Keypoints

Introduction

People with non-Hodgkin's lymphoma are very likely to see a number of different health professionals who specialise in different aspects of treatment and management.

The way that each lymphoma team is set up varies. The exact titles and roles of the individual health professionals may vary too, but essentially they are likely to include:

• Doctors specialising in lymphoma and perhaps in other similar diseases; there is likely to be a haematologist, and there may be an oncologist as well
• A radiotherapist, a doctor specialising in radiotherapy
• In some countries, a clinical nurse specialist, who coordinates the care of the patient and who may be the patient's main point of contact
• Nurses specialising in various aspects of lymphoma management, such as a treatment nurse
• Radiographers, who specialise in imaging studies, such as X-rays, CT scans, MRI scans and PET scans
• Surgeons, who perform operations such as a splenectomy
• A counsellor
• Other doctors, whom most patients probably won't see, such as a pathologist or an immunopathologist. These doctors specialise in reporting the results of tests on tissue samples taken during a biopsy or other surgery. Their reports help the clinical doctors with the exact diagnosis and to decide on the best treatment for each individual patient.

The lymphoma team can be large and it includes health professionals who specialise in various aspects of treatment and management of non-Hodgkin's lymphoma

As this list shows, the lymphoma team can be rather large, and it includes health professionals who specialise in various aspects of treatment and management of non-Hodgkin's lymphoma. Sometimes, this approach is referred to as a 'multidisciplinary' approach.

In most lymphoma teams, the healthcare professionals hold regular team meetings to discuss the various patients under their care. This is a very important part of the overall management of non-Hodgkin's lymphoma.

From time to time, patients with non-Hodgkin's lymphoma are likely to be seen by other health professionals outside the lymphoma team. For example, X-rays and many other imaging scans such as CT scans and MRI scans are usually done in the radiology department, and nuclear scans such as PET scans or gallium scans may be done in the nuclear medicine department. These departments are often in the same hospital as the lymphoma specialist.

Patients with non-Hodgkin's lymphoma generally continue to see their family doctor for any other health concerns that they may have. Although family doctors are not specialists in lymphoma, they will be able to help patients, and their families, by providing explanations and advice about non-Hodgkin's lymphoma and the various treatments and options. The lymphoma specialists should keep the family doctor informed about the exact diagnosis, the treatment and any other issues surrounding the management of the lymphoma.

• Haematologist and oncologist
• Radiotherapist
• Treatment nurse
• Pathologist
• Clinical nurse specialist

Haematologist and oncologist

A haematologist is a doctor who specialises in diagnosing and treating diseases of the blood. Non-Hodgkin's lymphoma is a disease of lymphocytes, which are a type of white blood cell that also circulate in the lymphatic system. Therefore, many patients with non-Hodgkin's lymphoma are cared for by a haematologist.

An oncologist is a doctor who specialises in treating cancers, especially through the use of chemotherapy or immunotherapy. Some patients with non-Hodgkin's lymphoma may find themselves under the care of an oncologist, either as well as or instead of a haematologist.

One of these specialist doctors will decide on the best course of treatment for each individual patient. He or she will be involved in the planning of any treatment, including such things as which drugs ought to be given, what the doses ought to be, how often the drugs are given, and how long the course of treatment will be.

Radiotherapist

A radiotherapist is a specialist cancer doctor with a particular interest in radiotherapy. The radiotherapist will be involved in planning radiotherapy, such as how much radiation is needed and the best way of delivering the radiation to the areas of the body that need it.

Radiotherapists are sometimes also known as radiation oncologists or clinical oncologists. They are different from radiographers, who carry out imaging tests such as X-rays, CT scans, MRI scans and PET scans to help with the diagnosis of patients with non-Hodgkin's lymphoma.

Treatment nurse

A treatment nurse is a nurse who has had special training in the use and administration of chemotherapy and monoclonal antibody therapy. Many patients having treatment in hospital or in an outpatients' clinic will have it given to them by a specialised treatment nurse.

The treatment nurse will also be able to give advice about side effects of the therapy and about what to do if anything unusual happens during a course of treatment.

Pathologist

Although pathologists will not have any contact with patients, they play an important role in the diagnosis and treatment of patients with non-Hodgkin's lymphoma, and will be mentioned by the lymphoma team.

Pathologists analyse tissue samples taken during, for example, a biopsy, so giving the final diagnosis of the disease and information on whether the non-Hodgkin's lymphoma is indolent or aggressive and the type. They also examine tissue that has been removed during surgery for the presence of disease.

Clinical nurse specialist

In some countries, a clinical nurse specialist is a nurse who has specialised in a particular area of medicine - in this case non-Hodgkin's lymphoma. Although not necessarily directly involved in any of the treatments that patients receive, the clinical nurse specialist can be the main point of contact for patients.