Lymphoma - Hodgkin - Childhood: After Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 07/2013

ON THIS PAGE: You will read about your child’s medical care after cancer treatment is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for Hodgkin lymphoma ends, talk with your child’s doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your child’s recovery for the coming months and years. All children treated for cancer, including Hodgkin lymphoma, should have life-long, follow-up care.

People with Hodgkin lymphoma are most often adolescents or young adults. While the treatment period is limited and the outcome is often excellent, there are several possible long-term side effects. The long-term side effects of chemotherapy also depend on the type and total dose of each drug. These include:

  • heart problems (after doxorubicin or radiation therapy),
  • lung problems (after bleomycin or radiation therapy),
  • thyroid problems (after radiation therapy),
  • secondary cancers (after radiation therapy or chemotherapy),
  • reproductive effects (after procarbazine, mechlorethamine, or pelvic radiation).

In addition, children who had a splenectomy (surgical removal of the spleen) have an ongoing chance of serious infection. Rarely, children with Hodgkin lymphoma develop a second cancer, acute myeloid leukemia, because of chemotherapy’s effects on bone marrow function. Fortunately, the risk of long-term side effects is much lower with newer treatment plans that limit the doses of drugs that cause serious health problems.

For most Hodgkin lymphoma survivors, the medical side effects of treatment do not significantly affect life span. However, Hodgkin lymphoma survivors report significant concerns regarding their health status compared with other survivors of childhood cancer. This may result from the social and emotional effects of treatment during adolescence, when the adolescent may feel different from healthy peers. In addition, some Hodgkin lymphoma survivors experience long-term fatigue that may require lifestyle changes, such as taking a reduced course load at college or choosing employment that is consistent with the individual’s energy level. Learn more about specific coping strategies for this age group.

Infertility may also affect the young adult who is hoping to someday become pregnant or father a child. Newer reproductive technologies may help some of these individuals; current treatment plans also attempt to reduce exposure to alkylating agents to limit such risks (see Frequently Asked Questions Regarding Hodgkin Lymphoma). Learn more about sexual and reproductive health after cancer.

Based on the type of treatment your child received, the doctor will determine what examinations and screening tests are needed to check for long-term side effects and the possibility of secondary cancers. Follow-up care should also address your child’s quality of life, including any developmental or emotional concerns. Learn more about childhood cancer survivorship.

The child’s family is encouraged to organize and keep a record of the child’s medical information. That way, as your child enters adulthood, he or she has a clear, written history of the diagnosis, the treatment given, and the doctor’s recommendations about the schedule for follow-up care. The doctor’s office can help you create this. This information will be valuable to doctors who care for your child during his or her lifetime. ASCO offers cancer treatment summary forms to help keep track of the cancer treatment your child received and develop a survivorship care plan once treatment is completed.

Children and teens who have had cancer can also enhance the quality of their future by following established guidelines for good health into and through adulthood, including not smoking, maintaining a healthy weight, eating a balanced diet, and participating in regular physical activity. Talk with the doctor about developing a plan that is best for your child’s needs.  Learn more about the next steps to take in survivorship.

Ongoing follow-up care by health care professionals experienced in long-term side effects is important. Preventive health care, including breast cancer screening (after mediastinal radiation therapy), not smoking (after bleomycin or radiation therapy due to enhanced lung cancer risk), and reducing the risk for heart disease through exercise, diet, and medication are important steps for Hodgkin lymphoma survivors. Such preventative measures may foster better, long-term outcomes and offer the person some control of his or her own health.

The next section offers a list of frequently asked questions regarding Hodgkin lymphoma in children and teens. Use the menu on the side of your screen to select Frequently Asked Questions, or you can select another section, to continue reading this guide.