Hodgkin Lymphoma: Treatment Choices

There are several treatment choices for Hodgkin lymphoma, also called Hodgkin disease. Which may work best for you? It depends on a number of factors, such as:

• The type of Hodgkin lymphoma

• The stage of the lymphoma

• Whether you have any B symptoms: weight loss, unexplained fever, or night sweats

• The results of certain blood or urine tests

• Your age and overall health

• Your personal concerns and preferences

Learning about your treatment options

You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.

Your doctor is the best person to answer your questions. He or she can tell you what your treatment choices are and how successful they’re expected to be. Your doctor can also tell you what the risks and side effects are. Your doctor may advise a specific treatment. Or he or she may suggest more than one, and ask you to decide which you’d like to use. It can be hard to make this decision. It is important to take the time you need to make the best decision.

Types of treatment

Hodgkin lymphoma treatments may be local, which means they focus on one area. Or they may be systemic and reach cancer cells all over your body. You may have only one treatment or a combination of treatments.

Local treatment removes, destroys, or controls cancer cells in one area. This is done with:

Radiation therapy

Radiation therapy kills cancer cells using high-energy X-rays. It may be used as a single treatment type or as part of a treatment plan that includes chemotherapy.

Systemic treatment destroys or control cancer cells throughout the whole body. The types of systemic treatment include:

Chemotherapy

This treatment uses medicines to kill cancer cells. Chemotherapy is the most common treatment for Hodgkin lymphoma. It may be used alone or with radiation. Most people have several medicines through IV and pills.

Stem cell transplant

If Hodgkin lymphoma returns after treatment (relapses), very high doses of chemotherapy may be used for treatment. These high doses can permanently damage the bone marrow. Stem cell transplants allow doctors to give higher doses of chemotherapy. A health bone marrow is needed to make blood cells and immune system cells. A stem cell transplant is used to rebuild healthy bone marrow after high-dose chemotherapy. The stem cells may come from a done (an allogenic transplant). Or, they may come from you (an autologous transplant). If your own cells are used, they are collected before the high doses of chemotherapy are given. The cells are stored in a freezer to be used later.

Immunotherapy. Also called biologic therapy, this treatment works to boost the body's immune system to fight the lymphoma. Immunotherapy includes:

• Monoclonal antibodies. These medicines are manmade, or synthetic, forms of immune system proteins. They target a specific part of a cancer cell. They may be used alone or along with chemotherapy to treat certain types of Hodgkin lymphoma. 

• Immune checkpoint inhibitors. An important part of the immune system is to protect the body from harmful cells such as cancer. Checkpoints are molecules on immune cells. They detect normal cells from abnormal cells such as cancer. Checkpoints turn the immune system on or off to start an immune response. Cancer cells can sometimes find ways to use checkpoints to get into the body. Checkpoint inhibitors are medicines that target checkpoints to boost the immune system's ability to fight cancer.

Clinical trials for new treatments

Experts are also finding new ways to treat Hodgkin lymphoma. These new methods are tested in clinical trials. Before starting treatment, ask your doctor if there are any clinical trials you should consider.

Working with your doctor to choose a treatment plan

Your oncologist will help you make a treatment plan. Talking about your treatment choices will be one of the most important meetings you'll have with your doctor.

It may take time to choose the best plan. Ask your doctor how much time you can take to explore your options. You may want to get an opinion from another doctor before deciding on treatment. You may also want to talk with your family and friends.