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Non-Hodgkin Lymphoma: Stages

What does staging mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. Your provider can see if the cancer has spread to nearby areas. He or she can also tell if it has spread to other parts of your body. It’s very important to know the stage of your cancer. This helps to decide what kind of treatment you should have.   

The stages of non-Hodgkin lymphoma

The staging system for non-Hodgkin lymphoma (NHL) is called the Lugano classification. It has 4 stages. It uses Roman numerals I, II, III, and IV.

A letter E may also be added after the Roman numeral to give more information. The E is added in stages I or II and means the lymphoma has been found in an organ outside the lymph system, like the liver or lung.

Stage I is either of the following:

  • The cancer is in one group of lymph nodes (stage I) or one organ that's part of the lymph system, such as the tonsils.

  • The cancer is found only in one area of a single organ outside of the lymph system (stage IE).

Stage II is either of the following:

  • The cancer is in two or more groups of lymph nodes, either above or below your diaphragm (stage II). The diaphragm is a thin band of muscle that divides your chest and your belly or abdomen.

  • The cancer is in one organ and a group of nearby lymph nodes on the same side of the diaphragm (stage IIE).

Stage III is either of the following:

  • The cancer is in lymph nodes both above and below your diaphragm.

  • The cancer is in lymph nodes above your diaphragm and in your spleen.

Stage IV is when the lymphoma is widely spread in the bone marrow, liver, or brain.

NHL may be called "bulky disease" if there are big tumors in the chest. In this case, more intense treatment may be needed.

Talking with your healthcare provider

When your cancer is staged, talk with your healthcare provider  about what the stage means for you. Make sure to ask questions and talk about your concerns.

Online Medical Reviewer: Cunningham, Louise, RN
Online Medical Reviewer: Stump-Sutliff, Kim, RN, MSN, AOCNS
Date Last Reviewed: 4/1/2018
© 2013 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.