Treatment

Your treatment options depend on the stage of Hodgkin Disease, your overall health and your preferences about treatment. In all cases, treatment should be individualized for you. Although cancers are classified into particular stages, each person is unique.

You do not have to rush to make a decision, so consider the options carefully. Ask questions if you do not understand any aspect of treatment or the terms your doctors are using. One of the best ways to improve communication with your health care team is to prepare your visits so that you can best make use of the time.

A treatment plan is a way to deal with both the short and long term goals of managing your cancer. There are several treatment options for Hodgkin Disease, depending on the cancer stage and the patient’s age and general health. Patients have time for second opinions and to talk through all of their options with their doctors and develop a treatment plan that best fits their needs.

Lymphoma Treatment Options

Autologous Stem Cell Transplant
This type of transplant uses blood-forming stem cells from the patient's own blood or from the bone marrow. The stem cells are removed, frozen, and stored. Then very high doses of chemo (with or without radiation therapy) are given in order to kill the cancer. These high doses destroy bone marrow, too. When this happens, the body is no longer able to make new blood cells. So, after the treatment, the stored stem cells are thawed and put back into the patient's bloodstream through a vein. Over time the stem cells return to the bone, replacing the marrow and making new blood cells.

The Transplant Process

Stem cells are collected from the bloodstream in a process called apheresis. The cells are then frozen and stored. Patients are then given very high doses of chemo to kill the cancer cells. The patient might also get total body radiation to kill any cancer cells that the chemo may not have killed. After treatment, the stored stem cells are given to the patient like a blood transfusion. The stem cells settle into the patient's bone marrow over the next several days and start to grow and make new blood cells.

Patients who receive a donor's stem cells are given drugs to prevent rejection. Usually within a couple of weeks after the stem cells are given, they will start to make new white blood cells. Then they begin making platelets, and finally, red blood cells.

Patients having transplant must be kept away from germs as much as possible until their white blood cell count is at a safe level. They are kept in the hospital until the white cell count reaches a certain number, usually around 1,000. After they go home, they will be seen as an outpatient regularly for about 6 months.

One of the most common and serious side effect is a greater risk of infection. Other side effects include low red blood cell counts, nausea, vomiting, loss of appetite, mouth sores, and hair loss.

Some side effects can last for a long time, or may not happen until years after the transplant, such as infertility or early menopause.

Graft-Versus-Host Disease (GVHD), is the main problem of a donor stem cell transplant. This occurs when the immune system of the patient is taken over by that of the donor. The donor immune system then starts to attack the patient's other tissues and organs.

Symptoms of GVHD can include severe skin rashes with itching and severe diarrhea. The patient may also become tired and have muscular aches. The disease can be fatal.

Drugs that weaken the immune system may be given to try to control it. And, this disease also causes any remaining lymphoma cells to be killed by the donor immune system. Mild graft-versus-host disease can be a good thing.

Chemotherapy
Chemotherapy is the use of drugs to destroy cancer cells. More than half of all people treated for cancer receive chemotherapy and many different types are available. Each patient has a unique response to chemotherapy. Side effects will also vary depending on which chemotherapy drug or drug combination you receive, as well as the dose of your drugs, and the frequency of your chemotherapy treatments.

Chemotherapy is a systemic treatment. This means that it can destroy cancer cells almost anywhere in your body. Chemotherapy is most effective against rapidly dividing cells, like cancer. However, healthy, normal cells can also be damaged by chemotherapy.

Radiation Therapy
Radiation therapy (or radiotherapy) is the use of high-energy rays (ionizing radiation) to kill cancer cells. Radiation works by damaging the genetic material in cells. After radiation treatment ends, cancer cells will keep dying for days or even months.

For some people with cancer, radiation therapy is the only treatment needed. For others, radiation is given before, during or after chemotherapy, biotherapy or surgery. The goal of radiation is to damage as many cancer cells as possible without harming healthy tissue. To minimize damage to healthy cells, radiation doses are calculated very precisely. Treatment areas are carefully defined and treatment is spread-out over time.

Social networking and online support groups are important tools. Reaching out to others who have or have had similar experiences can provide you with valuable insights. Check out Cancer Support Community's The Living Room for more information on clinically facilitated support online. 

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