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What Happens After Treatment for Non-Hodgkin Lymphoma?


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

Follow-up Care
Lymphomas are a diverse group of diseases that require different treatments and can have very different prognoses. 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 probably 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 or so and gradually less often after that. Your physical exam will include careful attention to size and firmness of lymph nodes.

Imaging tests may be done, based on the type, location, and stage of lymphoma. 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 particularly useful if your doctors aren’t sure if a mass seen on CT scan is an active lymphoma or scar tissue.

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 sometimes 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.

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.

If the lymphoma does recur at some point, further treatment will depend on what treatments you’ve had before, how long it’s been since treatment, and your health.

Seeing a New Doctor
At some point after your cancer diagnosis and treatment, you may find yourself in the office of a new doctor. Your original doctor may have moved or retired, or you may have moved or changed doctors for some reason. 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 handy:

  • a copy of your pathology report(s) from any biopsies or surgeries
  • if you had surgery, a copy of your operative report(s)
  • if you were hospitalized, a copy of the discharge summary that doctors must prepare when patients are sent home
  • if you had radiation therapy, a summary of the type and dose of radiation and when and where it was given
  • if you had chemotherapy or other medicines, a list of your drugs, drug doses, and when you took them

It is also 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.

Lifestyle Changes
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.

Think about your life before you learned you had cancer. Were there things you did that might have made you less healthy? Maybe you drank too much alcohol, or ate more than you needed, or smoked, or didn’t exercise very often. Emotionally, maybe you kept your feelings bottled up, or maybe you let stressful situations go on too long.

Now is not the time to feel guilty or to blame yourself. However, you can start making changes today that can have positive effects for the rest of your life. Not only will you feel better but you will also be healthier. What better time than now to take advantage of the motivation you have as a result of going through a life changing experience like having cancer?

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

Learn more about lymphoma from Coping.

This article was published in Coping® with Cancer magazine, November/December 2009.