• Chemotherapy for Hodgkin’s Lymphoma

    Chemotherapy uses drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body in order to kill cancer cells. The side effects from the chemotherapy come from the fact that it destroys normal cells as well. Chemotherapy may be given either alone or along with radiation therapy . When given alone, it is given in a higher dose designed to kill off cancer cells. When given along with radiation therapy, it is delivered at a lower dose and is designed to make the cancer more sensitive to the radiation.
    The amount and type of chemotherapy you receive will be determined by the stage and type of Hodgkin’s disease, as well as factors such as your age and health.
    • Main drug regimen: ABVD ( doxorubicin [adriamycin], bleomycin [Blenoxane], vinblastine , and dacarbazine [DTIC])
    • Other drug regimens: MOPP ( methotrexate [Rheumatrex], vincristine [Vincasar PFS], prednisone , procarbazine [Matulane]) alone or alternating with ABVD or ABV, COPP, and ChlVPP ( chlorambucil [Leukeran], vincristine, prednisone, and procabizine)
    Other regimens are in development, and you may be eligible for a treatment trial depending on your stage and health. In addition, chemotherapy may be used to prepare a patient for bone marrow transplantation , which may also be used in advanced cases of Hodgkin’s disease or in cases of relapse.
    The side effects and amount of time required in the doctor’s office depend on the type of chemotherapy you receive, as well as how many cycles you receive and how often.
    Possible side effects of chemotherapy include:
    • Bone marrow suppression resulting in infection
    • Low white blood cell counts
    • Low red blood cell counts
    • Low platelet counts
    • Hair loss
    • Appetite loss
    • Taste changes
    • Nausea and vomiting
    • Inflammation and sores in the mouth, throat, and esophagus
    • Constipation
    • Diarrhea
    • Fatigue
    • Reproductive and sexuality problems and hormonal changes, such as hypogonadism
    In addition, certain chemotherapy drugs can cause:
    • Heart damage
    • Nervous system changes
    • Lung damage
    • Liver damage
    • Kidney and urinary system damage
    The likelihood and extent of these side effects will vary according to each patient. Ask your doctor what you are likely to experience. If you develop any new symptoms, be certain to report them to your doctor right away. These complications of treatment are always more easily managed when discovered early.
    When chemotherapy is given at a lower dose, as when it is given along with radiation, these side effects are less common. However, most people still feel very fatigued.
    Some of the medications associated with these procedures may cause infertility. If your fertility is a concern, discuss the possibility of storing sperm or eggs before starting treatment.

    References

    Hodgkin disease. American Cancer Society website. Available at: http://www.cancer.org/docroot/home/index.asp . Accessed April 24, 2009.

    Hodgkin lymphoma. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/hodgkin . Accessed April 24, 2009.

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