Your specific treatment plan will depend on your general health and your age, as many of the treatments can put a tremendous strain on the body. How far the cancer has spread is also an important factor in determining the best treatment.
Discussions about your treatment plan will usually take place with several doctors and other health professionals who specialise in different aspects of treating lymphoma. This is known as a multidisciplinary team (MDT).
Your MDT may include a:
- specialist cancer nurse or "key worker" – who is the first point of contact between you and the members of the care team
- haematologist – a specialist in blood and bone marrow disorders
- clinical oncologist – a specialist in radiotherapy
- social worker
- transplant specialist
- psychologist
- counsellor
Your MDT will recommend the best treatment options for you. However, you should not be rushed into making a decision about your treatment plan. Before deciding, you may wish to talk to friends, family and your partner.
The main treatments for Hodgkin lymphoma are chemotherapy alone, or chemotherapy followed by radiotherapy. Occasionally, chemotherapy may be combined with steroid medicine. Some people also have biological medicines.
Surgery isn't generally used to treat the condition, except for the biopsy used to diagnose it.
Overall, treatment for Hodgkin lymphoma is highly effective and most people with the condition are eventually cured.
Chemotherapy is a type of cancer treatment where medicine is used to kill cancer cells. It can be given in a number of different ways, depending on the stage of your cancer.
If doctors think your cancer is curable, you'll normally receive chemotherapy through a drip directly into a vein (intravenous chemotherapy). If a cure is unlikely, you may only need to take chemotherapy tablets to help relieve your symptoms.
Chemotherapy is usually given over a period of a few months on an outpatient basis, which means you should not have to stay in hospital overnight. However, there may be times when your symptoms or the side effects of treatment become particularly troublesome and a longer hospital stay may be needed.
Chemotherapy can have several side effects, the most significant of which is potential damage to your bone marrow. This can interfere with the production of healthy blood cells and cause the following problems:
- fatigue
- breathlessness
- increased vulnerability to infection
- bleeding and bruising more easily
If you experience these problems, treatment may need to be delayed so you can produce more healthy blood cells. Growth factor medicines can also stimulate the production of blood cells.
Other possible side effects of chemotherapy include:
- nausea and vomiting
- diarrhoea
- loss of appetite
- mouth ulcers
- tiredness
- skin rashes
- hair loss
- infertility, which may be temporary or permanent (see complications of Hodgkin lymphoma for more information)
Most side effects should pass once your treatment has finished. Tell your care team if the side effects become particularly troublesome, as there are treatments that can help.
If regular chemotherapy is unsuccessful or Hodgkin lymphoma returns after treatment, you may have a course of chemotherapy at a higher dose.
However, this intensive chemotherapy destroys your bone marrow, leading to the problems mentioned above. You'll need a stem cell or bone marrow transplant to replace the damaged bone marrow.
Radiotherapy is most often used to treat early-stage Hodgkin lymphoma, where the cancer is only in 1 part of the body.
Treatment is normally given in short daily sessions, Monday to Friday, over several weeks. You should not have to stay in hospital between appointments.
Radiotherapy itself is painless, but it can have some significant side effects. These can vary and will be directly related to the part of your body being treated. For example, treatment to your throat can lead to a sore throat, while treatment to the head can lead to hair loss.
Other common side effects include:
- tiredness
- nausea and vomiting
- dry mouth
- loss of appetite
Most side effects are temporary, but there's a risk of long-term problems, including infertility and permanently darkened skin in the treatment area.
Read more about:
Steroid medicine is sometimes used in combination with chemotherapy as a more intensive treatment for advanced Hodgkin lymphoma, or if initial treatment has not worked.
The steroid medicine is given intravenously, usually at the same time as your chemotherapy.
Common side effects of steroid medicine include:
- increased appetite, which can lead to weight gain
- indigestion
- problems sleeping
- feeling agitated
The side effects of steroid medicine usually start to improve once treatment finishes.
You might be offered a biological medicine if you're diagnosed with certain rare types of Hodgkin lymphoma, or if other treatments have not worked or are not suitable for you.
Biological medicines are also known as targeted therapies. They work by targeting cancer cells, or helping your immune system to attack cancer cells.
Biological medicines used for Hodgkin lymphoma include rituximab (used together with chemotherapy), brentuximab vedotin and pembrolizumab.
They're given through a drip into your vein (infusion).
Side effects depend on which medicine you have. Common side effects include:
- feeling or being sick
- skin rashes
- headaches
- tiredness
- muscle or joint pain
- shortness of breath
Side effects often improve as your body gets used to the medicine.
Read more about targeted therapy for Hodgkin lymphoma from Cancer Research UK
After your course of treatment ends, you'll need to have regular follow-up appointments to monitor your recovery and check for any signs of the cancer returning.
These appointments start off being every few weeks or months, but will become gradually less frequent over time.
For more information, see:
- Cancer Research UK: treating Hodgkin lymphoma
- Cancer Research UK: living with Hodgkin lymphoma
- Macmillan: Hodgkin lymphoma
- Blood Cancer UK: Hodgkin lymphoma
