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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Monitoring the Hodgkin lymphoma (HL) survivor for long-term complications

Monitoring the Hodgkin lymphoma (HL) survivor for long-term complications
Cancer screening
HL survivors should be advised of their increased risk of developing a malignancy following treatment, encouraged to participate in routine age-appropriate cancer surveillance, and encouraged to report any concerning symptoms to their physician.
Breast cancer
  • Starting at age 40 years (or if chest irradiated, eight years after radiation or age 25, whichever is later):
    • Annual screening mammogram
    • Consider annual breast magnetic resonance imaging (MRI) in addition to mammogram for women who received radiation to the chest between the age of 10 and 30 years
    • Consider referral to high-risk breast clinic for discussion of chemoprevention
Lung cancer
  • Consider annual low-dose chest computed tomography (CT) scan starting five years after diagnosis for those with a significant smoking history
  • Smoking cessation
Skin cancer
  • Annual complete skin examination
  • Sun safety practice
Colon cancer
  • Begin colorectal cancer screening 10 years earlier than for the general population
Cardiovascular health
Screening and counseling techniques are similar to those used for other high-risk populations. At a minimum, patients should be instructed not to ignore persistent troubling symptoms and to bring such symptoms to the attention of their physician without delay.
Cardiac disease
  • Referral to cardiologist for baseline evaluation after treatment for patients who received an anthracycline or radiation therapy
  • Resting and stress echocardiogram (frequency depending on baseline findings and existence of other cardiac risk factors)
  • Traditional risk factors should be minimized (eg, smoking, obesity, hyperlipidemia, hypertension)
Non-coronary vascular disease
  • Annual examination for carotid bruits; obtain carotid ultrasound if suspicious clinical findings
  • Traditional risk factors should be minimized (eg, smoking, obesity, hyperlipidemia, hypertension)
Pulmonary assessment
HL survivors should be advised to report respiratory symptoms, assessed for pulmonary findings, and counseled to avoid smoking.
Respiratory function
  • Baseline pulmonary function tests (PFT) with diffusing capacity for patients who underwent radiation to the chest wall, with or without bleomycin therapy
  • Referral to a pulmonologist with imaging and/or PFTs for patients with chronic and/or progressive respiratory symptoms
Endocrine assessment
HL survivors, especially those who received radiation therapy, should be advised to report symptoms that might suggest thyroid dysfunction, diabetes mellitus, and infertility.
Infertility
  • Referral to reproductive endocrinologist as needed
Hypothyroidism
  • Annual thyroid examination and thyroid function tests (ie, thyroid-stimulating hormone [TSH]) for HL survivors whose treatment included radiation to the neck or mediastinum
Diabetes mellitus
  • Fasting glucose or hemoglobin A1c every two years in HL survivors whose treatment included radiation to the chest or abdomen
Neurologic and psychiatric evaluation
Annual evaluation should include a discussion of psychiatric health including an assessment of symptoms of depression.
Graphic 85763 Version 4.0

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