Non-Hodgkin lymphomas: Living with and after the disease
Follow-up after the treatment of non-Hodgkin's lymphoma depends on the nature of the lymphoma.
Psychological repercussions
Beyond the constraints of regular supervision, the patient must learn to live with the psychological repercussions of the disease.
The announcement of cancer and the start-up of treatments that cause potential side effects can have an impact on the morale of patients. In the context of their management, they can benefit from a psychological follow-up.
In the case of indolent lymphomas, they are susceptible to chemotherapy but present a risk of recurrence. This chronicization of cancer can be difficult to live on a daily basis with a permanent anguish of relapse. The medical team, which knows the psychological consequences of non-Hodgkin lymphomas, is attentive to patients. It can advise associations of patients who allow to exchange with people who have experienced the same route and/or to orient to a psychologist.
Follow-up after treatment
Follow-up is different depending on whether it is untreated indolent non-Hodgkin's lymphoma (surveillance in the context of therapeutic forbearance), treated indolent non-Hodgkin's lymphoma or aggressive non-Hodgkin's lymphoma.
It is therefore individualized and suitable for each patient. It consists of regular consultations – their frequency is set by the hematologist – during which the doctor has particular attention to the palpation of the lymph nodes. Blood and imaging tests complete this follow-up, allowing for early detection of recurrence. An example of a calendar: for large B-cell diffuse lymphomas, the consultations take place every three months for two years, then every six months for the next three years and thereafter each year.
Smoking cessation, a priority
The management of patients with non-Hodgkin's lymphoma must be comprehensive: for example, it should focus on late complications of treatment. These are less serious than they used to be because current treatments are less harmful to the organism but are more effective. For example, the risk of second cancer is no longer increased. On the other hand, the risk of cardiovascular disease, increased by anti-cancer treatments, is more important if the person smokes. It is therefore imperative to stop smoking, with the help of smoking cessation professionals if necessary.
Fertility
As a precaution, doctors propose to carry out sperm storage at a specialized centre called the Human Egg and semen study and Conservation Centre (CECOS) before the treatment begins. In most cases, fertility returns to normal after treatment and the vast majority of men treated for non-Hodgkin's lymphoma may have children without the use of in vitro fertilization techniques. During the duration of the chemotherapy and during the year following the end of the treatment, a possible pregnancy must be avoided in view of the risks of fetal malformations related to the treatment, whether for a woman with a non-lymphoma Or for a patient's partner. Contraception is therefore recommended during this period.
Social aspects
Lymphomas that are part of cancers with a high rate of cure, patients are invited to think about their life after cancer.
Some may even continue to work during the treatments, others, on the other hand, need rest and then take the necessary time. After the illness, occupational reintegration can be difficult because of the image of cancer. However, it is as often as possible and strongly encouraged by doctors. Other aspects of the return to social life can be problematic. Associations exist to help people who have been diagnosed with a serious illness such as non-Hodgkin's lymphoma.
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