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Hodgkin lymphoma 

Hodgkin lymphoma treatment options

We treat Hodgkin lymphoma with radiation, surgery, chemotherapy and immunotherapy. Which treatment may be appropriate for you depends on the stage and extent of your disease and other factors. Your multidisciplinary team of cancer experts will answer your questions and recommend treatment options based on your unique diagnosis and needs. Treatment options for Hodgkin lymphoma include those listed below.

Chemotherapy

Chemotherapy for Hodgkin lymphoma often consists of taking several drugs together in a set regimen. Depending on the regimen, Hodgkin lymphoma chemotherapy treatments may be administered in pill form, as an injection or intravenously. You may receive chemotherapy alone, or in combination with radiation therapy and/or stem cell transplantation.

Because each medication destroys tumor cells in a different way, a combination of drugs may make the cells more vulnerable to treatment. While chemotherapy destroys rapidly-dividing cancer cells, it may also affect normal cells, such as those in the hair, mouth, GI tract and bone marrow.

Sometimes, chemotherapy temporarily lowers your blood counts, causing:

  • Increased risk of infection (from neutropenia, or low white blood cell count)
  • Fatigue (from anemia, or low red blood cell count)
  • Easy bruising and bleeding (from thrombocytopenia, or low platelet count)

Other side effects of chemotherapy for Hodgkin lymphoma may include nausea and vomiting, diarrhea, hair loss, mouth sores, fertility problems, shortness of breath and heart damage. Throughout your Hodgkin lymphoma treatment, your care team may recommend a combination of supportive care services to prevent or manage chemotherapy-related side effects. Your doctor may prescribe certain drugs before you begin treatment to combat nausea or prevent infection.

Stem cell transplantation

This procedure may be an option for patients with Hodgkin lymphoma that relapsed or is refractory (unresponsive to primary treatment).

Before a stem cell transplant for Hodgkin lymphoma, you will undergo a conditioning regimen, which involves intensive treatment, such as high-dose chemotherapy, to destroy as many cancer cells as possible. Then, you will receive the stem cells intravenously (similar to a blood transfusion). The procedure takes about an hour. After entering the bloodstream, the stem cells travel to the bone marrow and begin to produce healthy new blood cells in a process known as engraftment.

Sometimes, the high doses of chemotherapy or radiation you receive before the stem cell transplant causes side effects, such as infection. An allogeneic stem cell transplant poses the risk of graft-versus-host-disease (GVHD), a condition where the donated cells attack the patient’s tissues. Your doctor may prescribe certain drugs to reduce the risk of infection or GVHD.

Recovery from stem cell transplantation can take several months. You may need supportive care, such as pain management, nutritional counseling or naturopathic support to help you manage side effects and maintain your quality of life.

Radiation therapy

Radiation therapy may be used to destroy lymphoma cells, to prevent the cells from spreading, and/or to relieve pain or discomfort caused by an enlarged spleen or swollen lymph nodes. For Hodgkin lymphoma patients, radiation treatments are commonly directed at lymph nodes in the neck, chest, underarms, abdomen, spleen, pelvis and/or groin.

Your care team may combine radiation with other Hodgkin lymphoma treatments, like chemotherapy, to prevent the growth of new cancer cells.

Depending on where in the body your radiation dose is directed, along with other factors, radiation therapy for Hodgkin lymphoma may cause certain side effects. It may lower white blood cell count, which increases the risk of infection. Other potential side effects include fatigue, nausea, dry mouth, skin reactions and fertility problems (from radiation to the pelvic area).

As you receive treatment for Hodgkin lymphoma, your care team will work with you to manage these radiation-induced side effects. We’ll monitor your blood counts regularly. If needed, you’ll receive therapies to stimulate your blood cell production and prevent or treat infection.

You’ll also have access to supportive care services like nutrition therapy, naturopathic support, pain management, oncology rehabilitation and mind-body medicine. These therapies are designed to help keep you strong so you are better able to continue treatment while participating in your everyday activities.

Immunotherapy

Immunotherapy drugs and treatments are designed to help stimulate the immune system or to help immune cells better identify and attack cancer cells. Checkpoint inhibitor drugs work by blocking signals cancer cells use to hide from the immune system. A checkpoint inhibitor may be used to treat some patients with classical Hodgkin lymphoma (cHl) whose previous treatment did not work or who have relapsed after receiving three or more types of treatment.

Because immunotherapy treatments may also cause the immune system to attack healthy cells in addition to cancer cells, they may cause side effects, such as flu-like symptoms, fatigue, skin rashes and gastrointestinal problems.