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What Happens After Treatment for Non-Hodgkin Lymphoma?


Completing treatment for non-Hodgkin lymphoma can be both stressful and exciting. You will be relieved to finish treatment, yet it is hard not to worry about cancer coming back (recurrence). This is a very common concern among those who have had cancer.

Follow-Up Care
Your care after treatment will depend to a large extent on what type of lymphoma you have, what type of treatment you received, and how effective it was.

Your doctor will want to see you regularly to discuss any symptoms you may have and to do physical exams, usually every few months for the first year and gradually less often after that. Your physical exam will include careful attention to size and firmness of lymph nodes.

You may need to have frequent blood tests to check that you have recovered from treatment and to look for possible signs of problems such as disease recurrence. Blood counts can also become abnormal because of a disease called myelodysplasia, which is a defect of the bone marrow that can lead to leukemia. Some chemotherapy drugs can cause this disease. It is also possible for a person to develop leukemia a few years after being treated for lymphoma. These blood disorders may occur in as many as 10% of lymphoma patients who were treated with either standard chemotherapy or high-dose chemotherapy followed by stem cell transplant.

Imaging tests may be done. If internal lymph nodes or other internal organs are or were affected, CT scans and/or PET scans may be used to measure the size of any remaining tumor masses. PET scans are useful if your doctors aren’t sure if a mass seen on CT scan is an active lymphoma or scar tissue.

At some point after your cancer diagnosis and treatment, you may find yourself seeing a new doctor.

After treatment it is important to keep your health insurance coverage. Even though no one wants to think about the cancer coming back, it is always a possibility. If it happens, the last thing you want to have to worry about is paying for treatment.

Seeing a New Doctor
At some point after your cancer diagnosis and treatment, you may find yourself seeing a new doctor. It is important that you be able to give your new doctor the exact details of your diagnosis and treatment. Make sure you have the following information:

  • a copy of your pathology report from any biopsies or surgeries;
  • if you had surgery, a copy of your operative report;
  • if you were hospitalized, a copy of the discharge summary that every doctor must prepare when patients are sent home from the hospital; and
  • since some drugs can have long-term side effects, a list of your drugs, their doses, and when you took them.

Lifestyle Changes to Consider During and After Treatment
Having cancer and dealing with treatment can be time-consuming and emotionally draining, but it can also be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even begin this process during cancer treatment.

Make Healthier Choices
Think about your life before you learned you had cancer. Were there things you did that might have made you less healthy? You can start making changes today that can have positive effects for the rest of your life. Start by working on those things that you feel most concerned about. Get help with those that are harder for you. For instance, if you are thinking about quitting smoking and need help, call the American Cancer Society’s Quitline® tobacco cessation program at 1-800-ACS-2345.

Diet and Nutrition
One of the best things you can do after treatment is to put healthy eating habits into place. You will be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Try to eat 5 or more servings of vegetables and fruits each day. Choose whole grain foods instead of white fl our and sugars. Try to limit meats that are high in fat. Cut back on processed meats like hot dogs, bologna, and bacon. If you drink alcohol, limit yourself to 1 or 2 drinks a day at the most.

Rest, Fatigue, Work, and Exercise
Fatigue is a common symptom in people being treated for cancer. For some, this fatigue lasts long after treatment, and can discourage them from physical activity. However, exercise can actually help you reduce fatigue. Studies have shown that patients who follow an exercise program tailored to their personal needs feel physically and emotionally improved and can cope better.

Talk with your healthcare team before starting, and get their opinion about your exercise plans. Then, try to get an exercise buddy so that you’re not doing it alone.

How About Your Emotional Health?
Once your treatment ends, you may find yourself overwhelmed by emotions. This happens to a lot of people.

Almost everyone who has been through cancer can benefit from getting some type of support. Support can come in many forms: family, friends, cancer support groups, church or spiritual groups, online support communities, or individual counselors. Whatever your source of strength or comfort, make sure you have a place to go with your concerns.

You can’t change the fact that you have had cancer. What you can change is how you live the rest of your life – making healthy choices and feeling as well as possible, physically and emotionally.

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Reprinted by the permission of the American Cancer Society, Inc. from All rights reserved.

This article was published in Coping® with Cancer magazine, May/June 2008.