Treatment Options for Hodgkin Lymphoma

Hodgkin Lymphoma can be treated with chemotherapy, radiotherapy or a combination of both. The decision on the exact course of treatment is usually decided on a number of factors. The most important is the stage of your disease. Other factors are also important. The number of nodes involved, the size of the tumor in your chest, the presence of lymphoma in other organs, some blood test reports, and even your age are related to the type of treatment which works best.

Chemotherapy is one of the main treatment options for Hodgkin disease. A combination of 3 or more drugs are generally used. All or most of the drugs are administered either as quick injections or as slow infusions into your veins. Some drugs may be taken as pills. There are a number of effective drug combinations. The most common is called ABVD. The choice of the exact schedule depends on your doctor. Chemotherapy is typically administered every 2-3 weeks for a number of ‘cycles’.

Radiation therapy is also very effective in Hodgkin disease. Radiation can be used as the only treatment, or added after chemotherapy. Taking radiation treatment is much like getting an X-ray taken. You lie flat on a couch, and a machine delivers X-rays to a part of your body from a distance. Radiation treatments are usually given 5 days a week for 3-5 weeks. Hodgkin lymphoma responds well to radiation and very high doses are not required.

When you have Stage I or Stage II disease and no other bad risk factors, you may be offered -

• Radiotherapy alone to a large area (extended field radiation)
• Combination chemotherapy for a few cycles followed by radiation to a small area (involved field radiation)

Both forms of treatment are very successful and most patients are cured.

If you have some poor risk factors that are mentioned above, you will probably be treated with combination chemotherapy followed by radiation.

Treatment for Stage III and IV disease mainly involves chemotherapy. Chemotherapy can reach the disease in all parts of your body through your blood. Radiotherapy may be added later to some parts where the disease was bulky, or if chemotherapy is unable to take care of the disease completely in a particular area. Since there is some scope to improve the results of advanced stage Hodgkin lymphoma, you may be asked to participate in a clinical trial using a new combination of drugs.

If your disease has relapsed after having disappeared following initial treatment, you may be treated with a different set of chemotherapy drugs. You can also be offered 'high-dose chemotherapy with autologous stem cell rescue'. This involves treatment with a high dose combination of drugs to destroy all cancer cells. The damage to your bone marrow is reversed by transplanting some marrow which has been stored in advance. This treatment has shown the best results in relapsed disease.