Treatment for Hodgkin lymphoma
With current treatments the majority of people with Hodgkin lymphoma can be cured, even when the lymphoma is in several different areas of the body.
The main types of treatment for Hodgkin lymphoma are chemotherapy and radiotherapy.
Your doctor will plan your treatment based on the results of the staging tests. They will also take other factors into account when planning your treatment, including:
your general health (including any other medical conditions you have)
your specific type of Hodgkin lymphoma
which parts of your body are affected
the size of the affected lymph nodes and whether or not the lymphoma involves other organs
whether or not you have symptoms such as high temperatures, night sweats or weight loss
the results of the blood tests you’ve had.
Your doctor will explain your treatment to you and the reasons why they’ve chosen it.
People with early-stage Hodgkin lymphoma will usually be given a course of chemotherapy before radiotherapy. When the disease is more widespread, chemotherapy is nearly always the main treatment but you may also be given radiotherapy.
If Hodgkin lymphoma doesn’t respond well to standard chemotherapy, or comes back, high-dose chemotherapy with stem cell support may be used.
Possible long-term effects
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Treatments for Hodgkin lymphoma may occasionally cause serious long-term side effects. Some chemotherapy drugs can cause permanent infertility. This can be distressing to cope with when you are already dealing with the illness and its treatment.
Chemotherapy and radiotherapy can also lead to a slightly increased risk of developing another cancer later in life. However, current treatments are designed to limit these risks as much as possible. It’s important to discuss any concerns you have with your doctors.
How treatment is planned
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In most hospitals a team of specialists will talk to you about the treatment they feel is best for your situation. This multidisciplinary team (MDT) will include:
a haematologist (a doctor who specialises in treating blood disorders)
medical and clinical oncologists (chemotherapy and radiotherapy specialists)
a radiologist (a doctor who helps to analyse scans and x-rays).
It may also include other healthcare professionals, such as a:
pathologist (a doctor who specialises in diagnosing disease by looking at cells under a microscope)
psychologist or counsellor.
Together, they can advise you on the best course of action and plan your treatment.
If two treatments are equally effective for your type and stage of lymphoma, your doctors may offer you a choice of treatments. Sometimes people find it hard to make a decision. If you’re asked to make a choice, make sure that you have enough information about the different options, what is involved and the possible side effects, so you can choose the right treatment for you.
Remember to ask questions about anything you feel worried about or don’t understand. You may find it helpful to discuss the benefits and disadvantages of each option with your doctor or specialist nurse. Or you can talk to our cancer support specialists.
Before you have any treatment, your doctor will explain its aims. They will ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need repeated explanations.
It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions. You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor, or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.
The benefits and disadvantages of treatment
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Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. However, these can usually be controlled with medicines.
Treatment can be given for different reasons and the potential benefits will vary depending on the individual situation. Many people with Hodgkin lymphoma will be cured with treatment. For a small number of people, the lymphoma has come back after initial treatment - but it’s still sometimes possible to be cured with further treatment.
For others, if the lymphoma has come back after initial treatment, any further treatment may only control it, leading to an improvement in symptoms and a better quality of life. For some people in this situation the treatment will have no effect on the cancer and they may get the side effects without any of the benefits.
If you have been offered treatment that aims to cure your lymphoma, deciding whether or not to accept it may not be difficult. However, if a cure isn’t possible and the purpose of treatment is to control the lymphoma for a period of time, it may be more difficult to decide whether or not to go ahead.
Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment or not. If you choose not to, you can still be given supportive (palliative) care with medicines to control any symptoms.
Your multidisciplinary team (MDT) uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready, so you can make sure your concerns are covered.