Chemotherapy for Hodgkins Disease

Hodgkins disease, also known as Hodgkin's disease, Hodgkin's lymphoma and Hodgkins lymphoma, is cancer of the immune system. It affects the cells of the lymphatic system, which comprises: lymph fluid, lymph vessels, lymph nodes, spleen, thymus, tonsils and bone marrow.

Hodgkins disease is a cancer that affects both children and adults.

Symptoms of Hodgkins Disease

• Before the patient's medical team can determine a chemotherapy regimen, the patient's cancer must be "staged." Staging cancer means determining how far cancer has progressed at the time of diagnosis. Chemotherapy treatments also vary depending on the patient's overall health, age, size and response to the drugs. The patient's symptoms are considered in both the staging process and the treatment decision.

  The most common symptoms of Hodgkins disease are: an obvious swelling in the neck, underarm or groin, unexplained frequent fevers or chills, night sweats, unexplained weight loss and itchy skin.

Treatment Options

• The preferred approach to the treatment of Hodgkins disease in both children and adults is two-pronged: chemotherapy (anti-cancer drugs) plus radiation.

  Chemotherapy dugs may be taken orally, via injection or intravenously. Combinations of drugs are frequently given acronyms. Here are the most commonly used chemotherapies:
  ABVD (made up of Adriamycin, bleomycin, vinblastine and dacarbazine)
  MOPP (mechlorethamine, vincristine, prednisone and procarbazine
  MOPP alternating with ABV
  MOPP alternating with ABVD
  ChIVPP (chlorambucil, vinblastine, procarbazine and prednisone)
  The Stanford V regimen (doxorubicin, vinblastine, mechlorethamine, bleomycin, vincristine, etoposide and prednisone)
  BEACOPP (cyclophosphamide, Adriamycin, etoposide, vincristine, bleomycin, procarbazine and prednisone)

  Patients may also enroll in clinical trials for new drug treatments. If interested, they should inquire about clinical trials at the outset of their treatment.

Possible Side Effects of Chemotherapy

• Chemotherapy can be rigorous for the body because in their efforts to destroy cancer cells, drugs also destroy healthy cells, which leads to unpleasant side effects.

  Common and temporary side effects may include: nausea and vomiting, diarrhea or constipation, hair loss, weight loss or weight gain, depression, mouth sores and leukopenia (decreased white blood cell count).

  Most of these side effects can be managed by other drugs.

  More troubling or long-lasting side effects may include: neutropenia (a severe drop in white blood cells), anemia (decreased red blood cell count), peripheral neuropathy (nerve damage), liver and kidney damage, thrombocytopenia (abnormal blood clotting), allergic reaction and tumor lysis syndrome (a result of the breakdown of cancer cells).

Critical Follow-up for Children and Adolescents

• Children and adolescents may have treatment-related side effects that appear long after
  finishing chemotherapy treatment for Hodgkins disease, so ongoing regular follow-up exams are very important. Late effects may include problems with fertility, thyroid, heart, or lungs; an increased risk of developing a second cancer and bone growth and development.

  The risk of late effects depends on the child's age when treated, the kind of treatment and
  genetic factors.

Prognosis Following Treatment

• If caught early, Hodgkins disease is considered curable, and most cases are treatable.
  According to the Mayo Clinic, up to 95 percent of patients diagnosed with stage I or stage II Hodgkins disease who undergo treatment survive five years or more. Later-stage disease results in a five-year survival rate of about 60 to 70 percent.