Prognostic discussions are critical in the care of patients with advanced lymphoma, given the disease’s complexity, rapidly evolving treatments, and shifting potential for cure. However, previous research has paid limited attention to how these discussions unfold from both patient and clinician perspectives, particularly in the context of early conversations. The current study sought to identify key experiences that inform improvements in clinician communication and patient understanding of prognosis for patients with advanced lymphoma.

We conducted a qualitative study from July 2023 to June 2024 with 19 patients diagnosed with advanced lymphoma and 3 oncologists. Semi-structured interview transcripts were analyzed using thematic content analysis, and emergent themes were identified through consensus among a trained coding team.

Two primary themes emerged. First, patients recalled early prognostic conversations as highly focused on curative intent. Second, oncologists cited incomplete diagnostic data and concerns about overwhelming patients as reasons for limiting early discussions, often delaying deeper prognostic conversations. Clinicians reported tension between maintaining patient hope and providing comprehensive information about disease trajectory and treatment uncertainty.

Findings highlight a need for communication strategies that balance hope with realism in early prognostic discussions for patients with advanced lymphoma. Oncologists may benefit from structured, evidence-based guidance to manage information delivery over time, particularly in the face of diagnostic ambiguity. Future research should prioritize inclusive sampling and explore timing and content of ongoing prognostic discussions to better support informed decision-making and goal-concordant care.

The rising cost of oncology care has motivated efforts to quantify the overall value of cancer innovation. This study aimed to apply the MACBETH approach to the development of a value assessment framework (VAF) for lymphoma therapies.

A multi-attribute value theory methodological process was adopted. Analogous MCDA steps developed by the International Society for Health Economics and Outcomes Research (ISPOR) were carried out and a diverse multi-stakeholder group was recruited to construct the framework. The criteria were identified through a systematic literature review and selected according to the importance score of each criterion given by stakeholders, related research and expert opinions. The MACBETH method was used to score the performance of alternatives by establishing value functions for each criterion and to assign weight to criteria.

Nine criteria were included in the final framework and a reusable model was built: quality adjusted life years (QALYs), median progression-free survival, objective response rate, the incidence of serious adverse events (grade 3–4), rates of treatment discontinuation due to adverse events, annual direct medical costs, dosage and administration, the number of alternative medicines with the same indication and mechanism, mortality of the disease. The weights of each criterion in the order presented above are 17.43 percent, 16.11 percent, 14.39 percent,13.54 percent,11.83 percent,11.30 percent,7.08 percent,4.59 percent, and 3.73 percent.

A criterion-based valuation framework was constructed using multiple perspectives to provide a quantitative assessment tool in facilitating the delivery of affordable and valuable lymphoma treatment. Further research is needed to optimize its use as part of policy-making.

Second primary breast cancers are among the most common risks to female patients who have received radiotherapy for mediastinal lymphoma.

This study aims to audit breast dose in women who received mediastinal radiotherapy for lymphoma and compare the combined dose parameter values measured to those in the literature.

Twenty-three patient datasets from 2017 to 2021 were obtained. Inclusion criteria, such as female gender and 30Gy prescription dose, were applied. Target volumes were delineated using involved site radiotherapy and planned on Eclipse (Varian, Palo Alto, CA) using either fixed field or VMAT. Breast contours were retrospectively outlined according to RTOG/EORTC guidance and descriptive statistics were used to compare findings to those from the literature.

Differences were found in V4gy, V5Gy and mean dose compared to the literature with mean dose being 2Gy in the literature and 4Gy in this audit.

Breast dose parameter values between patients in this study vary due to multiple factors. These include the treatment delivery method used and the position of the treatment field in relation to the location of breast tissue. Mean dose and V4% and V5% to breast tissue found in this study differ from that found in the literature. This study highlights the importance of accurate contouring and optimising breast tissue when possible.

We undertook a rapid review of literature relating to the diagnosis of blood cancers, to find out what factors contribute to delays in diagnosis, including symptom recognition, appraisal and help-seeking behaviours.

We used rapid review methodology following Tricco et al. to synthesise current literature from two electronic databases. We searched for studies about symptom appraisal help-seeking for all blood cancers published between 2001 and 2021, written in English.

Fifteen studies were included in the review, of which 10 were published in the United Kingdom. We found a number of factors associated with delays in blood cancer diagnosis. These included patient factors such as gender, age and ethnicity, as well as health system factors such as poor communication and seeing a locum clinician in primary care. A narrative synthesis of the evidence produced four types of symptom interpretation by patients: (1) symptoms compatible with normal state of health, (2) event-linked problems, (3) mild or chronic illness and (4) non-specific unwell state. These four interpretations were linked to different help-seeking behaviours. After seeking help, patients often experienced delays due to healthcare professionals’ (HCPs’) non-serious interpretation of symptoms, misleading blood tests, discontinuity of care and other barriers in the diagnostic pathway.

Blood cancers are difficult to diagnose due to non-specific heterogeneous symptoms, and this is reflected in how those symptoms are interpreted by patients and managed by HCPs. It is important to understand how different interpretations affect delays in help-seeking, and what HCPs can do to support timely follow-up for patients.

Traditionally, fine needle aspiration cytology was the primary diagnostic investigation for head and neck lumps; however, ultrasound-guided core biopsy offers the advantage of preserving tissue architecture with increased tissue yield. This study reviews the diagnostic utility of ultrasound-guided core biopsy for investigating head and neck lumps.

Overall, 287 ultrasound-guided core biopsies were reviewed between May 2017 and April 2019 at a single tertiary site for head and neck cancer.

On initial ultrasound-guided core biopsy, a diagnostic sample was obtained in 94.4 per cent of patients and in 83.7 per cent of patients with lymphoma. Where the initial ultrasound-guided core biopsy was non-diagnostic, 50 per cent of samples were diagnostic on repeat ultrasound-guided core biopsy. Overall, five complications were seen related to ultrasound-guided core biopsy, and all were managed conservatively. No cases of disease recurrence were identified at the biopsy site.

Ultrasound-guided core biopsy is a safe procedure with a high diagnostic yield when investigating head and neck lumps. Patients whose ultrasound-guided core biopsies were non-diagnostic should be considered for excisional biopsy over repeat ultrasound-guided core biopsy.