes usually stay in as long as they carry on draining fluid. This is normally a couple of days.

The nurses will help you to get up and gently move around as soon as possible. This helps you to get better and makes complications such as chest infections or blood clots much less likely.

You can usually go home a few days after this type of surgery. You will need to have your stitches out about 2 weeks after your operation. You may go back to the hospital or to your GP surgery for this.

Your nurse will give you an outpatient appointment before you leave the hospital. You will need to begin any further treatment for non Hodgkin lymphoma as soon as possible after your surgery.

 

More about NHL treatment

We have detailed information about non Hodgkin lymphoma treatments in this section.

If you would like more information about any aspect of non Hodgkin lymphoma, you can phone the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday. They will be happy to answer any questions that you have.

Our non Hodgkin lymphoma organisations page gives details of other people who can provide information about NHL and its treatment. Some organisations can put you in touch with a cancer support group. They often have free factsheets and information which they can send to you. 

There are also books, booklets, CDs and other resources available about non Hodgkin lymphoma. Some of these are free. Look at our NHL reading list for details.

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 10 September 2014