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Before they can decide which treatment is best, your doctors need to work out a prognostic index for you.
The prognostic index is based on your age, the results of blood tests and the stage your Hodgkin’s disease is at. The lower the prognostic index, the higher the chance that the cancer can be cured.
Your doctor will tell you about the risks, benefits and side effects of your treatment options. You will need to agree to the treatment before it can start. This is called giving your consent. Don’t be afraid to ask questions if there is anything you don’t understand.
You may be offered:
Radiotherapy
Radiotherapy uses radiation to kill cancer cells. You may have this treatment if the disease is in just one area of the body and you have a low prognostic index. Radiotherapy is normally given over a two- or three-week period. It may be combined with chemotherapy.
Chemotherapy
Chemotherapy uses special drugs to kill cancer cells. You may have this treatment if your prognostic index is good, but the doctor doesn’t think that radiotherapy is right for you. You are more likely to have chemotherapy if your cancer has spread. The treatment is given over a period of up to six months.
Intensive chemotherapy
If you have a high prognostic index, your doctor may recommend intensive chemotherapy. It normally lasts four or five months.
In the past, patients with a high prognostic index have not responded very well to treatment. Now, with this new intensive chemotherapy, response rates are very much better.
High dose chemotherapy with stem cell rescue
For some patients the final part of their treatment will be high dose chemotherapy with stem cell rescue. Your doctor may suggest this treatment if your Hodgkin’s disease has come back, or is proving difficult to treat.
Chemotherapy can damage bone marrow and lead to problems such as anaemia, infections and bleeding.
After standard chemotherapy, bone marrow recovers on its own… but high dose chemotherapy does more damage, and bone marrow needs help to recover.
Before you have high dose chemotherapy your doctors will take some stem cells from you. These are stored, ready to give back to you afterwards. When they are put back into your body the cells start to grow and multiply again.
There are two ways of getting the stem cells. The most usual way is to get them from the blood. A special machine collects bone marrow cells that are circulating in the blood. This is called peripheral blood stem cell harvesting. Less usually, some bone marrow is removed. This is called bone marrow harvesting.
After the harvesting, you have your high dose of chemotherapy. Later, your undamaged blood stem cells or bone marrow is given back to you through a drip.
The chemotherapy and stem cell rescue will involve a stay in hospital of two or three weeks.
For more information about treatments, go to our cancer treatments section.
