Ongoing Care for Patients in Remission

This content has been reviewed and approved by

James O. Armitage, MD
The Joe Shapiro Professor of Internal Medicine
Section of Oncology/Hematology
University of Nebraska Medical Center

After a complete remission has been verified, a patient with lymphoma will still need to interact with his or her oncologist on a regular basis--often for the rest of his or her life. Early in follow-up, the major focus is on trying to detect possible recurrent disease as soon as possible. As time passes and the chances of recurrence go down, much of the effort is focused on trying to identify any complications of therapy.

Most oncologists will see patients more frequently (every 2 to 3 months) after a remission has been verified, and the interval between visits will lengthen as time passes. Each visit should include taking a patient history, exam, and laboratory tests.

The use of further imaging studies after remission is controversial. Some oncologists favor imaging studies, such as CT scan or PET scan, at regular intervals. Others will only order these studies if a new symptom, physical finding, or laboratory test raised the possibility of recurrence. Neither approach has been absolutely proven to be the best.

When a new abnormality is found, it is extremely important that a biopsy be taken to discover whether it is recurrent lymphoma. Every new lymph node, abnormal laboratory test, or abnormality on an imaging exam will not represent recurrent lymphoma. Although it is very anxiety producing, it is worthwhile to remember that many of these findings often turn out to be a false alarms.

Follow-up also needs to focus on the possibility of the treatment being related to the development of subsequent health problems. These can include the development of shingles (common in everyone, but are particularly common in patients treated for lymphoma), the development of hypothyroidism in patients who had their neck irradiated, and others.