Referral to a specialist for symptoms of non-Hodgkin lymphoma

Your GP should arrange for you to see a specialist if you have symptoms that could be due to non-Hodgkin lymphoma (NHL).

Depending on your symptoms and other factors, this might be an urgent referral.

You will see a specialist as soon as possible. Ask your GP when this is likely to be.

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

UK referral guidelines

There are guidelines for GPs to help them decide who needs a referral. These vary slightly between the different UK nations. Your GP will use these guidelines as well as their own experience and judgement.

If your doctor thinks you need to see a specialist, they will refer you to a haematologist . 

England and Wales

Your GP should arrange for you to see a haematologist if you have one of these symptoms, and your GP can't explain the cause:

• swollen lymph nodes
• an enlarged spleen

Your doctor will ask about other symptoms, such as:

• unexplained fevers
• weight loss
• night sweats
• itchy skin
• shortness of breath

Your doctor will also want to know about any other symptoms. So do mention anything else you are concerned about.

If you are age 24 or younger

You should see a haematologist within 48 hours if you have swollen lymph nodes or an enlarged spleen and your GP can't explain the cause.  

Scotland

The Scottish guidelines are for all blood cancers, not just NHL.

You should have an urgent referral to a specialist if:

• your blood test shows you have acute leukaemia or chronic myeloid leukaemia
• you have swollen lymph nodes that are larger than 2cm and have either been swollen for more than 6 weeks or are getting bigger
• you have an enlarged liver or spleen , but you don’t have any known liver disease
• you have bone pain together with anaemia or an abnormal paraprotein 
• a bone x-ray suggests you may have myeloma

You might have an urgent referral to a specialist if you also have any of the following signs or symptoms:

• extreme tiredness (fatigue)
• heavy sweating at night
• weight loss
• itching
• infections that keep coming back
• bone pain
• bruising
• weeing a lot and feeling very thirsty due to high calcium levels in your blood

Northern Ireland

The Northern Ireland guidelines are for all blood cancers, not just NHL.

Your GP should refer you immediately to a specialist if:

• your blood test results show you have acute leukaemia
• your GP thinks you have myeloma and you have signs of spinal cord compression or kidney failure

Your GP should refer you urgently to a specialist if you have an unexplained, enlarged spleen that doesn’t get smaller.

Your GP should do further tests and consider referring you to a specialist if you have some of the symptoms listed below. The urgency of the referral depends on how severe your symptoms are and your test results. Symptoms include:

• extreme tiredness (fatigue)
• heavy sweating at night
• high temperature (fever)
• losing a lot of weight
• itching all over the whole body
• feel breathless
• bruising
• bleeding
• infection keep coming back
• bone pain
• tummy (abdominal) pain
• swollen lymph nodes
• enlarged spleen
• pain after drinking alcohol

If swollen lymph nodes are your only symptom, you do not need to see a specialist.

Other symptoms

Your GP will consider any other symptoms that you are having, so do mention these. They might also take into account whether you have any risk factors that affect your chances of developing NHL.

If you're still worried

Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print this page and the symptoms page. Ask your GP to explain why they don’t think you need a referral.

Contact your GP again if your symptoms don't get better or you notice any new or unusual symptoms. 

What should I do if I don’t get my appointment?

If your GP has referred you, ask them when you should get your appointment. Contact them again if you don’t get one. Or some hospitals have a referral service you could try contacting if you know which hospital you are going to. Explain that you are waiting for an urgent suspected cancer referral

Waiting times

Your hospital is working towards waiting time targets. For example, a target to find out whether you have cancer or not. And there are targets to start treatment if you are diagnosed with cancer. These are slightly different depending on where you live in the UK.