Best Types of treatment for Hodgkin lymphoma You Must Know

The main treatments

The treatment of Hodgkin lymphoma (Hodgkin’s disease) is usually very successful and many people are cured. How much treatment you need depends on the stage of your disease.
The main types of treatment are

  • Radiotherapy
  • Chemotherapy
  • Steroids
  • High dose treatment with bone marrow or stem cell transplant

Some people only need one type of treatment. Others need a combination of treatments. You may have steroids alongside chemotherapy, depending on which chemotherapy drugs you are having. People with the rare lymphocyte predominant type of Hodgkin lymphoma may have a type of biological therapy called rituximab.

Planning your treatment

Your doctor takes a number of things into account when deciding your treatment

  • The stage of Hodgkin lymphoma you have
  • Whether you have B symptoms or not
  • Your test results
  • The type of Hodgkin lymphoma you have
  • Your general health and fitness
  • Your age

Age is included because large trials have shown that people over 50 do not always do as well as younger patients and so may need more intensive treatment.
B symptoms (fevers, sweating and weight loss) are included in the staging for Hodgkin lymphoma. If you have these, your doctor will add a B to the number stage of your disease. So stage 2 with B symptoms, means you have stage 2B Hodgkin lymphoma. If you don’t have these symptoms, your stage would be 2A.
When deciding on treatment, doctors group the stages of Hodgkin lymphoma together. They call anything up to stage 2A early disease. Stages 2B and above are classed as advanced disease.
Before you start treatment your doctor will talk to you about your fertility.
Before you start treatment your doctor or specialist nurse may recommend that you have flu and pneumonia vaccinations. The vaccinations help to protect you from these infections if you have low immunity during treatment.

Early stage Hodgkin lymphoma

Early stage means the lymphoma is only in 1 group of lymph nodes (stage 1). Or it may be in 2 groups but they are on the same side of your diaphragm and you have no fevers, night sweats or unexplained weight loss (stage 2A).
If you have early stage disease, you will probably have a short course of chemotherapy. Your doctor may then recommend radiotherapy to the affected lymph nodes. You may also have radiotherapy to your spleen or other lymph nodes. If you have very early, localised disease and are not able to have chemotherapy for any reason, you may just have radiotherapy to the affected lymph nodes.

Advanced stage Hodgkin lymphoma

Advanced stage means that the lymphoma is on both sides of your diaphragm (stage 3), or in body organs (stage 4).
For advanced stage disease, you are most likely to have chemotherapy with or without steroids. You may also have radiotherapy to particular groups of lymph nodes if they are very enlarged or causing troublesome symptoms.

If your lymphoma comes back

If your lymphoma comes back after treatment (relapses), you may have high dose chemotherapy treatment with a bone marrow or stem cell transplant or your doctor might suggest treatment with a drug called Brentuximab. Or you may have more chemotherapy or radiotherapy, depending on the treatment you have already had.

If your lymphoma does not respond

Sometimes Hodgkin lymphoma does not respond as well to initial treatment as your doctor would hope. If this happens to you, your doctor may suggest high dose chemotherapy treatment with a bone marrow or stem cell transplant. Or they might add in more treatment – for example, radiotherapy as well as chemotherapy. They may change your chemotherapy drugs or give you the drug Brentuximab.

Fertility and cancer treatment

Chemotherapy and radiotherapy for Hodgkin lymphoma can potentially affect your ability to have a child. So it is important to talk to your doctor about this before you start treatment. They may be able to arrange sperm banking or having some of your eggs collected before treatment begins.
We have a section on fertility and chemotherapy.

Your treatment team

When lymphoma is diagnosed, several doctors and other health professionals work together to decide on the most appropriate treatment. The team of doctors and health professionals is called a multi-disciplinary team (MDT). The members of the team specialise in different areas of Hodgkin lymphoma treatment and support. The team usually includes the following people.

  • A haematologist or medical oncologist (a specialist in treating lymphoma)
  • A pathologist (a specialist in looking at biopsy samples)
  • A transplant specialist
  • A clinical oncologist (a specialist in radiotherapy)
  • A specialist cancer nurse
  • A pharmacist, social worker, psychologist and counsellor.


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