What Happens After Treatment for Non-Hodgkin Lymphoma in Children?

During treatment for childhood non-Hodgkin lymphoma (NHL), most families are mainly concerned with the daily aspects of getting through treatment and beating the lymphoma. After treatment, the concerns tend to shift toward the long-term effects of the lymphoma and its treatment, as well as the possibility of the lymphoma coming back (recurring).

It's certainly understandable for you to want to put lymphoma and its treatment behind you and to get back to a life that doesn’t revolve around cancer. But it’s important to realize that follow-up care is a central part of this process that offers your child the best chance for recovery and long-term survival.

Follow-up exams and tests

It's very important for your child to go to regular follow-up exams with the cancer care team for many years after treatment. The doctors will continue to watch for possible signs of lymphoma, as well as for short-term and long-term side effects of treatment. Doctor visits will be more frequent at first, but the time between visits may get longer as time goes on.

Checkups after treatment typically include physical exams, lab tests, and sometimes other tests such as CT, MRI, or PET scans. If the lymphoma does come back, it is usually while the child is still getting treatment or just after. It is unusual for childhood lymphoma to return if there are no signs of the disease within a year or so after treatment.

A benefit of follow-up care is that it gives you a chance to discuss questions and concerns that come up during and after your child’s recovery. For example, almost any cancer treatment can have side effects. Some might last for only a short time, but others can last longer or might not show up until months or even years later. It's important to report any new symptoms to the doctor right away so that the cause can be found and treated, if needed.

Ask your child’s doctor for a survivorship care plan

Talk with your child’s doctor about developing a survivorship care plan. This plan might include: 

  • A summary of the diagnosis, tests done, and treatment given
  • A suggested schedule for follow-up exams and tests
  • A schedule for other tests your child might need in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from the lymphoma or its treatment
  • A list of possible late- or long-term side effects from your child’s treatment, including what to watch for and when to contact the doctor
  • Diet and physical activity suggestions

Keeping health insurance and records of your child’s medical care

As much as you might want to put the experience behind you once treatment is done, it’s very important to keep good records of your child’s medical care during this time. Eventually, your child will grow up, be on his or her own, and have new doctors. It’s important for them to be able to give the new doctors the details of their cancer diagnosis and treatment. Gathering the details soon after treatment may be easier than trying to get them at some point in the future.

Ask your cancer care team where and how to get this information. Learn more in Keeping Copies of Important Medical Records.

It’s also important to keep health insurance coverage. Tests and doctor visits can cost a lot, and even though no one wants to think of the lymphoma coming back, this could happen.

Can we lower the risk of the lymphoma progressing or coming back?

If your child has (or has had) lymphoma, you probably want to know if there are things you can do that might lower the risk of the lymphoma growing or coming back, such as having them eat a certain type of diet or take nutritional supplements. Unfortunately, it’s not yet clear if there are things you can do that will help.

As your child gets older, adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight might help, but no one knows for sure. However, we do know that these types of behaviors can have positive effects on your child’s health that can extend beyond their risk of lymphoma or other cancers.

About dietary supplements

So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of lymphoma progressing or coming back. This doesn’t mean that no supplements can help, but it’s important to know that none have been proven to do so.

Dietary supplements are not regulated like medicines in the United States – they do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you’re thinking about having your child take any type of nutritional supplement, talk to your child’s health care team. They can help you decide which ones can be used safely while avoiding those that might be harmful.

To learn more, see Dietary Supplements: What Is Safe?

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Gross TG, Kamdar KY, Bollard CM. Chapter 19: Malignant Non-Hodgkin Lymphomas in Children. In: Blaney SM, Adamson PC, Helman LJ, eds. Pizzo and Poplack’s Principles and Practice of Pediatric Oncology. 8th ed. Philadelphia Pa: Lippincott Williams & Wilkins; 2021.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Pediatric Aggressive Mature B-Cell Lymphomas. Version 2.2021. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/ped_b-cell.pdf on July 1, 2021.

Sandlund JT, Onciu M. Chapter 94: Childhood Lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

Termuhlen AM, Gross TG. Overview of non-Hodgkin lymphoma in children and adolescents. UpToDate. 2021. Accessed at https://www.uptodate.com/contents/overview-of-non-hodgkin-lymphoma-in-children-and-adolescents on June 14, 2021.

References

Gross TG, Kamdar KY, Bollard CM. Chapter 19: Malignant Non-Hodgkin Lymphomas in Children. In: Blaney SM, Adamson PC, Helman LJ, eds. Pizzo and Poplack’s Principles and Practice of Pediatric Oncology. 8th ed. Philadelphia Pa: Lippincott Williams & Wilkins; 2021.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Pediatric Aggressive Mature B-Cell Lymphomas. Version 2.2021. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/ped_b-cell.pdf on July 1, 2021.

Sandlund JT, Onciu M. Chapter 94: Childhood Lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

Termuhlen AM, Gross TG. Overview of non-Hodgkin lymphoma in children and adolescents. UpToDate. 2021. Accessed at https://www.uptodate.com/contents/overview-of-non-hodgkin-lymphoma-in-children-and-adolescents on June 14, 2021.

Last Revised: August 10, 2021

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