{"entity":{"id":"lymphoma-living-scanxiety-and-surveillance","kind":"term","name":"The surveillance schedule, and the evidence that routine scans do not find relapse first","aka":["Scanxiety lymphoma","Surveillance imaging lymphoma","Follow-up scans after lymphoma","Patient-triggered follow-up"],"tldr":"Most people expect regular scans after lymphoma treatment and are unsettled when they are not offered. The evidence is that in most lymphomas relapse is found because the person notices something, not because a scan catches it, and that finding it by scan does not lengthen life.","summary":"**What people are not told.** Lymphoma Action's follow-up page states it in one sentence: you might have a scan at the end of treatment to check the response, but scans are not routinely used as part of ongoing follow-up, as they are unlikely to identify lymphoma, and there is no evidence to suggest that they change lymphoma treatment or outcomes. Scans are requested when the team has a concern about symptoms.\n\n**The study behind it.** Thompson and colleagues followed 680 people with diffuse large B-cell lymphoma treated with anthracycline-based immunochemotherapy in a prospective United States cohort, of whom 552 (81 per cent) reached remission. 112 of those 552 (20 per cent) relapsed. Sixty-four per cent of the relapses were identified before a scheduled follow-up visit, which is to say the person noticed something and came in. Surveillance imaging found a relapse before there were any symptoms in 9 of the 552 people followed after therapy, which is 1.6 per cent; in an independent French cohort it was 4 of 222, or 1.8 per cent. Survival after relapse did not differ according to whether the relapse was found at a scheduled visit or outside one, in either cohort. The authors' conclusion was that the data do not support routine surveillance imaging in follow-up of this lymphoma.\n\n**What follow-up is instead.** Lymphoma Action describes an end-of-treatment appointment with a holistic needs assessment, a written treatment summary for you and your general practitioner, then appointments every few months at first and less often afterwards, with a conversation, an examination of the abdomen, armpits, groin and neck, and blood tests where they are needed. A yearly thyroid blood test follows radiotherapy to the neck. Many hospitals now offer patient-triggered follow-up, where instead of pre-booked appointments you arrange one when you have a concern; the charity is careful to say that you can contact the team at any time either way.\n\n**The anxiety is the real symptom here.** Lymphoma Action says some people feel anxious in the lead-up to an appointment and suggests deciding beforehand what you want from it, taking someone with you, keeping a symptom diary, and talking it through with someone, and offers the thought that if you have no new or returning symptoms it is unlikely the lymphoma has returned. Its page on waiting for results is written for the same feeling. Knowing that the absence of a scan is a considered decision backed by data, rather than a service being withheld, is itself part of the answer.\n\n**Where this does not apply.** Follow-up is planned per disease and per person. A person on active monitoring has a different schedule, and Lymphoma Action says a scan there is done when the team suspects growth rather than on a timetable. Anyone whose own team has set a scanning schedule should follow it: the point of this record is that the absence of one is not neglect.","asOf":"2026-10-01","links":[{"label":"Thompson et al., utility of routine post-therapy surveillance imaging in diffuse large B-cell lymphoma, Journal of Clinical Oncology 2014","url":"https://doi.org/10.1200/JCO.2014.55.7561"},{"label":"Lymphoma Action: follow-up after lymphoma treatment","url":"https://lymphoma-action.org.uk/information-and-support/living-and-beyond-lymphoma/follow-after-lymphoma-treatment"},{"label":"Lymphoma Action: waiting for test and scan results","url":"https://lymphoma-action.org.uk/information-and-support/tests-scans-and-lymphoma-staging/waiting-test-and-scan-results"},{"label":"Lymphoma Action: CT and PET/CT scans","url":"https://lymphoma-action.org.uk/information-and-support/tests-scans-and-lymphoma-staging/ct-and-petct-scan"},{"label":"Cancer Research UK: follow-up for non-Hodgkin lymphoma","url":"https://www.cancerresearchuk.org/about-cancer/non-hodgkin-lymphoma/treatment/follow-up"}],"tags":[],"related":[],"cancers":["non-hodgkin-lymphoma","dlbcl","hodgkin-lymphoma","follicular-lymphoma","mantle-cell-lymphoma","marginal-zone-lymphoma","peripheral-t-cell-lymphoma","waldenstrom","primary-mediastinal-b-cell-lymphoma"],"sections":[],"technologies":["survivorship-care-plan","pet-ct","psycho-oncology"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["lymphoma-living-indolent-lymphoma","pet-ct","deauville","watchful-waiting"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Clinic basics"},"route":"/terms/lymphoma-living-scanxiety-and-surveillance/","neighbours":{"cancer":[{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"follicular-lymphoma","kind":"cancer","name":"Follicular lymphoma","route":"/cancers/follicular-lymphoma/"},{"id":"hodgkin-lymphoma","kind":"cancer","name":"Hodgkin lymphoma","route":"/cancers/hodgkin-lymphoma/"},{"id":"mantle-cell-lymphoma","kind":"cancer","name":"Mantle cell lymphoma","route":"/cancers/mantle-cell-lymphoma/"},{"id":"marginal-zone-lymphoma","kind":"cancer","name":"Marginal zone lymphoma","route":"/cancers/marginal-zone-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"peripheral-t-cell-lymphoma","kind":"cancer","name":"Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)","route":"/cancers/peripheral-t-cell-lymphoma/"},{"id":"primary-mediastinal-b-cell-lymphoma","kind":"cancer","name":"Primary mediastinal (thymic) large B-cell lymphoma","route":"/cancers/primary-mediastinal-b-cell-lymphoma/"},{"id":"waldenstrom","kind":"cancer","name":"Waldenström macroglobulinaemia","route":"/cancers/waldenstrom/"}],"technology":[{"id":"pet-ct","kind":"technology","name":"PET/CT","route":"/technologies/pet-ct/"},{"id":"psycho-oncology","kind":"technology","name":"Psycho-oncology and distress screening","route":"/technologies/psycho-oncology/"},{"id":"survivorship-care-plan","kind":"technology","name":"Survivorship care and late-effects surveillance","route":"/technologies/survivorship-care-plan/"}],"term":[{"id":"lymphoma-living-hodgkin-survivorship-screening","kind":"term","name":"After Hodgkin lymphoma: the late effects, and the screening that follows them","route":"/terms/lymphoma-living-hodgkin-survivorship-screening/"},{"id":"deauville","kind":"term","name":"Deauville score and PET-adapted therapy","route":"/terms/deauville/"},{"id":"lymphoma-living-indolent-lymphoma","kind":"term","name":"Living with an indolent lymphoma rather than being cured of one","route":"/terms/lymphoma-living-indolent-lymphoma/"},{"id":"lymphoma-decision-watch-and-wait","kind":"term","name":"Watch and wait in follicular lymphoma: being told you have cancer and that nobody will treat it","route":"/terms/lymphoma-decision-watch-and-wait/"},{"id":"watchful-waiting","kind":"term","name":"Watchful waiting, and how it differs from active surveillance","route":"/terms/watchful-waiting/"}]}}