Hodgkin's Disease

WHAT YOU SHOULD KNOW:

Hodgkin's Disease (Inpatient Care) Care Guide

  • Hodgkin disease is cancer in your lymph nodes and lymphatic system. Your lymph nodes make white blood cells to fight infection. The lymphatic system acts like a filter to catch germs and get rid of waste from your body. With cancer, your cells grow out of control and form too much tissue called a tumor. Your chances of having Hodgkin disease increase if a close relative has had the disease. An infection called the Epstein-Barr virus also increases your risk. Common symptoms of Hodgkin disease include weight loss, sweating during the night, and a fever (high temperature). You may also find a lump on your neck or underarm area.

  • Treatment for Hodgkin disease is usually a combination of chemotherapy and radiation, although they are sometimes used alone. Chemotherapy is medicine that kills tumors. Radiation kills cancer and keeps the cancer from spreading. You might also need a stem cell transplant which will help you fight infection. The type and stage of your Hodgkin disease may help your caregiver decide what treatment is best for you. The stages of Hodgkin disease include early stage favorable, early stage unfavorable, and advanced stage. With treatments such as chemotherapy and radiation therapy, your Hodgkin disease may go away for good. You may also feel better and live longer.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Treatment for Hodgkin disease may make you feel more tired than usual. You may get more cavities in your teeth. Having radiation therapy on your neck may cause hypothyroidism, a condition where you have decreased thyroid hormones. Both chemotherapy and radiation may make you feel sick to your stomach. You may also lose some or all of your hair. You may develop problems with your blood, such as a low number of white blood cells. You may become immunosuppressed, which means that your body has more trouble fighting germs than usual. Your cancer may return and you may need treatment again.

  • Serious risks include damage to your lungs and heart. You might also not be able to have children. Some risks of chemotherapy and radiation for Hodgkin disease can cause death. These risks include diseases such as leukemia, non-Hodgkin lymphoma, and bacterial sepsis (a blood infection). You may get cancer in other body organs, such as your lungs, skin, or breasts. If Hodgkin disease is left untreated, the cancer may spread to other parts of your body. Your symptoms may worsen and you may die. Ask your caregiver if you have questions or concerns about your disease, treatment, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may be given the following medicines:

  • Vaccine: A vaccine is a shot given to prevent certain medical conditions. You may need to get vaccinated against the flu, pneumonia, or meningitis before radiation therapy. Ask your caregiver for more information about these conditions and vaccines.

Tests:

Tests may show if your cancer has spread. These tests may also be used to help plan your treatment. Ask your caregiver for more information about these tests. You may need any of the following:

  • Bone Marrow Biopsy: Your caregiver may decide that you need a bone marrow biopsy. Bone marrow is spongy tissue that is inside of your bones. A biopsy is when a piece of tissue is removed from your body. Caregivers first put numbing medicine into your skin so you will have little pain. The tissue is removed with a hollow needle or a knife during surgery. The bone marrow sample will be sent to the lab. Your caregiver will use the results to help figure out the stage of your Hodgkin disease.

  • Blood and urine tests: You may need blood tests often during treatment. Blood tests show how your body is doing and how much chemotherapy is needed.

    • HIV test: You may need a special blood test called an HIV test. Ask your caregiver for more information about HIV testing.

    • Pregnancy test: Certain women may need a pregnancy test to help your caregiver decide which treatment is best.

  • Imaging tests:

    • Chest x-ray: This is a picture of your lungs and heart. Caregivers x-ray your chest to look for tumors. Caregivers also may use x-rays to see how your lungs and heart are doing. X-rays may show pneumonia, collapsed lungs, or fluid around the heart and lung.

    • Computed tomography scan: This is also called a CT or CAT scan. CT scans may be used to look for tumors in your lung, heart, and other organs. A special x-ray machine uses a computer to take pictures of your body. Before taking the pictures, you may be given dye through an IV in your vein. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions.

    • Positron emission tomography scan: This test is also called a PET scan. A PET scan helps your caregiver determine the stage of your cancer.

    • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.

    • Magnetic resonance imaging: This test is also called an MRI. During an MRI, pictures of your chest or abdomen are taken. An MRI may be used to look at the organs, muscles, joints, bones, or blood vessels. You will need to lie still during the MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal object. This can cause serious injury.

  • Pulmonary function tests: Pulmonary function tests (PFTs) help caregivers learn how well your body uses oxygen. You breathe into a mouthpiece connected to a machine. The machine measures how much air you breathe in and out over a certain amount of time. PFTs help your caregivers decide the best treatment for you.

Treatment options:

Hodgkin disease is often treated with a combination of chemotherapy and radiation therapy. These treatments can also be used alone or in combination with a stem cell transplant. Some of these treatments may keep you from being able to have children. Men may want to have their sperm stored in a sperm bank. Women may have surgery to move their ovaries away from where radiation therapy will be applied. Ovaries are the part of a woman's body that make her eggs. Ask your caregiver for more information about these options.

  • Radiation therapy: Radiation therapy uses x-rays or gamma rays to treat cancer. Radiation kills cancer and keeps the cancer from spreading. It also keeps cancer cells from dividing into new cells, which is one way cancer spreads. Radiation may help decrease pain, control bleeding, and shrink the tumor.

  • Chemotherapy: This medicine, often called "chemo", works by killing tumor cells. Chemotherapy also is used to shrink your lymph nodes. A combination of different chemotherapy medicines is often used to treat Hodgkin disease. ABVD is the name of one group of medicines commonly used. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Even if the chemotherapy does not cure your cancer, it may help you feel better and live longer.

  • Stem cell transplant: During a stem cell transplant, special blood cells (stem cells) are put into your blood. The stem cells usually go to your bone marrow. The bone marrow is the soft, spongy tissue inside your bone. Stem cells grow in the bone marrow and become white blood cells to help fight infection.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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