Some patients may present with symptoms of recurrent or residual disease after a previous cancer diagnosis. Access to the best available therapies, including clinical trials, as well as treatment overseen by a multidisciplinary team, are crucial to achieving the best outcomes for anyone with recurrent or residual disease.

Signs and symptoms will depend on the type of cancer initially diagnosed and the location of disease. Most cases of recurrent Hodgkin or DLBCL are identified through routine follow-up or by the patient presenting with symptoms, or with abnormal ‘non-specific’ laboratory tests such as serum LDH. Symptoms can often present as described in section 2.1.

When there is clinical suspicion of recurrence:

• Comparing current PET-CT or CT scans to previous images can help to confirm recurrence. If recurrence is detected, tissue biopsy and restaging may be necessary.
• Bone marrow biopsy may be necessary if aggressive treatment is being considered.
• LDH levels and other testing may be used to determine prognostic factors.