How treatment is planned

A group of specialists with expert knowledge in non-Hodgkin lymphoma will manage your treatment. This is called a multidisciplinary team (MDT).

The MDT will meet to discuss your test results and plan your treatment. One of the most important things they will take into account is whether the lymphoma is:

  • low-grade or indolent (slow-growing)
  • high-grade or aggressive (fast-growing).

Because low-grade lymphomas tend to be slow growing, some people don’t always need to start treatment straight away. This is called watch and wait.

Early-stage low-grade lymphoma is usually treated with radiotherapy. This may cure the lymphoma.

The most common treatment for advanced-stage low-grade lymphoma is chemotherapy. It often shrinks the lymphoma and stops symptoms. This is called remission. Some low-grade lymphomas change into high-grade lymphomas with time. If this happens, they are treated in the same way as high-grade lymphomas.

High-grade lymphomas need immediate treatment, usually with chemotherapy. This aims to make the lymphoma disappear (complete remission) – and many people are cured.  If the lymphoma comes back it can sometimes be put back into remission with further treatment, which may be more intensive.

You will need to give permission (consent) for the hospital staff to give you the treatment.

How treatment is planned

Usually, a team of specialists called a multidisciplinary team (MDT) meets to plan your treatment.

The MDT may include:

  • haematologists and oncologists – these are doctors who specialise in treating lymphoma 
  • a radiologist – this is a doctor who analyses scans and x-rays
  • a clinical nurse specialist, who will make sure you get help and support throughout your treatment.

It may also include other specialists, such as a pharmacist, dietitian, physiotherapist, occupational therapist, psychologist or counsellor.

Having the right information was very important to me. When I went to my first appointment, I felt the consultant was more open with me because I had informed myself about my cancer.


Talking about your treatment options

Your lymphoma doctor will talk to you about your treatment options. You might find it useful to write down a list of your questions before you meet with them. It’s also a good idea to have a family member or friend with you at the meeting. They can help you remember what was said and talk it over with you afterwards.

Your doctor will explain what your treatment involves and what its main aims are. This may be to:

  • try to cure the lymphoma
  • control it for as long as possible
  • relieve symptoms.

They will also explain the side effects of treatment. People often worry about these, but most side effects can be controlled or managed.

If you do not understand something, ask your doctor or nurse to explain it again. If you feel worried about anything, it is important to discuss this with your doctor.

Deciding about treatment

You decide on your treatment plan with your lymphoma doctor. Your doctor is an expert in lymphoma and treatments. But you know best about what you want and what you believe is right for you.

You may find it easy to make your decision, especially if you are told that treatment has a good chance of curing the lymphoma or putting it into remission. But sometimes the decision is more complicated. You may find it harder to decide to have treatment if you are told that it has a smaller chance of working or a high risk of side effects.

Some people are offered a choice of treatment plans. Before you decide which one is right for you, make sure you have enough information about the different options. Check that you understand what each treatment will be like, and the possible advantages and disadvantages of each one. You may have more than one meeting with your doctor to discuss your treatment plan.

Second opinion

Your multidisciplinary team (MDT) uses local and national treatment guidelines to decide on the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your lymphoma doctor or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.

Giving your consent

Before you have any treatment, your doctor will usually ask you to sign a form. This form gives permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent. Before your doctor asks you to sign the form, they should give you full information about:

  • the aims of the treatment
  • the type and extent of the treatment
  • its advantages and disadvantages
  • any significant risks or side effects
  • any other treatments that may be available.

You are free to choose not to have the treatment. If you decide not to have treatment for the lymphoma, you can still have treatment to help control any symptoms. A doctor will record your decision in your medical notes. You do not have to give a reason for not wanting treatment, but it can help to let the staff know your concerns. This will help them give you the information you need.

Back to Who will be involved in your decision

Getting a second opinion

There are many reasons for wanting a second opinion about your treatment. Speak to your specialist or GP.