After you've finished treatment for follicular lymphoma, your doctor might tell you that your cancer is in remission. It's a big milestone because it means you have few or no signs of cancer in your body.
You'll be in one of two types of remission:
Complete remission is when tests and scans show no signs of your cancer. Your doctor might not use the word "cure" because you could still have a few cancer cells left that are too small for tests to detect. But if you stay in remission for 2 years or more, there's a good chance you still won't have any more signs of the disease. You might even be cured.
Partial remission means there are a lot fewer cancer cells in your body, but the cancer isn't completely gone.
How long remission lasts is different for each person. Your cancer may stay under good control for many years. But it's always possible that it could come back in the future or change into a different type.
You can think of follicular lymphoma like a chronic disease. It may come back from time to time, but there are treatments to control it. As more new treatments come out, your chance of having a long-term remission or cure increases.
Maintenance Therapy
This is a treatment you can get once you're in remission. Maintenance therapy involves taking medicines to kill any cancer cells that are still in your body. It helps to keep you in remission for longer.
The monoclonal antibody rituximab (Rituxan) is the maintenance therapy doctors often prescribe for follicular lymphoma. This drug seeks out and attaches to a protein called CD20 on the outside of your cancer cells. Rituximab helps cells of your immune system find and kill your cancer.
Rituximab is an injection your doctor gives you once every 2 months.
After the injection, you may have side effects like these:
- Soreness in the area where you got the shot
- Fever
- Low white blood cell count
- Chills
- Infection
Your doctor can tell you what to expect while you're on this medicine and how to manage any side effects that you do have.
It's common to keep taking rituximab maintenance therapy for 2 years. Studies are looking at whether staying on this drug longer, or taking other medications during remission, might lead to greater benefits.
Follow-Up Visits
After you finish treatment, your doctor will tell you what comes next. Together, you'll create a care plan that will include regular checkups to monitor your health and cancer status.
Your appointments will probably be 2 to 3 months apart at first. As time passes, you may be able to go longer in between visits.
During each checkup, your doctor will:
- Ask how you feel
- Check your neck, underarms, and groin for any swelling or lumps
- Feel your belly for any changes
- Help you manage any side effects from your treatment
You may have one or more tests to help your doctor learn more about your overall health and whether your cancer has returned:
Blood tests. A complete blood count (CBC) checks for lower-than-normal blood cell levels. Blood chemistry tests find out how well organs like your kidneys, liver, and thyroid are working. Other blood tests look for signs of heart disease, which can be a risk from some follicular lymphoma treatments.
Imaging scans. These tests show whether you have cancer in your body or if treatment has caused any problems with your organs:
- X-ray. It uses radiation in low doses to make images of your chest and belly.
- CT scan. It's a powerful X-ray that makes detailed pictures inside your body.
- MRI. It uses powerful magnets and radio waves to make pictures of organs and structures inside your body.
- Ultrasound. It uses sound waves to make pictures of your organs.
If you have any new symptoms between visits, don't wait for your next appointment. Call your doctor about problems like:
- Fever that doesn't go away
- New lump or swelling in a gland or other area of your body
- Night sweats
- Weight loss without trying
A bone marrow biopsy, the same test you may have had when you were first diagnosed, also helps your doctor find out if your cancer has returned.
For as long as you still have this cancer, you'll keep seeing your doctor for follow-up visits. Having these regular appointments ensures that if any new problems do arise, your doctor can respond to them quickly.
Taking good care of yourself during maintenance therapy will help you feel better and possibly avoid some of the late side effects from your treatment. Try to eat a well-balanced diet, exercise, and get all the vaccines your doctor recommends to prevent you from getting sick.
