The rationale for active surveillance and determining when radiation is appropriate

The rationale for active surveillance is that follicular lymphoma is an indolent disease, Poh explains, and in asymptomatic patients with a low tumor burden, there may not be an immediate benefit to exposing patients to the potential toxicities of systemic therapy. The decision between treatment and observation hinges on several factors, Poh says, including the extent and location of disease, the size of the lymph nodes, symptoms, the risk of involvement of organs, age and overall health preferences. The potential long-term effects of radiation, especially if a patient is young or if the disease is located near a critical organ, must also be considered, she says.