Diagnostic visits and check-ups
If you’ve been diagnosed with indolent non-Hodgkin's lymphoma (NHL), you’ll already have had some tests to make sure that the diagnosis is correct.
However, to find out exactly what type of NHL you have, it’s sometimes necessary to have more tests.
You may have to wait a couple of weeks for the results of these tests, but because the results will help the doctor decide on exactly the right treatment for you, it is important to wait until they come through before you move forward with treatment.
It is common to have no symptoms at first
Very often, patients with indolent non-Hodgkin’s lymphoma (NHL) have no symptoms when they are diagnosed.
Your lymphoma might be recognised during a physical examination by your family doctor, who may find an enlarged lymph node that you’ve not noticed. Alternatively, your doctor may notice your NHL because of a blood test or a chest X-ray, which is being done for some other reason altogether.
Your diagnosis will be confirmed by hospital specialists
All of the symptoms that can be caused by NHL can also be explained by other conditions as well. So, in most cases, a family doctor will be unable to confirm a diagnosis of NHL. If you are suspected of having non-Hodgkin's lymphoma you’ll probably have to see specialist hospital doctors. Often, it is necessary to see more than one person before the diagnosis can be confirmed.
You may have various tests to confirm diagnosis
Biopsy – tissue taken from a swollen lymph node to find out what type of lymphoma you have
Tissue taken in a biopsy is examined under a microscope to find out:
- If you have lymphoma and whether it is Hodgkin’s or non-Hodgkin’s lymphoma (NHL)
- Whether it is growing slowly (indolent) or rapidly (aggressive)
- Exactly what sub-type of NHL you have
Find out more about biopsies for non-Hodgkin’s lymphoma
Blood tests – used to check your general health
One blood sample will be used to check several things at once:
- The number of red blood cells, white blood cells and platelets you have in your blood, known as a full blood count
- How well the liver is working, known as liver-function tests
- How well the kidneys are working, known as renal-function tests
- How much lymphoma there is in the body, shown by how much of a substance called lactate dehydrogenase (LDH) is found in your blood
- Various other, specialised tests, that will inform your doctor on specific aspects of the lymphoma and possibly affected organs
Once your diagnosis is confirmed, blood tests will be repeated at regular intervals, both during treatment and afterwards to keep a check on how you’re doing.
Staging tests – used to check how far your non-Hodgkin’s lymphoma has progressed
Many different tests, such as X-rays, CT scans and PET scans, as well as the bone marrow biopsies and blood tests that have already been mentioned, are carried out to help decide on the stage of your non-Hodgkin's lymphoma (NHL), which can be stage I, II III or IV.
These tests tell you
- How many groups of lymph nodes are affected
- Whether the lymphoma is only in the lymph nodes or whether it is in other organs as well
- Whether the lymphoma is just in the chest or abdomen, or is in both areas
It is vital to know the stage of the lymphoma before starting treatment. It might seem that treatment is being delayed unnecessarily while staging tests are being done. However, correct treatment depends on the correct diagnosis and being able to give you the best treatment from the start will more than make up for any slight delay.
Find out more about staging tests for non-Hodgkin’s lymphoma
Usually, you’ll attend an outpatients' clinic at the hospital or your doctor’s office
Your visits to the hospital for tests, check-ups and, later, for treatment, will probably take place in a specialist lymphoma clinic or at your doctor’s office. You’ll see your doctor regularly for check-ups and probably before each treatment session as well.
You will have a main point of contact at the clinic who will be able to give you advice, guidance and any other information you need. In some countries, this is the clinical nurse specialist, and in others it is the haematologist or the oncologist.