Lymphomas

Physicians diagnose the cancer and determine what kind it is by looking at a sample of the tumor under a microscope. This alone does not determine what treatment you should have. Before treatment, your doctors must determine how much lymphoma you have. This is called staging the cancer.

Treatment options, as well as the outlook for your recovery, depend on both the exact type and the stage of the lymphoma.

Once identified, a suspected lesion is biopsied. If it is found to be lymphoma, it will be surgically removed, often with the surrounding lymph nodes. A number of diagnostic tests may be performed, including a PET scan and a sentinel node biopsy.

Tests used to gather information for staging may include:

• A physical examination
• Blood tests
• A bone marrow aspiration and biopsy
• A lumbar puncture (spinal tap)
• Imaging tests, including a PET scan

PET is the most useful test that you can have when doctors are staging or re-staging lymphoma because it accurately shows the extent of the cancer.

How PET works:
In cancer, cells begin to grow at a much faster rate, feeding on sugars like glucose. PET works by using a small amount of a radioactive drug called a tracer in combination with a compound such as glucose. Once you are injected with the tracer and glucose, the tracer travels through your body. It emits signals as it travels and eventually collects in the organs targeted for examination. If an area in an organ is cancerous, the signals will be stronger since more glucose will be absorbed in those areas.

In tissues or organs affected by lymphoma, more of the radioactive glucose will be taken up as compared to normal lymph nodes and tissues. This helps the doctors understand exactly where the lymphoma is. Proper staging of the location and extent of the tumor is the first step in appropriate treatment. Moreover, once treated, patients are often re-staged to determine the effectiveness of the treatment. In addition to providing basic staging information, the initial PET scan provides a baseline for subsequent evaluation of whether the therapy was effective or not. Whole Body PET may be particularly useful in detecting extra nodal sites of disease such as bone marrow, liver and spleen.

The treatment of lymphoma has been one of the true cancer success stories of the last 20-30 years. Continued improvements in chemotherapy and radiotherapy have resulted in better survival rates. After first showing the doctors where the cancer cells are, PET can also see if the therapy has been effective at killing them.

Call the doctors at the PET centers nearest you if you have lymphoma and would like to discuss your treatment options or whether PET would be useful in your care.