Treatment
Hodgkin lymphoma can usually be treated successfully with chemotherapy alone, or chemotherapy followed by radiotherapy.
Your treatment plan
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 will recommend the best treatment options for you. However, you shouldn't be rushed into making a decision about your treatment plan. Before deciding, you may wish to talk to friends, family and your partner.
Treatment options
The main treatments for Hodgkin lymphoma are chemotherapy alone, or chemotherapy followed by radiotherapy. In a few cases, chemotherapy may be combined with steroid medication.
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
Chemotherapy is a type of cancer treatment where medicine is used to kill cancer cells. This medication 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 shouldn't 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.
Read more about the side effects of chemotherapy.
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
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 shouldn't 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 medication
Steroid medication is sometimes used in combination with chemotherapy as a more intensive treatment for advanced cases of Hodgkin lymphoma, or if initial treatment hasn't worked.
The steroid medication is given intravenously, usually at the same time as your chemotherapy.
Common side effects of steroid medication include:
- increased appetite, which can lead to weight gain
- indigestion
- problems sleeping
- feeling agitated
The side effects of steroid medication usually start to improve once treatment finishes.
Rituximab
If you're diagnosed with a rare type of Hodgkin lymphoma called lymphocyte-predominant Hodgkin lymphoma, you may have chemotherapy in combination with a medication called rituximab.
Rituximab is a type of biological therapy called a monoclonal antibody. It attaches itself to the surface of cancerous cells and stimulates the immune system to attack and kill the cell.
It's given through a drip directly into a vein over the course of a few hours.
Side effects of the drug can include:
You may be given additional medication to prevent or reduce side effects. Any side effects should improve over time as your body gets used to the medication.
Brentuximab vedotin
Brentuximab vedotin is a relatively new drug used to treat a particular type of Hodgkin lymphoma.
It is available on the NHS for people with CD30-positive Hodgkin lymphoma who:
- have already had a stem cell transplant using their own cells or cannot have chemotherapy
- cannot have a stem cell transplant using their own cells, but have already had at least 2 other treatments
It is given in the same way as rituximab, but the treatment session takes around 30 minutes.
Side effects of brentuximab vedotin include:
- skin rash
- shortness of breath
- cough
- fever
- back pain
- chills
- headache
- feeling sick (nausea) or being sick (vomiting)
Follow-up
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.
Want to know more?
For more information, see:
- Cancer Research UK: treating Hodgkin lymphoma
- Cancer Research UK: living with Hodgkin lymphoma
- Macmillan: treating Hodgkin lymphoma
- Macmillan: living with Hodgkin lymphoma
Your multidisciplinary team
During your treatment for Hodgkin lymphoma, you may see any of the following professionals:
- 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
Page last reviewed: Mon Sep 2021 Next review due: Wed Feb 2020
