After Treatment

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 (usually less than months) and the outcome is often excellent, there are several potential long-term consequences as a result of treatment. These include cardiac/heart (after doxorubicin or radiation therapy), pulmonary/lung (bleomycin, radiation therapy), thyroid (radiation therapy), secondary cancer (radiation therapy or chemotherapy), and reproductive effects (procarbazine, nitrogen mustard, pelvic radiation). In addition, those who had a splenectomy (surgical removal of the spleen) have an ongoing risk of serious infection.

In most Hodgkin lymphoma survivors, the medical side effects of treatment do not significantly limit 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, many 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 stamina. Sterility or infertility may also affect the young adult who is hoping to some day start a family. Newer reproductive technologies may help some of these individuals; current treatment plans also attempt to reduce exposure to alkylating agents to limit such risks.

Based on the type of treatment the child received, the doctor will determine what examinations and tests are needed to check for long-term side effects and the possibility of secondary cancers. Your child’s doctor can recommend the necessary screening tests. Follow-up care should also address the 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, so that as the child enters adulthood, he or she has a clear, written history of the diagnosis and details of the treatment given. The doctor’s office can help you compile this, and it should include recommendations from the doctor about the schedule for follow-up care. This information will be valuable to doctors who care for your child during his or her lifetime.

Children 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.

Ongoing follow-up care by health-care professionals experienced in long-term consequences is important. Efforts at preventive health care include breast cancer screening (after mediastinal radiation therapy), smoking cessation (after bleomycin or radiation therapy due to enhanced lung cancer risk) and reduction of risk for atherosclerotic heart disease through exercise, diet, and medication. Such preventative measures may foster better, long-term outcomes and offers the person a degree of control of his or her own health.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: After Treatment.