Sunday, February, 12, 2012

Hodgkin's Disease - Staging and Treatment Guidelines

Table of Contents

Stage II. Disease is limited to two or more lymph nodes on the same side of (above or below) the diaphragm or extends locally from the lymph node into a nearby organ.

Stage III. Disease is in lymph nodes on both sides of the diaphragm or has spread to nearby organs, the spleen, or both.

Stage IV. Disease has become widespread involving organs outside the lymph system, such as liver, lung, or bone marrow.

Treatment Options by Stage

Early Stages (I or II). For disease in stages I or II, the following treatments may be used:

  • Treatment in Adults. Doctors usually recommend chemotherapy and sometimes radiation therapy as the first-line treatments for adults with Hoddkin's. Treatment provides excellent remission rates, although it may produce serious long-term complications in some patients. Select patients in early stages may also be candidates for radiation limited only to areas above the diaphragm (called the mantle field).
  • Treatment in Children. Chemotherapy and low-dose radiation is the standard treatment for most children and adolescents who have not reached full growth. Specific chemotherapy combinations have been developed to reduce the risks for infertility, leukemia, and toxic effects on the heart and lungs.

Later Stages. For stage III disease, chemotherapy, often with radiation, is a standard treatment. For stage IV disease, chemotherapy alone is generally recommended. Newer types of chemotherapy regimens are achieving survival rates that reach 90%.

Relapse. Relapse after treatment occurs in 20 - 35% of patients. Treatments for relapse include chemotherapy, radiation, and bone marrow or blood stem cell transplantation. Many patients respond favorably to such treatments, although another relapse is still possible.

Preparing for Side Effects before Treatment

Review Date: 01/27/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)