We have been having issues with delays in our biopsy reports from Mayo due to staffing issues there (close to 3 weeks recently). While waiting for lymphoma confirmation, is it ok to start steroids for symptomatic support? Has that thinking changed or do we still need to wait until the path is reported to start steroids in case the biopsy needs repeated?
It depends on how significant the symptoms are and the urgency of diagnosis. In patients who are very symptomatic I and many others do start steroids after the biopsy to control the lymphoma, particularly if I am confident that it was a good quality biopsy (excisional or at least multiple cores). If you do happen to need a repeat biopsy, the steroids can be held prior to the biopsy. While not always ideal, this is preferable to having the patient clinically decline prior to treatment.