Cancer centres keep a close eye on people in the years immediately following treatment, and some survivorship programmes continue surveillance well into adulthood. For example, obesity and smoking can dramatically increase the risk of complications such as lung cancer.
This leaves them with community practitioners who are unfamiliar with their particular health risks, and thus may be ill-equipped to guide them. To fill this void, some survivorship specialists encourage their patients to take the initiative. Such efforts can help, but they also require a collaborative doctor—patient relationship.
More from Nature Outlooks. The oncology community is exploring options that might broaden access to care — for example, Bhatia envisions close partnerships between dedicated cancer-survivorship programmes and community practitioners. In the ongoing EMPOWER-II clinical trial, Oeffinger is investigating the use of smartphones to relay important information about medical care to patients and doctors in the form of text messages and video vignettes.
Cancer doctors still see considerable opportunities to eliminate, or at least reduce, the cost of a cure. Several studies have found genetic factors that predispose certain patients to particular complications. Research by Bhatia and colleagues, for example, indicates that preexisting mutations might render some patients especially vulnerable to damage from radiation. Her team is now looking for genetic and physiological signatures that might lead to personalized treatment regimens.
Advanced treatment options could also contribute to healthier survivorship. A radiotherapy approach called proton-beam therapy, for example, might enable more precise killing of cancer cells, although the technique is still too young for long-term survivorship data to be available. These might prove safer than conventional chemotherapy, but this remains to be demonstrated over the long run. For now, the hard conversations will continue — although there are ways to make them easier.
Oeffinger cites the importance of countering what he calls Damocles syndrome, a reference to the legendary Ancient Greek courtier who sat through a feast under the shadow of a sword suspended by a single hair. Fortunately, the knowledge that researchers and clinicians have accrued can confer considerable agency to survivors, enabling them to make informed decisions to safeguard their own health.
This article is part of Nature Outlook: Lymphoma , an editorially independent supplement produced with the financial support of third parties. About this content. Bhatia, S. PubMed Article Google Scholar. Blood , — Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible.
It can also help prevent more serious problems in the future. Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website. However, progressive disease is uncommon for people with Hodgkin lymphoma. If progression happens, it is a good idea to talk with doctors who have experience in treating it.
Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.
Complete recovery from progressive Hodgkin lymphoma is not always possible. This treatment appears to be more effective for progressive Hodgkin lymphoma than standard chemotherapy. Palliative care is also important to help relieve symptoms and side effects.
For most people, a diagnosis of progressive Hodgkin lymphoma is very stressful and difficult. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.
A remission is when lymphoma cannot be detected in the body and there are no symptoms. A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back.
While many remissions are permanent, it is important to talk with your doctor about the possibility of the disease returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the lymphoma does return. Learn more about coping with the fear of recurrence.
If the lymphoma returns following remission after the original treatment, it is called recurrent lymphoma. Recurrence is uncommon for people with Hodgkin lymphoma. However, if Hodgkin lymphoma does recur, a new cycle of testing much like that done at the time of diagnosis will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent lymphoma.
Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects. People with recurrent lymphoma often experience emotions such as disbelief or fear. You are encouraged to talk with the health care team about these feelings and ask about support services to help you cope. Recovery from Hodgkin lymphoma is not always possible. If the lymphoma cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
It is also important to discuss newer treatment options that are being tested in clinical trials. Finding a second opinion may be useful, too.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations.
Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced care planning. After the death of a loved one, many people need support to help them cope with the loss.
Learn more about grief and loss. The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with lymphoma.
Use the menu to choose a different section to read in this guide. Therapies using medication Systemic therapy is the use of medication to destroy cancer cells. The types of systemic therapies used for Hodgkin lymphoma include: Chemotherapy Immunotherapy Each of these types of therapies is discussed below in more detail.
Chemotherapy Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells. First-line chemotherapy Newly diagnosed Hodgkin lymphoma is often treated with regimens that use a combination of chemotherapy drugs given at 1 time.
Second-line chemotherapy There are several second-line treatments available for Hodgkin lymphoma. Learn more about the basics of chemotherapy. Immunotherapy Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer. Radiation therapy Radiation therapy is the use of high-energy x-rays or protons to destroy cancer cells.
These include: Involved-site radiotherapy, which focuses the radiation on the lymph nodes that contain cancer. Learn more about the basics of radiation therapy.
Physical, emotional, and social effects of cancer Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects.
Progressive Hodgkin lymphoma "Progressive disease" is the term used when the cancer becomes larger or spreads while the original lymphoma is being treated. Remission and the chance of recurrence A remission is when lymphoma cannot be detected in the body and there are no symptoms.
Learn more about dealing with cancer recurrence. If treatment does not work Recovery from Hodgkin lymphoma is not always possible. Types of Cancer. Lymphoma - Hodgkin Guide. Net Guide Lymphoma - Hodgkin. Medical Illustrations. Risk Factors. Symptoms and Signs. Types of Treatment. About Clinical Trials. Latest Research. Coping with Treatment. Sometimes, swollen lymph nodes occur with other symptoms, such as coughing or difficulty breathing.
This is because of the pressure a swollen lymph node puts on the chest. Still other symptoms some people may experience include :. Anyone can develop Hodgkin lymphoma, which occurs when healthy cells divide and grow uncontrollably.
However, some factors can increase the risk of this condition, including :. There is no known effective strategy for preventing Hodgkin lymphoma or the EBV, which increases the likelihood of developing this type of cancer. Ways to lower the risk of HIV include limiting intravenous drug use and avoiding unprotected sex. Learn more about the causes of HIV here. There are several factors doctors look at when staging Hodgkin lymphoma:.
People with bulky disease have stage 2 or higher cancer. They have tumors that are larger than 4 inches anywhere in the body, or a tumor that is at least one-third as wide as the chest. This type of cancer occurs when B lymphocytes develop into a type of cancer called Reed-Sternberg cells. There are four subtypes of CHL:. Both Hodgkin and non-Hodgkin lymphoma affect the lymphatic system. The main difference between these two types of cancer is that people with non-Hodgkin lymphoma do not have Reed-Sternberg cells.
Most people who have survived 5 years with Hodgkin lymphoma will go on to recover. Moreover, some people relapse after going into remission or do not respond to initial treatment.
A biopsy of the lymph node can test for cancer cells. In most cases, a doctor will cut out the entire lymph node for testing. They may also insert a needle into the lymph node and remove some fluid. If a person gets a lymphoma diagnosis, a doctor may recommend a bone marrow biopsy.
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