Most diffuse large B-cell lymphomas (DLBCL) that recur (come back after treatment) are found based on symptoms reported by patients, abnormal blood test results, or abnormal findings on a physical examination, rather than by a computed tomography (CT) scan, according to a recent study. DLBCL is the most common form of lymphoma and is typically curable. However, up to a third of patients will have the disease recur. A CT scan is a way to create pictures of the inside of the body and is currently recommended as a regular part of follow-up care for patients with DLBCL to watch for a recurrence.
This study included 644 patients with DLBCL who received the standard initial treatment for the disease and had a remission (no signs of the disease). Researchers then looked at how many of these patients had a recurrence, needed additional treatment, or died from DLBCL after the initial treatment. They found that after about five years, 20% (109 patients) experienced a recurrence. When these recurrences were found, 68% of patients had symptoms of a recurrence, 42% had an abnormal finding on physical exam, and 55% had abnormal blood test results. A recurrence was detected only by a planned CT scan for only 8 patients.
What this means for patients
“Scans expose patients to radiation and that may increase the risk of a second cancer. Surveillance scans have also been shown to increase a patient’s anxiety and lead to unnecessary biopsies,” said lead study author Carrie A. Thompson, MD, a hematologist at Mayo Clinic, Rochester, Minnesota. “While our study shows that most of recurrences are found through a patient’s symptoms, whether to do CT scans and how often should be tailored for each patient.” Because a DLBCL recurrence usually causes symptoms, it is important for patients to report any new symptoms or a change in symptoms to the doctor. Some signs of a possible recurrence include swollen lymph nodes (tiny, bean-shaped organs that fight infection), night sweats, unexplained fever, and unintentional weight loss.
Questions to Ask Your Doctor
- What type of lymphoma did I have?
- What is the risk that the disease will recur?
- What tests will I need to watch for a recurrence and how often will I need them?
- What are the risks and benefits of these tests?
- What are the signs and symptoms of a recurrence that I should watch for?
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