Defining Survivorship for Relapsed/Refractory Follicular Lymphoma
How can relapsed/refractory follicular lymphoma survival and quality of life be addressed? Expert Dr. Brad Kahl from Washington University School of Medicine discusses follicular lymphoma monitoring, treatment strategy, coping methods, and patient advice.
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Transcript:
Lisa Hatfield:
How can survivorship be defined for those of us living with relapsed/refractory disease? And I’m wondering if this person is asking what it looks like as far as monitoring or what their life might be like or quality of life. Can you speak to that a little bit please, Dr. Kahl?
Dr. Brad Kahl:
Sure. Yeah. Yeah. So it’ll be different for everybody because some patients with follicular lymphoma will be in remission, and they’re just coming in for checkups where we make sure they’re still in remission. And those visits can be stressful for patients, because literally the doctor is looking for something that nobody wants to find. But we have to look from time to time to make sure things are still good. Other patients are not in remission, but maybe they don’t need treatment right now.
You might recall when I talked about the watch-and-wait strategy for newly diagnosed patients. We have a lot of patients with relapsed follicular lymphoma who don’t need treatment immediately. And I think to stretch out patients’ intervals in between treatments for as long as you can is often in the patient’s best interest. So a lot of times if a patient has no symptoms and their disease burden is really low, we will just tell them, let’s just watch.
We have all these treatments, but we don’t want to burn through our ammunition too quickly here. So let’s just watch your disease. You might be able to go two years, three years, four years, not needing anything. And so again, you have to get patients psychologically comfortable with the idea that we’re just monitoring, we see the disease, but it’s not hurting you right now. Let’s save our ammunition for when we really need it. So that’s another strategy that patients need to get used to.
So there’s a lot of psychological coping that patients need to do and there definitely is not a one-size-fits-all approach there. That’s one thing I’ve learned over the years, and I’ve been doing this for a long time. Every patient is different in how they react to news, how they cope. Some people are best if they’re active corpus they need more information, they need more monitoring. Some patients are actually avoidant corpus, and that’s okay. They want less, less visits, less scans, less news. [laughter] And I will adapt as long as we’re within the realm of what’s medically appropriate. Do a lot of individualization as we’re taking a follicular lymphoma patient through their treatment. So we come up with a plan that works best for them and their coping strategy.
Lisa Hatfield:
Okay. Thank you. And just listening to you and hearing about all these nuances with follicular lymphoma, I would probably recommend as a patient myself with a different kind of cancer, seeking out at least a consult from somebody who specializes mostly in follicular lymphoma, at least a hematologist who can tease through some of these nuances to help you as a patient find the best treatments and therapies and quality of life.
