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Treatment of Hodgkin's Disease usually includes chemotherapy and radiation therapy. Most modern treatments for advanced stage Hodgkin's Disease involve the use of both of these treatments. Bone marrow transplantation is also used for special cases of Hodgkin's Disease, and most commonly for recurrence. For most patients, except for biopsy and staging, there is little use of surgery. Chemotherapy Chemotherapy, sometimes referred to simply as "chemo," is the use of drugs for killing cancer cells. Chemo drugs can be either by mouth in pill or liquid form or by injection into the vein or under the skin or into a muscle. Chemotherapy is systemic therapy, and once it enters the body usually circulates throughout the whole system to destroy malignant cells. The Chemotherapy used to treat Hodgkin's Disease traditionally is prescribed in combinations because different drugs kill cancer cells in different ways. The many drugs used in combination to treat Hodgkin's Disease, like in many cancers, are often referred to by abbreviations that are easy to remember. Two common examples which have been used commonly in treating Hodgkin's are MOPP and ABVD. MOPP refers to mechlorethamine (nitrogen mustard), vincristine (Oncovin), procarbazine, and prednisone. ABVD refers to doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine. Chemotherapy drugs kill normal healthy cells as well as malignant cells. Careful attention is given to reduce the unwanted effects of chemotherapy. These " side effects" depend on the type and dose of drugs given and the length of time they are taken. Drugs used in chemotherapy specifically find and destroy cells that are rapidly dividing. These drugs are effective because malignant cells divide faster than normal cells do. Normal tissues such as bone marrow, mouth and intestine lining, and the hair follicles that grow rapidly are the ones most likely to be affected by chemotherapy. As a result, patient often experience hair loss, mouth sores, lowered blood counts and resistance to infection, bleeding, and fatigue. Loss of appetite, nausea, and vomiting result in part from damage to intestinal cells. Effects of drugs on areas of the brain controlling appetite and vomiting also contribute to many of these problems. Most chemotherapy side effects are temporary and alleviate after treatment is finished. Luckily, there are drugs to handle most side effects of chemotherapy treatment. Long-term side effects can include affects on a patient's heart, lungs, growth, and ability to have children. The risk of developing a second type of cancer is also an effect. New studies of promising experimental treatments for patients are known as clinical trials. Clinical trials are usually used when there is reason to believe that the treatment being studied may be of value to the patient. To learn more about clinical trials, visit our clinical trials page. Radiation Therapy Radiation therapy is the use of high-energy rays for the destruction of malignant cells. Hodgkin's Disease usually is treated with a carefully focused beam of radiation and is delivered from a machine outside the body, known as external beam radiation. It is most useful when the disease is localized to one part of the body. At one time, the whole body was radiated to treat Hodgkin's Disease. Today, its more common to treat only the known area of disease with radiation. This is called involved field radiation. After the prescribed courses of chemotherapy, involved field radiation is usually administered. Mantle field radiation is also used in some cases. The mantle field includes the neck, chest, and sometimes the lymph nodes under the arms. Drawbacks to external beam radiation is that the radiation can severely damage nearby healthy tissue along with the malignant cells. Short-term side effects for radiation therapy include skin changes similar to sunburn, tiredness, upset stomach, or loose bowels. Radiation therapy can also have long-term side effects. These effects depend on the dose and location of the therapy, as well as the age of the patient at the time of treatment. These side effects may be heightened by the combination of chemotherapy and radiation treatments. Autologous Bone Marrow Stem Cell Transplantation In some cases, Hodgkin's Disease may become resistant to standard methods of treatment with chemotherapy and radiation therapy. Autologous, or taken from the patient and not a donor, stem cell transplantation is a newer type of treatment and may be offered as part of a clinical trial or also may be administered outside of a clinical trial. In this treatment, the patient's own bone marrow is taken out and stored. During the transplantation, very high doses of chemotherapy, with or without radiation therapy, are given to kill the malignant cells. These high doses of chemotherapy destroy bone marrow. After the high dose treatments, the stored marrow is thawed and given back through a vein where it enters the bloodstream and returns to the bone, replacing the marrow that was destroyed and the blood cells needed to fight infection and carry oxygen throughout the body. Another type of autologous transplant is called peripheral blood stem cell transplant (PBSCT). In this treatment, a machine removes the patient's blood a little at a time, takes out only the stem cells, or immature cells from which all blood cells develop, and returns the rest of the blood to the body. The stem cells that are collected are then frozen until they are returned to the patient during transplant. To learn more about PBSCT's, please visit our Stem Cell Transplantation page.
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