(BPT) – The global COVID-19 pandemic is affecting nearly every part of daily life, and many people are choosing to skip or forgo their medical visits, screenings and tests. For people living with follicular lymphoma (FL), a typically incurable blood cancer that has to be closely managed, the importance of continuing routine check-ins is crucial to ensure doctors can monitor for disease progression or recurrence.
FL is a form of blood cancer called non-Hodgkin’s lymphoma, and it may be non-aggressive, or, aggressive. It originates in the lymphatic system, a system of lymph nodes found throughout the body, including in the neck, underarms, chest, abdomen and groin/pelvis. FL can affect anyone at any age; however, it is more prevalent in white men and women over the age of 60, with slightly higher rates among men. According to the American Society of Clinical Oncology, an estimated 77,000 cases of non-Hodgkin’s lymphoma were diagnosed in the United States in 2020. FL typically accounts for 20 percent of diagnosed non-Hodgkin’s lymphoma cases. While common signs of FL include swelling in the lymph nodes and fatigue, some patients may not notice any symptoms. Less common symptoms include fever, night sweats and weight loss or enlarging and persistent lumps that can serve as a warning that the cancer may be progressing.
“Follicular lymphoma is a heterogeneous subtype of non-Hodgkin’s lymphoma, with some patients having a very indolent, or slow growing cancer, and others, much more aggressive disease,” said Lori A. Leslie, MD, of the John Theurer Cancer Center in Hackensack, New Jersey, who specializes in hematology and medical oncology, including cancers like FL. “When discussing long-term treatment plans with patients, I like to focus on the rapidly evolving treatment landscape. With many novel therapies recently approved or in the advanced stages of development, it is important to remain hopeful and to take an individualized approach to treatment.”
Following treatment, patients with FL often experience periods of remission before their disease returns. Patients may also become resistant to previous treatments received, as their disease progresses and becomes more difficult to treat.
Bob Mesloh, an FL survivor, knows all too well that FL can return at any time. Following his initial diagnosis and round of treatment, Bob was in remission for five years before his FL returned — which his oncologist discovered during a routine check-up. Bob mentioned that many patients may live relatively unaffected by FL, making routine medical visits easy to overlook or miss, especially in a pandemic. Today, Bob lives in Florida cancer-free and is diligent in his follow-up care by continuing to see his oncologist every six months.
“I always stress the importance of having routine doctor visits to ensure the best health outcomes, knowing follicular lymphoma can relapse at any time,” said Bob. “Without routine in-person check-ins, patients may not realize if they’ve relapsed.”
“Patients and caregivers have many concerns due to COVID-19, including whether they are at risk due to cancer or cancer treatment, and if their ability to get the best treatment will be compromised due to the pandemic,” said Dr. Leslie. “My guidance is to discuss your specific situation with your treating provider to make the best choice together. I encourage patients to stay engaged with their healthcare professionals and encourage their family or friends to do the same. Avoiding a check-up and workup for developing symptoms due to fear of exposure to the healthcare environment can have devastating consequences.”
Across the medical field, many safety protocols are in place to ensure patients can visit their doctors in person with the lowest risk possible during the pandemic. If a patient feels uncertain or uncomfortable with an in-person visit, they should call their doctor’s office in advance to learn what precautions are in place and what they can expect during an actual visit.
Telemedicine has also become a viable option for staying in touch with healthcare providers, as long as patients understand that virtual visits should not fully replace in-person appointments.
A patient’s FL treatment journey should always be informed by continuous, open conversations with their healthcare team to develop a long-term treatment plan that addresses the severity of the disease, taking into consideration available treatment options. Treatment plans should consider several factors including age, other health conditions the patient may have, disease aggressiveness and individual lifestyle needs. The good news is that oral treatment options are available and can be taken from home, which can be helpful during the COVID-19 pandemic.
“With an explosion of new, targeted and immune-based therapies over the past few years, it is a very exciting and hopeful time,” said Dr. Leslie. “We are no longer in an era of one-size-fits-all chemoimmunotherapy as the importance of determining a personalized treatment plan for each patient is increasingly apparent.”
To learn more about FL, please visit the Lymphoma Research Foundation.
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