Treatment options for stage 4 non-Hodgkin lymphoma depend on whether the disease is diagnosed as indolent or aggressive. A diagnosis of stage 4 non-Hodgkin lymphoma is almost always indolent, and your doctor may opt not to treat it all, asking instead for you to come in for periodic monitoring checkups, or treat extremely targeted regions with radiation. Even with such treatment, the lymphoma can return in untreated parts of the body as much as a decade afterward, so long-term monitoring will be necessary for some time.
The much rarer, aggressive form of stage 4 non-Hodgkin lymphoma calls for correspondingly aggressive treatment. Treatment will usually be some combination of chemotherapy using cancer-fighting drugs and targeted radiation therapy. Stem cells may be used to supplement a particularly high-dose regimen of chemotherapy.