Follicular lymphoma is a slow-growing cancer that may appear in your lymph nodes, your bone marrow and other organs. There are ways to treat follicular lymphoma, but the condition often returns. Healthcare providers are hopeful that newer treatments, like immunotherapy drugs, may mean a cure is on the horizon.
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Follicular lymphoma is a form of non-Hodgkin lymphoma that may appear in your lymph nodes, bone marrow and other organs. Non-Hodgkin lymphoma (NHL) is cancer that affects your lymphatic system. Follicular lymphoma is the second most common type of NHL, with about 15,000 to 20,000 new diagnoses in the U.S. each year.
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Follicular lymphoma is an indolent (slow-growing) cancer. But there’s a small chance it can progress to a more aggressive cancer called diffuse large B-cell lymphoma.
It’s not curable — at least not yet. But new treatments are helping people live longer with follicular lymphoma. Most people with this condition die with it, not from it.
You can have follicular lymphoma without having any symptoms. When people do have them, the ones that usually show up are painless swelling in the neck, armpit or groin. This is a sign of enlarged lymph nodes.
Other symptoms include:
Researchers don’t know what causes follicular lymphoma. They do know changes in people’s chromosomes happen in about 85% of cases. The changes transform normal B cells into cancer cells.
B cells are white blood cells that make antibodies to fight infections. But cancer cells don’t function in this way. Instead, they multiply and grow. Eventually, they may cause symptoms.
These changes happen at some point in your lifetime. Follicular lymphoma isn’t inherited.
People age 65 and older are more likely to have this condition. People who are white receive this diagnosis more often than people of other races.
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Children can develop follicular lymphoma. But it’s so different from the adult form that researchers consider it a different type of cancer. Unlike the adult type, pediatric follicular lymphoma is often curable.
Having a biopsy done is the only way to know for sure if you have follicular lymphoma. After confirming your diagnosis, your healthcare provider will order tests to stage it. Cancer staging can show how early or advanced the disease is. You may need:
Follicular lymphoma stages range from I to IV:
Since follicular lymphoma doesn’t cause symptoms right away, most people have Stage III or IV disease by the time they’re diagnosed.
You may not need treatment if you don’t have symptoms. Research shows that early treatment of asymptomatic follicular lymphoma doesn’t improve survival. Instead, your provider may suggest active surveillance. They’ll check on your condition regularly. You’ll only get treatment if you develop symptoms that treatment can ease or that keep the disease from getting worse.
Treatments include:
Experts are constantly finding new treatments that work on follicular lymphoma. In particular, immunotherapy drugs like rituximab have been a game-changer for people with this diagnosis. Researchers are hopeful that follicular lymphoma may one day be curable.
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You’ll see your provider regularly. You may need blood or imaging tests so your provider can monitor your condition or treatment. But you should also contact them if you notice changes that may be signs of new or worsening symptoms.
Follicular lymphoma is a slow-growing condition that’s considered a chronic illness. About half of all people diagnosed with it are alive 20 years later. About 9 out of 10 of people are alive five years after diagnosis. Since most people diagnosed are over 50, this means that many people eventually die of causes unrelated to the cancer.
But there are lots of ways this disease can unfold. You may never need treatment, or you may develop more aggressive disease, like diffuse large B-cell lymphoma. Your chances of cancer progression increase slightly each year.
Managing the disease in the long term often becomes a way of life with this diagnosis.
Your healthcare provider can suggest ways to cope with a lymphoma diagnosis. You may be living with cancer for a long time. Long-term survival is good news, of course, but living with a chronic illness may be challenging.
Making changes to your diet may help you feel better. Talking to a therapist or finding a support group can help, too. Finding cancer survivorship support is an important part of living with this disease.
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There’s currently no cure for follicular lymphoma. Radiation to treat Stage I disease sends the cancer into long-term remission for many people. But there’s always the chance that the cancer may come back.
This is why your healthcare provider will check on you even after treatment.
It’s possible. When it does, it usually spreads to your bone marrow and other organs in your lymphatic system.
You can have follicular lymphoma without symptoms for years. If they start, you may find yourself cycling through periods of treatment, remission, relapse and more treatment. The back-and-forth can take a physical and emotional toll. This is why it’s important to learn as much as you can from your healthcare provider about what to expect. Ask them about new therapies that may be effective. More and more, providers are using treatments that may one day move follicular lymphoma from the list of chronic diseases to the list of curable ones.
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When you hear that you might have lymphoma, you want care from experts you can trust. At Cleveland Clinic, we craft a treatment plan tailored for you and your needs.
Last reviewed on 10/20/2025.
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