Ongoing check-ups
Once you have been diagnosed with aggressive non-Hodgkin’s lymphoma (NHL), you will usually start treatment fairly soon after diagnosis. During treatment, and afterwards, you will have regular check-ups to see how well the treatment is working and to monitor the disease.
Even if you have no symptoms, and are apparently disease-free, your healthcare team will still want to keep an eye on your condition and your symptoms in case you suffer a relapse. If you do suffer a relapse then your doctor can discuss your treatment options with you. If you are completely free of all signs and symptoms for several years, then you may be classed as cured.
You will normally have a number of tests at your check-ups, which are used to monitor the success of your treatment and to assess the stage of the disease. The results of these tests may lead to changes in your treatment plan. You may have to wait a couple of weeks for the results of these tests, but because the results will help the doctor assess your treatment, it is important to wait until they come through before you move forward with your treatment.
You should also be aware of the common symptoms of NHL and speak to your healthcare team without delay if you notice any changes such as the return of symptoms. However, it is important not to panic as flu, for example, can have many of the same symptoms as relapsing aggressive NHL.
You may have various tests to monitor your condition
Different tests may be carried out by different members of the healthcare team.
Biopsy – tissue taken from a swollen lymph node
Find out more about biopsies to test for non-Hodgkin’s lymphoma
Blood tests – used to check your general health
Blood tests will be repeated at regular intervals, both during treatment and afterwards to keep a check on how you’re doing.
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
Staging tests – used to check how far your non-Hodgkin’s lymphoma has progressed
Many different tests, such as X-rays, CT (computerised tomography) scans, MRI (magnetic resonance imaging) scans and PET (positron emission tomography) 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
, 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 your lymphoma. Changes in your diagnosis may affect your treatment plan. If this happens, your healthcare team will let you know.
Find out more about staging of non-Hodgkin’s lymphoma
Usually, you’ll attend an outpatients' clinic at the hospital or your doctor’s office
How often you have a check-up after treatment for non-Hodgkin’s lymphoma depends on a range of factors, such as your type of disease, the treatment given and your overall health and response to therapy.
At the beginning, patients will often be seen every month. If good progress is being made, the time between visits will be gradually increased until the patient has a check-up every 3–6 months, or even once a year.
As always, it’s important to prepare in advance for each check-up, and have everything ready that you were asked to bring. Also, make sure that any questions you may have are written down, rather than trying to remember them at the time.
It can be quite stressful to be reminded about the disease, and many patients worry that the doctor may give them bad news. However, check-ups are an ideal opportunity to catch the first signs of a relapse, should it occur, and for you to tell the doctor about any remaining symptoms you have.
If you are worried about the visit, or are concerned that you may forget things that you are told, think about taking a friend or family member along for support.
Your visits to the hospital for tests and check-ups 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.