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Treatment decisions

Find out how your doctor decides which treatment you need, the types of treatment you might have and treatment by stage.

Deciding which treatment you need

When lymphoma is diagnosed, several doctors and other health professionals work together to decide on the most appropriate treatment. The team of doctors and health professionals is called a multidisciplinary team (MDT). The members of the team specialise in different areas of Hodgkin lymphoma treatment and support. The team usually includes the following people:

  • a haematologist or medical oncologist (a specialist in treating lymphoma)
  • a pathologist (a specialist in looking at biopsy samples)
  • a transplant specialist
  • a clinical oncologist (a specialist in radiotherapy)
  • a specialist cancer nurse
  • a pharmacist, social worker, psychologist and counsellor

Treatment overview

The treatment of Hodgkin lymphoma is usually very successful and many people are cured. How much treatment you need depends on the stage of your disease.

The main types of treatment are:

  • radiotherapy
  • chemotherapy
  • steroids
  • high dose chemotherapy with a stem cell or bone marrow transplant

Surgery is not used as a treatment for Hodgkin lymphoma. But you might have a small operation to remove a lymph node to check for lymphoma cells.

Some people only need one type of treatment. Others need a combination of treatments. You may have steroids alongside chemotherapy, depending on which chemotherapy drugs you are having. People with the rare lymphocyte predominant type of Hodgkin lymphoma may have a type of biological therapy called rituximab.

Planning your treatment

Your doctor takes a number of things into account when deciding your treatment:

  • the stage of Hodgkin lymphoma you have
  • whether you have fevers, sweating and weight loss (B symptoms) or not
  • the type of Hodgkin lymphoma you have
  • your general health and fitness

Your doctor or specialist nurse may recommend that you have flu and pneumonia vaccinations. The vaccinations help to protect you from these infections if you have low immunity during treatment.

Limited (early) stage Hodgkin lymphoma

Limited stage usually means stage 1 or 2A lymphoma.

You will probably have a short course of chemotherapy if you have limited disease. Your doctor might then recommend radiotherapy to the affected lymph nodes. You might also have radiotherapy to your spleen or other lymph nodes.

You might just have radiotherapy to the affected lymph nodes if you have very early, localised disease and are not able to have chemotherapy for any reason.

Early nodular lymphocyte predmoniant Hodgkin lymphoma may not need any treatment. It is a slow growing cancer and your doctor may prefer to wait before giving you any treatment. 

Advanced stage Hodgkin lymphoma

Advanced stage generally means that you have stage 2B, 3 or 4 Hodgkin lymphoma.

You are most likely to have chemotherapy with or without steroids. You may also have radiotherapy to particular groups of lymph nodes if they are very swollen (enlarged) or causing symptoms.

Lymphoma that has come back

You might have high dose chemotherapy with a stem cell or bone marrow transplant, if your lymphoma comes back after treatment (relapses). Or your doctor might suggest treatment with a biological therapy drug called brentuximab.

Or you might have more chemotherapy or radiotherapy, depending on the treatment you have already had.

Lymphoma that does not respond

Sometimes Hodgkin lymphoma does not respond as well to initial treatment as your doctor would hope. You might have more treatment, for example, radiotherapy as well as chemotherapy. Or they may change your chemotherapy drugs, or give you the biological therapy drug brentuximab. 

Or your doctor might suggest high dose chemotherapy treatment with a stem cell or bone marrow transplant.

Fertility and cancer treatment

Chemotherapy and radiotherapy for Hodgkin lymphoma can potentially affect your ability to have a child. So it is important to talk to your doctor about this before you start treatment. They may be able to arrange sperm banking or egg collection before treatment begins. 

Clinical trials

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Last reviewed: 
07 Feb 2018
  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2015

  • Developments in the management of Hodgkin's lymphoma
    L Lowry and others
    The Lancet, 2010. Volume 375, Issue 9717

  • Hoffbrand’s Essential Haematology (7th edition)
    AV Hoffbrand and PAH Moss
    Wiley Blackwell, 2016

  • Novel therapy for Hodgkin lymphoma
    CL Batlevi and  A Younes
    American Society of Hematology, Hematology - The Eduction Programme, 2013, Volume 2013, Number 1

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