Today, there are more treatment options for Hodgkin lymphoma than ever before. Physicians are better able to control the disease or put it into remission, even if the disease is advanced.
Our Hodgkin lymphoma specialists work closely with you, your family and each other to get you back to health. At Fred Hutchinson Cancer Center, we provide all standard therapies for Hodgkin lymphoma and offer you access to the latest treatments through clinical trials.
“For Hodgkin lymphoma, it's generally the age and the stage of the patient that helps determine the treatments that are used.”
— Ryan C. Lynch, MD, hematologist-oncologist
Treatment for Hodgkin lymphoma is different for each person. When it comes to treatment options, we think about every detail of your Hodgkin lymphoma, from type to subtype, along with your goals and priorities.
The treatment plan we design for you depends on many factors, including:
While treatment is different for each person, Hodgkin lymphoma is most often treated with chemotherapy. Sometimes this is the only treatment needed, but it may be combined with radiation therapy. Physicians most often use radiation to treat cancer in the spleen or in the lymph nodes in the neck, chest, armpits or groin. Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy. Both targeted therapies and immunotherapies are often used with relapsed Hodgkin lymphoma.
If initial treatment doesn’t cure your lymphoma or your disease recurs, your physician may recommend a blood or marrow transplant.
At Fred Hutch, our standard always involves caring for you as a whole person. We help you get relief from side effects and provide many other forms of support, like integrative medicine, nutrition counseling and physical therapy.
Our patients can also choose to receive promising new Hodgkin lymphoma therapies that you can only get through a clinical trial. Many people come to Fred Hutch to be part of these studies. Your care team will tell you about studies that may be right for you, so you can think about joining them.
Depending on your lymphoma type, subtype, stage and overall health, you may respond to treatment in different ways. At Fred Hutch, we choose, combine and schedule your treatments based on what will work best for you. Your care team will make sure you understand each type of treatment and all of your choices.
Hodgkin lymphoma is most often treated with chemotherapy. Sometimes this is the only treatment needed, but it may be combined with radiation therapy.
Chemotherapy, called “chemo” for short, uses medicines to kill fast-growing cells (like cancer cells) or to keep them from dividing, which is how cancers grow. Your hematologist-oncologist prescribes your chemotherapy and sets your treatment schedule. Usually, chemotherapy is given by infusion. Liquid medicine is put into a vein through an intravenous (IV) line. This can be a line in your arm (peripheral venous catheter) or a port in your chest (central venous catheter). Treatment happens in repeating cycles every two to six weeks.
Your Fred Hutch team will talk with you about which drugs we recommend for you, how you’ll take them, your treatment schedule and what to expect. Your team will also explain how to take the best possible care of yourself during and after treatment and connect you with support resources throughout Fred Hutch.
Cancer nurses who specialize in infusions will give you these treatments. They will watch over you during treatment, deal with any medical issues that come up and help keep you comfortable.
Many people with Hodgkin lymphoma receive a chemotherapy combination of drugs called ABVD:
For people with the most aggressive forms of Hodgkin lymphoma, your physician may use other combinations.
Based on your type of Hodgkin lymphoma and if it has spread, your physician may recommend external-beam radiation therapy, alone or along with chemotherapy.
Radiation therapy uses high-energy rays to kill cancer cells. A radiation oncologist decides on the type, dose and schedule of your treatment.
Usually, this means that a machine aims rays right at your tumor. You get this treatment daily, Monday through Friday, for several weeks.
For Hodgkin lymphoma, physicians most often use radiation to treat cancer in the spleen or in the lymph nodes in the neck, chest, armpits or groin.
Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy.
Targeted therapies work in one of three ways:
Who needs targeted therapy?
Patients with relapsed (the disease gets better but then gets worse) or refractory (does not respond to treatment) Hodgkin lymphoma are often good candidates for targeted therapy.
For relapsed Hodgkin lymphoma, physicians use the targeted therapy brentuximab vedotin along with standard chemotherapy. Brentuximab works like a Trojan horse. It enters cancer cells and then releases a toxin that makes it harder for the cell to reproduce.
Immunotherapies are some of the latest innovations at Fred Hutch. They use the power of your immune system to fight your cancer. We are working hard to make immunotherapy part of Hodgkin lymphoma treatment in the best possible way. Our research teams are focused on finding out if immunotherapy can improve outcomes or if we can safely give patients fewer chemotherapy drugs.
Nivolumab (Opdivo®) and pembrolizumab (Keytruda®) are antibody therapies that may boost your immune system’s anti-cancer response by blocking “off signals” on your T cells.
Who needs immunotherapy?
If you have classic Hodgkin lymphoma that progresses (gets worse or spreads) or comes back after other treatments, immunotherapy may be an option for you.
If initial treatment doesn’t cure your lymphoma or your disease comes back, your physician may recommend a blood or marrow transplant. The transplant resets your body’s ability to make healthy blood cells.
Physicians and researchers at Fred Hutch pioneered blood and marrow transplants decades ago. Today, at Fred Hutch, we continue to improve transplant techniques and develop new options.
A team of Fred Hutch transplant experts will care for you. Your team will include a transplant oncologist, transplant nurse, pharmacist, dietitian, team coordinator and social worker.
Most transplant recipients with Hodgkin lymphoma have a transplant using their own stem cells (autologous transplant).
If your lymphoma is very aggressive and chemotherapy has not shrunk your tumors, an autologous transplant is usually not an option. In this case, patients have a transplant using cells from a donor (allogeneic transplant).
More people are eligible for allogeneic transplants than ever before, due to advances available at Fred Hutch, such as:
While you’re in active treatment, your Hodgkin lymphoma care team will see you regularly for exams and tests to check:
We update your treatment plan based on the best scientific evidence as well as how your disease responds and what you prefer.
Along with treating your Hodgkin lymphoma, Fred Hutch provides a range of services to support you and your caregiver before, during and after treatment. This is part of how we take care of you — not just your disease.
From dietitians to chaplains, we have experts who specialize in caring for people with cancer. We also offer support groups to help connect patients to each other. We understand this may be one of the most intense and challenging experiences you and your family ever go through. We’re here to provide the care you need.
Learn more about Supportive Care
When your disease is in remission and your active treatment ends, it is still important to get follow-up care on a regular basis. At follow-up visits, you will see the same team who treated your Hodgkin lymphoma. They will check your overall health and look for signs that your cancer has come back (signs of recurrence).
Your team will also help with any long-term side effects (which go on after treatment ends) or late effects (which may start after treatment is over).