What Is Stage 3 Lymphoma?

Stage 3 lymphoma is diagnosed when cancer cells have been found in the lymph areas above and below the diaphragm. Lymphoma is also considered stage 3 when cancer cells are in a lymph area above the diaphragm and in the spleen.

Lymphoma is measured in stages from 1 to 4. Stage 1 has the least amount of spread. This article will define what stage 3 lymphoma is, discuss the symptoms and treatments you may have in stage 3, and your potential prognosis.

Getting a Diagnosis of Stage 3 Lymphoma

After receiving a lymphoma diagnosis, your healthcare provider will run tests to identify the stage the cancer is in. This helps determine the type of treatment that will be best for you. Tests include:

• Physical exam to check for swollen lymph nodes
• Oral medical history of your symptoms, risk factors, and family health history
• Lymph node biopsies (a sample is taken and analyzed in the lab)
• Blood tests to measure red and white blood cell counts and to ascertain liver function and kidney function
• Imaging tests to check for enlarged lymph nodes and organs, such as magnetic resonance imaging (MRI), positron emission tomography (PET) scan, and computed tomography (CT) scan 

Both Hodgkin and non-Hodgkin lymphomas are stage 3 if one of these two criteria are met:

1. Cancerous cells have been found in lymph nodes above and below the diaphragm. Areas containing lymph nodes above the diaphragm include the armpits and neck. Areas containing lymph nodes below the diaphragm include the groin.
2. Cancerous cells have been found in lymph nodes above the diaphragm and also in the spleen. The spleen is part of the lymphatic system.

Symptoms of Stage 3 Lymphoma

Stage 3 lymphoma symptoms vary based on the location of the tumors. If lymphoma is in your spleen, your stomach may be affected. Tumors in or near the chest may cause shortness of breath and other symptoms.

Symptoms of Hodgkin and non-Hodgkin lymphoma can include:

• Easy bruising
• Swollen lymph nodes in various parts of the body
• Back pain
• Fatigue
• Chest pain
• Shortness of breath
• Fatigue
• Feeling full after eating very little food
• Loss of appetite
• Bloated, swollen stomach
• Frequent or serious infections
• Itchy skin

What Are B Symptoms?

A specific group of lymphoma symptoms is identified as B symptoms. You can have B symptoms at any stage, from 2 to 4. If you have B symptoms, a B is added to your stage designation. If you’re in stage 3 and have B symptoms, you are in stage 3B. If you don’t have B symptoms, you are in stage 3A.

B symptoms are:

• Drenching night sweats
• Fever of 100.4 F or greater
• Unexplained weight loss of 10% or more of your body weight over six months
  

Treatments for Stage 3 Lymphoma

Stage 3 lymphoma is treatable. Your healthcare provider may recommend several different therapies for you. Treatments at this stage are geared towards shrinking or eradicating tumors.

Chemotherapy is the main treatment used for stage 3 lymphoma. Chemo is beneficial for killing cancer cells throughout the body. Based on the drugs used, you may have anywhere from three to eight cycles.

Chemo may be given intravenously or orally. In some instances, Adcetris (brentuximab vedotin), a targeted therapy monoclonal antibody drug, may be added to your treatment protocol.

Radiation therapy may be done after chemo to target areas of the body with large or multiple tumors. The type of radiation used is typically external beam radiation. A machine will deliver a focused beam of radiation directly at the tumor site.

Immunologic drugs may be used alone or in addition to chemotherapy. Immunologic medications boost your immune system, so you're better able to kill or slow down the growth of lymphoma cells. Immunologic drugs are given intravenously.

Targeted drug therapy may be tried. Targeted therapy drugs zero in on the proteins on cancer cells that instruct them to grow and divide.

If you don’t respond favorably to treatment, or your lymphoma comes back (relapse), a stem cell transplant may be recommended to you. Stem cell transplants are also known as bone marrow transplants. This treatment allows your healthcare provider to give you higher doses of chemotherapy, which damages the bone marrow.

In a stem cell transplant for lymphoma, stem cells are usually harvested from the person before the high-dose chemotherapy. They are then infused after treatment and migrate to the bone marrow to restore its ability to produce blood cells.

Prognosis

Many variables affect your prognosis. They include the type of lymphoma you have, your age, and overall health. Your response to treatment is also an important factor.

Data about survival rates is usually indicated by a five-year time frame. Relative five-year survival rates give you information about people who were diagnosed with your condition and stage five or more years ago.

By its very nature, this data does not reflect new treatments which have become standardized within the last five years. These percentages are estimates. They’re not predictions about your condition.

The five-year relative survival rates for lymphoma are based on spread, not stage. The three spread levels are localized, regional, and distant. This data is acquired from the Surveillance, Epidemiology, and End Results (SEER) database that is maintained by the National Cancer Institute.

Distant spread is defined as lymphoma that has spread to distant parts of the body, or to lymph node areas located above and below the diaphragm. Stage 3 lymphoma is considered distant spread.

• For non-Hodgkin diffuse large B-cell lymphoma, the five-year relative survival rate is 57%.
• For non-Hodgkin follicular lymphoma, the five-year relative survival rate is 86%.
• For Hodgkin lymphoma, the five-year relative survival rate is 82%
  

Summary

Stage 3 lymphoma is defined in one of two ways. Either cancer cells have been found in lymph areas above and below the diaphragm, or cancer cells are in a lymph area above the diaphragm plus in the spleen.

Stage 3 lymphoma is usually treated with chemotherapy. Other treatments can include radiation, targeted therapy, and immunologic drugs.

The prognosis for stage 3 lymphoma varies and is based on several factors, including the type of lymphoma you have, your overall health, and your response to treatment.  

A Word From Verywell

Lymph nodes are located all over the body, and lymphoma symptoms can indicate many other conditions. For these reasons, it’s not uncommon to first be diagnosed with lymphoma when you’re in stage 3. Don’t let that throw you for a loop. Stage 3 lymphoma is treatable and often curable.

Advances in new research, and clinical trials, are happening worldwide for this condition. You have every reason to hope and plan for a cancer-free future.