Friday 7th September 2012
Trish Hughes, Macmillan Haematology CNS, on treating young people with Hodgkin lymphoma.
Lucy (name has been changed) was 19 when she was diagnosed with Hodgkin lymphoma. It was August and she was due to go to university the following month to study biomedical science. Lucy and her parents were naturally very distressed. A diagnosis of cancer in this age group is the last thing people expect.
Young people are often at university or college or may even have young families, so this has a huge impact on their lives. They are often very frightened and it is my role to support them through this experience. As a key worker for young people like Lucy, I provide psychological support and information for the young person and their parents. This includes spending time explaining the diagnosis and treatment options.
I kept in regular telephone contact with Lucy while she was undergoing tests before commencing treatment. I also contacted her tutor to organise for her place at university to be deferred. Lucy was given chemotherapy by haematology clinic staff, who also played a part in providing holistic care for Lucy.
At the end of treatment I supported Lucy with her transition back to university by organising some work experience for her with our laboratory staff. Lucy did this for a few months after completing treatment and thoroughly enjoyed the experience.
I saw Lucy in clinic recently and she has just completed her first year of university and remains very well.
When a young person has finished treatment for Hodgkin lymphoma there is regular follow-up through the haematology department. In the past I have had an informal chat with patients, however I am about to commence a holistic needs assessment clinic for people at the end of treatment, where we will discuss concerns and make a care plan.
Hodgkin lymphoma is a cancer of the lymphatic system. Around 1,870 people are diagnosed with it in the UK each year.
These can include a painless swelling of a lymph node (lymphadenopathy) night sweats, fevers, fatigue and weight loss and itching. In some cases there is no visible swelling and a young person may present at the GP with vague symptoms such as itching.
A lymph node biopsy is needed to confirm the diagnosis. Other staging tests include a CT scan or a PET scan, a bone marrow test and blood tests.
Depending on the stage of the lymphoma, treatment is usually chemotherapy. If the lymphoma is localised to one group of lymph nodes radiotherapy can be given.
A case study - Charlie's story
Macmillan has information about Hodgkin lymphoma. It also has a booklet written especially for young people with cancer called I'm still me. You can order it for free from be.Macmillan.
Lymphoma Association. Frequently asked questions.
Improving supportive and palliative care for adults with cancer. 2004 London, NICE.
Improving outcomes in children and young people with cancer. 2005. London, NICE.