Chemotherapy for Hodgkin's lymphoma

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. They work by disrupting the growth of cancer cells. The drugs circulate in the bloodstream around the body.

You usually have chemotherapy for Hodgkin’s lymphoma through a drip into a vein. You normally have several chemotherapy drugs together during a course of treatment. Some chemotherapy combinations include a course of steroids. You usually have radiotherapy as well as chemotherapy for Hodgkin's lymphoma.

A course of chemotherapy is made up of a number of cycles. You have treatment, usually over 1 to 3 days, depending on the particular combination of drugs. Then you have a break of a few weeks to allow your body to recover from the effects of the chemotherapy. Then another cycle begins. The number of cycles you have depends on

• Which drugs you are having
• The stage and type of your Hodgkin’s lymphoma
• The results of your tests
• How well the Hodgkin’s lymphoma responds to the treatment

You are most likely to have your treatment as an outpatient, although with some drugs you may have to stay in hospital for a day or two.

You may have chemotherapy for Hodgkin’s lymphoma through a small tube (cannula) into a vein in your arm. Or you might have the treatment through a central line. This means that you don't have to have a tube put into a vein every time you need chemotherapy. There are three main types of central line. The first is a long, bendy plastic tube that goes into your chest, is tunnelled under the skin up towards the collarbone and then into a large vein in your chest. This is a short procedure and you usually have it in the outpatient clinic. You usually have an injection of local anaesthetic to numb the area where the tube is to go in. Or you may be put to sleep for a short time with a general anaesthetic. 

The last six inches or so of the tube hangs out of the chest. It has a clamp and a screw cap to seal it off. The chemotherapy drugs are injected straight into the tube and so go straight into your bloodstream. The tube can stay in for as long as it is needed. Your nurse will show you how to look after it and keep it clean. You or your nurse will flush it through with liquid once a week to prevent it from blocking. 

The second type of central line is called a port or Portacath. This is a small chamber or box put under the skin of the chest during a small operation. The chamber is attached to the central line tube inside your body. So there is no tube coming out of the chest. A special needle is pushed through the skin into the port to give the chemotherapy.

The third type of central line is called a PICC line. This is a very long, thin tube that goes into a vein in your arm and threads its way up to the larger blood vessels in your chest. PICC stands for 'peripherally inserted central catheter'.

You can find detailed information about central lines, Portacaths and PICC lines in the how you have cancer drugs section.

If you have high dose treatment, it kills off the cells in your bone marrow that make your blood cells. You will then need to have a drip (transfusion) of either bone marrow or blood stem cells. The stem cells go from your blood into the bone marrow and start to make blood cells again.

Look at the section on Hodgkin’s lymphoma and bone marrow and stem cell transplants for detailed information about this treatment.

We don't yet know much scientifically about how some nutritional or herbal supplements may interact with chemotherapy. Some could be harmful. It is very important to let your doctors know if you take any supplements. Or if you are prescribed them by alternative or complementary therapy practitioners.

Talk to your specialist about any other tablets or medicines you take while you are having active treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section of CancerHelp UK.

Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking or thinking of taking these supplements talk to your doctor to find out whether they could affect your treatment.

Look at the main chemotherapy section in CancerHelp UK. It explains the treatment in detail including

• What chemotherapy treatment involves
• How chemotherapy is planned
• How you have treatment
• General side effects
• Side effects of individual chemotherapy drugs
• Living with chemotherapy

If you would like more information about anything to do with chemotherapy, contact one of the Hodgkin's lymphoma organisations. They will be happy to help. They often have free factsheets and booklets that they can send to you. You can also contact our cancer information nurses who would be happy to help.