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How Is Lymphoma Staging Determined?
Staging is the classification of a cancer type by its size and whether and how much it has spread around the body. Determining a cancer's stage is very important because it tells the oncologist which treatment is most likely to work and what are the chances of remission or a cure (prognosis).
Staging of lymphomas is based on the results of imaging studies and related tests that reveal the extent of the cancer involvement.
HL is often described as being "bulky" or "nonbulky." Nonbulky means the tumor is small; bulky means the tumor is large. Nonbulky disease has a better prognosis than bulky disease.
NHL is a complicated set of diseases with a complex classification system. In fact, the classification system is continuously evolving as we learn more about these cancers. The newest classification system takes into account not only the microscopic appearance of the lymphoma but also its location in the body and genetic and molecular features.
Grade is also an important component of the NHL classification.
The "staging," or evaluation of extent of disease, for both HL and NHL, are similar.
If the cancer is also found in the spleen, an "S" is added to the classification.
Several risk factors have been extensively evaluated and shown to play a role in treatment outcome. For HL, the International Prognostic Index includes the following seven risk factors:
The absence of any of the above risk factors is associated with an 84% rate of control of Hodgkin's disease, whereas the presence of a risk factor is associated with a 77% rate of disease control. The presence of five or more risk factors was associated with a disease control rate of only 42%.
The outcomes for these patients were also determined by the treatment they received, which occurred primarily in the 1980s. Newer treatments for Hodgkin's lymphoma may improve these predicted outcomes. Furthermore, new treatments are being developed for patients with greater risk factors.
The International Prognostic Index for NHL includes five risk factors:
The prognostic models were developed to evaluate groups of patients and are useful in developing therapeutic strategies. It is important to remember that any individual patient might have significantly different results than the above data, which represent statistical results for a patient group. There are specific IPIs for certain types of lymphoma, such as follicular or diffuse large B-cell.
What Types of Doctors Treat Lymphoma?
Although the patient's primary-care doctor or pediatrician can help manage the patient's care, other specialists are usually involved as consultants. Oncologists, hematologists, pathologists, and radiation oncologists are usually involved in making treatment plans and caring for the patient. Occasionally, other specialists may need to be involved depending upon what organs may be at risk in the individual's disease process.
Medically Reviewed by a Doctor on 5/25/2016
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