• Skin-directed therapy in mycosis fungoides: creams, light and small radiotherapy fields: Early mycosis fungoides is treated on the skin, not through the bloodstream.
• What it costs to aim at a lineage antigen: Almost every lymphoma drug that finds the cancer by a surface marker finds healthy cells carrying the same marker.
• Living with an indolent lymphoma rather than being cured of one: Slow-growing lymphomas are usually controlled rather than cured: treatment works, the disease goes away for a while, and at some point it comes back and is treated again.
• Going back to work after lymphoma, and the money in the meantime: Some people work through lymphoma treatment and some cannot, and the difference is mostly the job rather than the person.
• Fatigue after lymphoma treatment, and why it is a symptom to report: The tiredness that follows lymphoma treatment is not ordinary tiredness and does not reliably improve with rest.
• What the NHS in England funds for lymphoma, appraisal by appraisal: A drug licensed for lymphoma is not automatically available on the NHS: NICE appraises each use separately and can recommend it, fund it for a while through the Cancer Drugs Fund, or refuse it.
• B-cell, T-cell and NK-cell lymphoma: The first thing a lymphoma report says is which kind of lymphocyte the cancer came from.
• A clinical trial or standard treatment in lymphoma: Lymphoma has more trials open to it than almost any other cancer, and in several situations a trial is a reasonable choice beside standard treatment rather than a last resort.
• Indolent and aggressive lymphoma: Lymphomas are split by how fast they grow, and the split decides what happens next.
• Nodal and extranodal lymphoma: A lymphoma that starts in a lymph node is called nodal; one that starts in an organ is called extranodal.

Biomarker results to ask for: Stage (skin, node, blood, viscera), CD30 expression (brentuximab vedotin), CCR4 expression and blood involvement (mogamulizumab), Large-cell transformation on biopsy, T-cell receptor clonality in skin and blood, Staging that shows no lymphoma outside the skin, which is what makes a cutaneous lymphoma primary, The clinical history and dated photographs, which WHO-HAEM5 calls indispensable because the appearances overlap, CD30, which separates the two CD30-positive lymphoproliferative disorders and decides whether brentuximab vedotin is an option, CD4 against CD8, and alpha-beta against gamma-delta T-cell receptor, which separate the indolent entities from the aggressive ones, A clonal T-cell receptor rearrangement in the skin and, where relevant, in the blood, Blood involvement, which moves the disease from a skin problem to a systemic one.

Scans and tests linked to this cancer: Histopathology & immunohistochemistry, Multidisciplinary tumour boards, Multiparameter flow cytometry MRD, Confocal microscopy and optical coherence tomography for skin (VivaScope, VivoSight, deepLive).

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

• Early stage (patches and plaques): Topical steroids, nitrogen mustard or bexarotene gel; narrowband UVB or PUVA phototherapy; local radiotherapy; total skin electron beam therapy for widespread disease. (Total skin electron beam therapy, Superficial and orthovoltage radiotherapy for skin cancer, Bexarotene)
• Advanced skin or blood disease: Extracorporeal photopheresis, interferon, oral bexarotene, low-dose methotrexate; mogamulizumab for blood involvement (MAVORIC); brentuximab vedotin for CD30-positive disease (ALCANZA); vorinostat or romidepsin. (Methoxsalen (extracorporeal photopheresis), Bexarotene, Methotrexate, Mogamulizumab, Brentuximab vedotin, Vorinostat, Romidepsin)
• Refractory or transformed: Gemcitabine or liposomal doxorubicin chemotherapy; allogeneic stem cell transplant in fit younger patients. (Gemcitabine, Allogeneic stem cell transplantation)

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.