The patient treatment pathway

Your referral letter will be sent to the secretaries of the lymphoma consultant you are referred to. They will register your details and allocate you with a unique hospital number. The referral letter can then be accessed by the lymphoma consultant and on their guidance the secretarial team will contact you with an appointment. The secretarial team sometimes need to chase any information required in addition to the referral letter, e.g. biopsy results and recent scans which will make up your case notes ready for your first visit.

The time and place of your first visit can vary depending on which consultant you are referred to and your age. If you are under 21 you may be seen in the Teenage and Young Adult Unit. 

You will be informed of when and where to attend by our secretaries and a map of the Christie including car parking information and appointment details will be posted out to you.

After arriving for your appointment you will have some blood tests taken usually while you are waiting.

During this visit it is common to meet the lymphoma consultant, a registrar and a clinical nurse specialist. All of the lymphoma team will be involved in your diagnosis and care, and are part of the decision making process for your treatment plan. So whoever you see, they will be well informed about you.

You will undergo a physical examination during this appointment. You can expect this to involve checking your height and weight. To help build a better picture of your journey so far, they will also ask you about family history and past medical history, together with other questions relating to your health.

The lymphoma team discuss your diagnosis and prognosis (outlook for the future) and will make a general assessment about your clinical condition.

You may require a certain type of treatment (therapy) for which the team will need to make a plan. This may be decided at your first visit or you may need further investigations to assist their decision making.

The team will explain your treatment options and discuss with you any available clinical trials. If you take part in a clinical trial, you may be one of the first people to benefit from new treatment. Clinical trials help us understand how best to treat diseases such as lymphoma now and in the future. Some clinical trials are very different and dondon't always involve testing a new drug, for example, you could be given standard treatment in a slightly different way. No matter how different the clinical trial, every single patient participating in one provides us with valuable knowledge and understanding essential to medical research, which could change the way patients with lymphoma are treated around the world.

If no trial is available for you or you choose to select the standard treatment, the treatment plan will be discussed in detail with you and you will also receive written information.

If more tests are needed you will come back to the hospital for these. It could be that you require a further scan or a further biopsy. The team will then have all the information they need to carefully plan your treatment schedule and explain it to you.

You will have a further consultation with member/s of the lymphoma team and at this point if you haven’t already, you will sign a consent form. This will give the team permission to provide you with the agreed treatment.

You will receive your first dose of treatment either that same day or on another day shortly afterwards; this may be oral (by mouth) or IV (intravenous, directly into the veins) or radiotherapy.

Where you attend for treatment will be different depending on what you are receiving. You will be kept well informed about the schedule and where and when your next treatment will take place.

Whilst you are undergoing treatment we will need to see you regularly in our follow up clinic to check how your body is being affected by the treatment, this can include blood tests, recording of any side-effects, physical examinations, scans, heart (ECG) checks amongst others which will be explained to you at the time.

Sometimes a member of the lymphoma team will give you an appointment card/slip to take to the reception desk after your appointment. They will then be able to book your next appointment or on some occasions they will pass it to the secretaries who will organise it and send the details in the post to you.

Your end of treatment follow up will be different depending on what treatment you received. If you had chemotherapy you may require an end of treatment PET/CT scan to assess how your lymphoma has responded to the treatment you received.

PET/CT scan results can take up to 7 days. We will see you in our outpatient follow up clinic once we receive the results to explain what they show and assess how you are doing clinically. 

If your treatment was radiotherapy you are usually followed up after treatment by your referring consultant which may be in your local hospital or at The Christie.