Non-Hodgkin's Lymphoma: When To Call A Doctor

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When To Call a Doctor

Call your doctor to schedule an appointment if you have had any symptoms for longer than 2 weeks, such as:

• Painless swelling in the lymph nodes in the neck, underarm, or groin.
• Unexplained fever.
• Drenching night sweats.
• Extreme fatigue.
• Unexplained weight loss in the past 6 months.
• Itchy skin.
• Cough or shortness of breath.
• Pain in the abdomen or back.

Watchful Waiting

Watchful waiting (surveillance) is a period after the diagnosis of some types of non-Hodgkin's lymphoma (NHL) when little or no treatment is used. Watchful waiting is not appropriate for aggressive or high-grade lymphoma. Watchful waiting does not mean that your doctor is giving up or refusing to give you treatment. During this time you will:

• Have regularly scheduled appointments with your doctor.
• Receive periodic medical tests, including scans and blood tests.
• Be told which symptoms to report to your doctor immediately.

Watchful waiting is often as effective as immediate aggressive treatment for some types of NHL. People with advanced low-grade, indolent lymphomas often live a long time without symptoms.^{3 4}

Watchful waiting ends when one of the following occurs:

• Symptoms develop.
• Lymphoma tumor size is larger than and growing.
• Organs do not function normally.

Who To See

Doctors who can help diagnose non-Hodgkin's lymphoma (NHL) include:

• Family medicine doctor.
• Internist.
• Surgeon.
• Nurse practitioner.

When NHL is suspected, a tissue sample (biopsy) is needed to make a diagnosis. A biopsy for non-Hodgkin's lymphoma is usually taken from a lymph node, but other tissues may be sampled as well. A surgeon will remove a sample of tissue so that a pathologist can examine it under a microscope to check for cancer cells.

Non-Hodgkin's lymphoma is usually treated by a medical oncologist or a hematologist. If you require radiation therapy, you will also see a radiation oncologist.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Last updated:	April 22, 2008
Author:	Bets Davis, MFA
Reviewed By:	Anne C. Poinier, MD - Internal Medicine, Douglas A. Stewart, MD - Medical Oncology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC