The diagnosis of Non-Hodgkin’s Lymphoma requires the completion of several steps before a treatment plan begins. This article will provide an overview of what to expect during the diagnosis stage, as well as a detailed look at the treatment options that may be available to you.
As with any major health concern, frequent and open communication with your doctor will help you navigate this difficult time.
How Non-Hodgkin's Lymphoma is Diagnosed
When you go in to discuss possible symptoms of Non-Hodgkin's Lymphoma with your primary care doctor, you can expect your doctor to ask you a series of detailed questions related to your personal and family medical history. Gathering a list of family health issues known to you, and perhaps reaching out to confirm with family members if possible, will help you prepare for your appointment.
After discussing medical history and detailing any signs you’ve been experiencing, your doctor will then wish to put you through one or more tests to assist with the diagnosis. These tests may include:
Routine Physical Examination
Regardless of how long it's been since your last examination, your doctor will likely perform a simple physical exam during your first visit. You can expect your doctor to measure your vitals, such as blood pressure, cholesterol levels, and weight. Your doctor will also carefully inspect your neck, underarms, and groin area for signs of lymph node enlargement, gently palpitating the areas with their gloved hands.
They may also order common blood and urine laboratory tests in order to help rule out infections or other health issues. After the physical, your doctor may then wish to refer you for additional testing or procedures.
Lymph Node Biopsy
If the lymph node examination reveals swelling, your doctor may recommend a biopsy. A biopsy is a procedure in which a radiologist or surgeon removes all or part of a swollen lymph node. This procedure is considered minor, often involving being placed under local anesthesia, or occasionally, under general anesthesia. Local anesthesia involves the numbing of the biopsy area with an injection, as well as medications to prevent discomfort. General anesthesia involves being put to sleep while under biopsy and is relatively pain-free.
After the brief procedure is over, the area will be stitched up while the sample is sent to the laboratory for examination under a microscope. At this stage, the tissues may indicate whether you have Non-Hodgkin’s Lymphoma and what type. If the biopsy has confirmed a diagnosis, your doctor may then wish to order a few more tests to indicate the stage the lymphoma is in.
In order to assist in the detailed diagnosis and creation of your treatment plan, one or several imaging tests may also be performed. These imaging tests include:
- X-Ray (electromagnetic wave imaging)
- CT Scan (computed tomography scan)
- MRI Scan (magnetic resonance imaging)
- PET Scan (positron emission tomography)
These tests have many applications, but in the case of Non-Hodgkin’s, they are useful in determining if any lymphoma cells exist in other parts of your body.
If other tests have raised the issue that lymphoma may be affecting the fluids surrounding your spinal cord, then a lumbar puncture may also be ordered. Also known as a spinal tap, a lumbar puncture is a simple and brief outpatient procedure. A doctor or specially trained nurse will insert a thin needle in your lower back and remove a bit of spinal fluid for further examination. You will also be given a local anesthesia to help numb the area. Other tests may also be indicated, such as a different type of biopsy.
Bone Marrow Sample
If a bone marrow sample is in order, the simple procedure is another form of biopsy involving the use of a needle to remove a sample of bone marrow from your hip bone. Like a lumbar puncture, this procedure is performed outpatient and is relatively quick. Local anesthesia is provided, and a mild sedative may also be offered to help ease any discomfort. The fluids are then sent to the lab for further analysis.
After all necessary tests have been performed and analysis completed, your doctor will be able to stage the lymphoma, or determine the stage at which the cancer has spread. Creating and beginning a robust treatment plan is the next course of action.
Non-Hodgkin’s Lymphoma Treatment Options
At the treatment stage of Non-Hodgkin’s Lymphoma, you will likely come to communicate with not just your primary care physician, but a team of several healthcare and oncology professionals. Your treatment team will be in close communication with one another to ensure that the most effective course of action is laid out for your treatment.
You should expect to openly discuss all possible side effects, risks, and benefits of each treatment option made available to you. Such options may include:
Chemotherapy is the most frequently used treatment for people with lymphoma, and may be used either alone or in conjunction with other therapies, including stem cell transplant. Chemo consists of powerful drugs, taken by either mouth or as an injection, and entering the bloodstream to flow to nearly every area of the body. Often, several types of drugs are combined in chemo treatment.
Non-Hodgkin’s patients are treated in cycles, allowing their bodies to rest between each powerful dose of chemotherapy. Steroids may be prescribed as well, as they increase the effectiveness of chemotherapy. Most often, chemo is an outpatient treatment, but occasionally, a brief hospital stay may be involved. If chemo is in your lymphoma treatment plan, your medical team will ensure that the combination of drugs works is optimized for you, adjusting as necessary.
Keep in mind that chemo comes with side effects, including fatigue, loss of appetite, nausea, hair loss, ease of bleeding or bruising, neuropathy, fertility issues, and shortness of breath. Your doctors will help you reduce the side effects as much as possible. Most symptoms go away after chemotherapy is over.
Radiotherapy is sometimes used as the main type of therapy, particularly if a patient’s lymphoma is in the early stages. It is also sometimes used in conjunction with chemotherapy, in the case of more aggressive or advanced lymphomas. Radiation therapy is also used as a method of easing nerve pain that may result from tumors pressing upon internal organs.
The procedure is entirely painless and very brief, much like getting an X-ray. If radiotherapy is right for you, your medical team will discuss the side effects with you, such as nausea or diarrhea, peeling or blistering skin, or tiredness. While these effects do go away, there are other, longer term side effects your doctors may discuss with you, depending upon where in your body the treatment is focused.
Another possible treatment option for Non-Hodgkin’s Lymphoma, immunotherapy, is a method of boosting the patient’s own immune response in order to slow or kill lymphoma cells. Monoclonal antibodies are one popular way to target the lymphoma cells. These cells are proteins made by our own immune systems which assist in fighting off infection, injected into your veins over the course of a few hours. The caveat? These proteins will target the body’s cells and the lymphoma cells, alike.
However, your healthy cells will rebound again over time. There are also man-made proteins which are highly specific in the cells that they target. This type of lymphoma treatment is sometimes used alone, and sometimes used in conjunction with other therapies. Like other treatments, side effects are common and include things like feeling tired or sick, nausea, headache, fever, chills, a fast heartbeat, or low blood pressure. Typically, your body will grow accustomed to the treatment and the side effects will ease.
For some Non-Hodgkin’s patients, the lymphoma is slow moving, and their bodies are generally handling the disease on their own. In such a case, you would not embark on aggressive treatments. Instead, you would remain in regular contact with your doctors, ensuring that as soon as any concerning symptoms emerge, you are ready to begin full treatment.
For patients who are in more advanced stages of Non-Hodgkin’s lymphoma, there are other ways in which doctors provide supportive care throughout. For example, some patients may require treatment of low blood count. Injections, blood transfusions via IV, or drugs such as corticosteroids may be prescribed to alleviate this issue. Other people with lymphoma may also experience more frequent viruses and infections due to lowered immunity. In this case, you would be prescribed antivirals or antibiotics as needed.
Finally, know that you will be supported with palliative care, or management of pain and side effects, as necessary throughout your treatment. Ranging from ibuprofen to more potent pain killers, as well as oxygen treatment, nutritional support, and more, your medical team’s job is to treat the lymphoma and support your well being along the way.
The diagnosis of Non-Hodgkin’s Lymphoma is a thorough process that begins with visiting your primary care doctor. After your doctor and referred medical team complete all tests and procedures, including fluid tests, imaging tests, and a biopsy, you will receive a diagnosis. A diagnosis will be informed by several doctors’ analysis of your test results, and consists of the stage and subtype of Non-Hodgkin’s. From there, a dedicated team of doctors, oncologists, and other medical professionals will create a detailed treatment plan. This team will work to optimize the best treatment options available to you.
While chemotherapy and radiotherapy are the most common lymphoma treatment options, immunotherapy, supportive drugs, palliative care, and other treatments may also be involved in your plan. After treatment ends, it's your job to comply with follow-up communications and appointments. Follow-up is critical in ensuring that the cancer does not return. In time, these follow-up visits may decrease as your recovery progresses.
If you or a loved one has received a diagnosis of Non-Hodgkin's Lymphoma related to the use of Roundup, we can help. Contact us today to learn about your legal options.