Much of the advice that can be given about healthy living with non-Hodgkin's lymphoma could equally well be given to everyone. A healthy diet, adequate exercise and adequate rest are all important.
People with non-Hodgkin's lymphoma may wish to explore one or more of the various alternative therapies, and certain patients find that some of these therapies improve their wellbeing. It is worth remembering, however, that none of these therapies has any proven benefit in the treatment of non-Hodgkin's lymphoma as such.
Some of the treatments for non-Hodgkin's lymphoma, including both chemotherapy and radiotherapy, can affect the body's immune system and so increase the risk of infection. This effect is not permanent. During these periods, it might be wise for patients to avoid exposure to large crowds and contact with people who obviously have an illness.
It might also be advisable for people living with the patient to take certain precautions, such as having a flu vaccination, to reduce the risk of infection to the patient. These are issues that ought to be discussed with the doctor or another member of the lymphoma team.
Eating healthily is important for everybody, including people with non-Hodgkin's lymphoma. Both the condition itself and the effects of many of the treatments mean that a healthy diet can be particularly beneficial during the treatment period and afterwards.
There are no special dietary requirements for people with non-Hodgkin's lymphoma. A sensible, well-balanced diet is what ought to be aimed for. Patients who want advice about their diet may find it helpful to talk to a dietician. The specialist doctor or another member of the lymphoma team will be able to provide information about dieticians in the local area. Most family doctors can also advise patients about seeing a dietician. It is not a good idea to try faddish or unproven diets while the body is trying to deal with non-Hodgkin's lymphoma and its treatment.
A problem that many patients with non-Hodgkin's lymphoma face is loss of appetite, often accompanied by nausea (feeling sick) or vomiting (being sick). This is typically due to the treatments at least as much as it is due to the disease. Chemotherapy and radiotherapy, for example, can both cause a loss of appetite with nausea and vomiting. They can also cause food to taste different from usual - either making it lose its taste or else making it taste unpleasant. These side effects are temporary and go away once the treatment is finished. Usually, the worst effects last only a few days at most.
There are dietary adjustments and changes to the daily eating pattern that can help to minimise these problems. Patients, and family members and friends, often get very worried if they think that they are not eating well. It is important to remember that, for most people, not being able to eat for a few days is not likely to cause significant problems, although it is of course unpleasant.
It is very important, though, to drink enough fluid. It might be easier to take small amounts of fluid throughout the day. Water and fruit juice are better choices than tea and coffee, which are not so good at keeping the body well hydrated.
As with liquids, it is often easier to take small amounts of food at fairly frequent intervals rather than try to stick to the usual routine of three meals a day. In particular, many people find it helpful to:
It is often a good idea to avoid favourite foods during times of sickness after chemotherapy or radiotherapy. This is because such foods can become associated with the sickness and then always bring on feelings of nausea. This is especially likely in children. Patients are also advised to avoid alcohol during treatment.
There are many alternative therapies (sometimes known as complementary therapies) available.
Some of the most common include:
Many of these therapies can be very valuable - for example, many people benefit greatly from meditation and report a big improvement in their physical and mental wellbeing. However, it is worth remembering that there is no proven benefit from any of these alternative therapies in the treatment of non-Hodgkin's lymphoma.
People with non-Hodgkin's lymphoma who wish to investigate the use of alternative therapies ought to seek suitably qualified and reputable alternative practitioners. They also should always inform the practitioner that they have non-Hodgkin's lymphoma.
It is also very sensible, before embarking on an alternative therapy, to talk about it to the doctor or the lymphoma team. It is also important to remember that any alternative therapies ought not to interfere with the mainstream medical treatment. Indeed, reputable practitioners of alternative medicine will not encourage their patients with non-Hodgkin's lymphoma to discontinue or change their medical treatment.
Being diagnosed with cancer, including non-Hodgkin's lymphoma, is a stressful and emotional experience. It is normal for patients and their families to find it hard to cope, especially in the initial stages before treatment has begun.
Despite the fact that many patients with non-Hodgkin's lymphoma will have a lengthy period of remission or may even be cured, people often feel a sense of indignity and that they have lost control over their lives. In addition, patients are often nervous about the impact of the side effects of treatment on their wellbeing and their ability to live a normal life.
It is important that patients, and their families, should not feel guilty about such feelings, even if they become angry about the diagnosis or ask the common question: 'Why me?'
Consequently, patients diagnosed with non-Hodgkin's lymphoma often go through periods of great stress. If these feelings are not addressed, they can build up and start to have an impact on patient's lives, potentially developing into severe anxiety or even depression.
Every patient will approach a diagnosis of non-Hodgkin's lymphoma and its treatment in their own way. There are many ways in which patients can successfully cope with their feelings and maybe even learn from the experience to help take stock of their lives.
One of the most well known ways of coping with stress is through the support of other people. In addition to their families, patients will often have access to support through the lymphoma team at the hospital. Even between appointments, patients can call up the team, often clinical nurse specialist, to ask questions about their diagnosis, the course of the disease and its treatment. (For more information, see Questions to ask the doctor.)
It may also be helpful to take along a family member, partner or friend to hospital visits, not only to provide support but also to help remember information that is given out and prompt any questions that the patient may have.
Support groups such as cancer charities can also provide extra information on non-Hodgkin's lymphoma, while self-help patient organisations can help patients to put their experiences into context. However, it is important to remember that the specific diagnosis, outlook and treatment of non-Hodgkin's lymphoma will be different for every patient. (For more information, see Finding support.)
Many patients try to reduce feelings of stress by trying to keep their life as normal as possible after being diagnosed with non-Hodgkin's lymphoma. Although not always possible, staying on at work can help to keep patients busy and distract them from concerns about their condition. Keeping up with hobbies can also help to take patients' mind off what they are going through.
Relaxation techniques can be of great benefit to patients, as they can be performed in almost any situation and allow people to feel a sense of control over their feelings. There are many techniques available, ranging from physical techniques, which tackle muscular tension and allow patients to 'let go', to visualisation techniques, which encourage people to use their imagination to create positive feelings.
Whatever the technique a patient feels most comfortable with, making it part of the daily routine helps to recognise the physical symptoms of stress as they happen and so significantly reduce stress levels. Benefits also include reductions in aches and pains as a result of muscular tension, better preparation for sleep and lower levels of tiredness.
If a patient is thinking of using relaxation techniques, they should speak to their family doctor or lymphoma team, as they may be able to refer the patient to a local occupational therapy department, which can help to devise a routine of techniques.
Although not everyone diagnosed with non-Hodgkin's lymphoma will be sexually active or necessarily in a relationship at the time, for those who are, the diagnosis can have a profound effect on how they feel about sex. Patients can often feel different about themselves simply as a result of having the disease, and feel they are consequently less attractive to their partner.
Also, the shock of the diagnosis and the adjustments patients may have to make to their lives can affect the balance of their relationship with a partner. Sometimes, treatments such as chemotherapy or radiotherapy may make them feel too tired to even think about sex.
Although every patient reacts to the diagnosis and treatment of non-Hodgkin's lymphoma differently, it is more than likely that every patient will go through a period when they are less interested in sex than they are normally. This can put strain on relationships, especially if the source of the change in sexual activity is not recognised.
Sex is a subject that people often find hard to discuss, particularly during times of stress, and they may think that they are the only ones suffering problems. It is therefore important that patients discuss any questions or problems they may have with their family doctor or lymphoma team.
Doctors and nurses do not always think to speak to their patients about the possible effects of non-Hodgkin's lymphoma and its treatment on sexual activity, but they are trained to deal with such questions. Even if they are not able to answer the patient's questions straight away, they can either arrange a separate time to talk or may recommend that the patient contacts a counsellor or have specialist treatment. (For more information, see Questions to ask the doctor.)
Confidential helplines can also be a useful way of discussing problems that a patient feels too embarrassed to ask about during a visit to the hospital. Even if this later leads to the same questions being asked at their next appointment, speaking to a trained counsellor on a helpline may help patients to realise that their concerns are valid and need to be dealt with.
One of the most common questions that patients have when they are diagnosed with non-Hodgkin's lymphoma is how the treatment will affect their ability to have children. Chemotherapy and radiotherapy can cause, in women, menstrual periods to become irregular or stop and, in men, the sperm count to decline. Although this may be temporary, infertility may be permanent with some treatments. It is therefore important to talk to the lymphoma team about this before treatment begins.
However, patients who are particularly ill at the time of diagnosis may have to start treatment straight away, and so will not have a chance deal with such concerns beforehand. It is important for them to remember that the crucial thing is to make sure they are successfully treated and return to health.
Women with non-Hodgkin's lymphoma who are concerned that their treatment may cause infertility are recommended by their doctor or nurse to store embryos before starting treatment, and are referred to a fertility clinic.
For men, it can be difficult to predict whether their fertility will be permanently affected by treatment for non-Hodgkin's lymphoma, or whether it will return to normal once it is over. As a consequence, many men are advised to store sperm for future use.
All details related to these issues will be discussed with the patient at the fertility clinic. It may also be helpful to discuss any concerns with a partner or relative, or a trained counsellor, beforehand.