The Power of Right Decisions
- Early precision matters: Diffuse large B-cell lymphoma (DLBCL) is aggressive but often curable when diagnosed and treated correctly. Getting the pathology right at the start can make the difference between cure and relapse. Because there are more than 70 types of lymphoma, a hematopathologist’s second opinion can re-classify as many as 15–20 percent of cases.
- “Time is of the essence, but that’s where your caregiver and family comes in to be your advocate and say, no, let’s pause here for a minute or two and make sure we’re on the right track before you start in. And that would be a message that I would really want people to hear,” Dr. Lauren Pinter-Brown says, when it comes to a diagnosis of relapse or recurrence of diffuse large B-cell lymphoma (DLBCL).
- Taking a few days to review the diagnosis, confirm the treatment plan, or seek another opinion almost never harms outcomes. But starting down the wrong path can.
- Remember to breathe before starting therapy. Patients often feel pressure to act immediately, but Dr. Pinter-Brown urges families to pause long enough to confirm the diagnosis and plan with a true lymphoma specialist. “Time is of the essence,” she says, “but make sure you’re on the right track before you start.”
- The message: pause, ask questions, and get it right the first time.
“I can’t emphasize enough to patients,” says Dr. Lauren Pinter-Brown, a hematologist-oncologist who specializes in the diagnosis and treatment of patients with lymphomas, at UC Irvine Comprehensive Cancer Center, in Orange County, Calif.
Read MoreWhy the Right Diagnosis Matters So Much
One of the biggest challenges in lymphoma care is diagnosis. There are more than 70 types of lymphoma, and telling them apart requires deep expertise.“We’re talking about for diffuse large B-cell lymphoma, curing patients,” Dr. Pinter-Brown says. “If the person gets the wrong diagnosis or the wrong treatment, they’re not going to be cured.”
That’s why the biopsy (the piece of tissue removed to confirm the diagnosis) should ideally be reviewed by a hematopathologist, a pathologist who specializes in diseases of the blood and lymphatic system. They can recognize subtle details that might completely change how treatment should proceed.
In fact, studies show that up to 15–20% of lymphoma cases are reclassified when an expert takes a second look at the slides. Sometimes, what was thought to be DLBCL turns out to be another form of lymphoma entirely and that changes everything.
Over the past 20 years, researchers have learned that DLBCL isn’t just one disease. By looking closely at the cells and the genetic “signals” inside the lymphoma, specialists can now sort DLBCL into several subtypes. Studies show that these subtypes can help doctors identify which patients may have a higher-risk form of the disease and may not respond as well to standard treatment.
Getting a Second Opinion Is More Than Okay — It’s Smart
If you’ve been recently diagnosed, it’s natural to want to start treatment immediately. You might feel like you can’t afford to wait even a day. But a brief pause, just long enough to confirm the diagnosis or get a second opinion, can make a life-changing difference. As shown in a Mayo Clinic and University of Iowa study of aggressive B-cell lymphomas, starting therapy within one week versus three to four weeks did not affect survival, as long as the diagnosis and staging were correct.
“Time and time again in the medical literature, and again, I don’t think that this is meant to be self-serving,” Dr. Pinter-Brown says. “When people are seen at an academic center that has a focus in lymphoma, they do better. So I don’t mean that people have to be treated at my institution, but it would be prudent for people with lymphoma to at least get a second opinion from somebody that is truly a lymphoma specialist.”
She continues, “Not somebody that says they are, but they do a whole bunch of other things. There are many people in the world that only do lymphoma. I’m not unique at all.
“And so it would be helpful to see somebody like that and get your roadmap and then you have an established relationship with that person.”
Even if you proceed with treatment close to home, a consultation at a major cancer center can give you a “roadmap,” a clear plan that’s been vetted by someone who sees lymphoma every day.
That plan helps ensure you’re moving in the right direction from the start.
The “Deer in the Headlights” Moment
Getting any cancer diagnosis triggers fear, urgency, and an almost reflexive need to do something right now.
Describing what she often sees in her patients, Dr. Pinter-Brown says, “I know that when somebody gets a cancer diagnosis that there’s kind of a deer in the headlights phenomenon. I just want to treat it now. I want to get this over with.
“Time is of the essence, but that’s where your caregiver and family comes in to be your advocate and say, no, let’s pause here for a minute or two and make sure we’re on the right track before you start in. And that would be a message that I would really want people to hear.”
This is where loved ones can make a tremendous difference. A spouse, a child, a friend — they can help ask questions and make sure the next steps aren’t rushed.
Spending a few days to review the diagnosis, confirm the treatment plan, or get a second opinion rarely affects outcomes—but heading down the wrong path can.
More On Diffuse Large B-Cell Lymphoma (DLBCL)
- Diffuse Large B-Cell Lymphoma and CAR T-Cell Therapy: When to Seek a Second Opinion
- CAR T-Cell Therapy Explained: What Diffuse Large B-Cell Lymphoma Patients Should Know
- Evaluating Efficacy of CAR T-Cell Therapy for Diffuse Large B-Cell Lymphoma
- How Bispecific Antibodies Are Changing Diffuse Large B-Cell Lymphoma Treatment
- When Caught Early, Diffuse Large B-Cell Lymphoma Is Highly Treatable
- When Diffuse Large B-Cell Lymphoma Comes Back: The First Steps After a Relapse
- Why Clinical Trials for Diffuse Large B-Cell Lymphoma Are So Important
Questions to Ask Your Doctor
You don’t have to memorize everything. Bring these with you to appointments:
- Has a hematopathologist reviewed my biopsy?
- What exact type of lymphoma do I have?
- Should I get a second opinion from a lymphoma specialist?
- What is the goal of my treatment — cure, remission, or control?
How Bispecific Antibodies Are Changing Diffuse Large B-Cell Lymphoma Treatment
Avoid Mistakes—Get It Right Upfront
DLBCL is one of the most studied cancers in the world, and outcomes are improving year after year. Three decades ago, many patients had few options. Today, most people can be cured, and for those who aren’t, there are new and better therapies on the horizon.
“A lot of times I will see patients that are already treated and then they ask me, did I get the right treatment? Well, if they didn’t, what can I do about it? It’s done,” Dr. Pinter-Brown says.
“That’s why I want people to pause, take a moment, and make sure they’re on the right track before they start in.”
Those words carry the message every patient needs to hear: Pause, breathe, and get it right the first time.
Remember to:
- Seek the advice of someone who truly specializes in lymphoma.
- Ask questions until you understand the plan.
- Let your caregivers help you make decisions when things feel overwhelming.
And most importantly, understand that many people live full, healthy lives after a DLBCL diagnosis.
When the diagnosis is correct, the treatment is right, and the team is strong, hope is within reach.
At SurvivorNet, our goal is to stand beside you every step of the way, bringing expert-backed, clear, and compassionate information to help you or your loved one make the best possible decisions. You are not alone.
When CAR T-Cell Therapy Doesn’t Work: What Are My Options?
Learn more about SurvivorNet's rigorous medical review process.
