Frequently Asked Questions

Is my child/adolescent being treated on a treatment plan (regimen) designed for this age group rather than for adults?

Pediatric treatment regimens are designed specifically to minimize the long-term side effects of treatment. Specifically, current pediatric regimens in the Children’s Oncology Group do not use doxorubicin for more than four cycles (4 months) or radiation therapy that exceeds 21 Gy unless the disease has recurred. In most instances, less is used. The care of adolescents and children should be directed by a pediatric oncologist to ensure that the treatment given will reduce the potential for long-term effects of treatment as much as possible.

What are the immediate and long-term side effects of the treatment planned? Are there other regimens that might be as effective with different risks?

Unfortunately, all regimens have potential side effects. For some patients or families, one set of risks is less tolerable than others. Many new clinical trials give the drugs at a faster rate, since this may be more effective. There could be more side effects early on, but the child may need less therapy in total, thus reducing long-term effects. Be sure to talk with your child’s doctor to understand the balance between early side effects and long-term effects. For example, high-dose radiation therapy (without chemotherapy) is often easier and faster than chemotherapy, but the side effects for young people are significant. This approach is not recommended for most children or adolescents.

Under what circumstances should sperm banking be considered?

Boys who will receive alkylating agents should try to bank sperm before treatment begins, since these drugs can cause sterility (alkylating agents most commonly used in Hodgkin lymphoma are cyclophosphamide, nitrogen mustard, procarbazine, and ifosfamide). Your doctor can advise you whether the planned dose is likely to cause significant risk. For boys who are too young to bank sperm, the importance of using a regimen that does not include procarbazine or nitrogen mustard is increased.

If an adolescent girl receives pelvic radiation therapy, can fertility be preserved?

The ovaries can be moved out of the radiation field to try to preserve fertility.

What is recommended for long-term care of my child?

At the end of treatment, it is important to talk with your doctor about which screening tests should be performed in the months, years, and decades that will follow. As the child matures, this information should be passed to them, so they will understand any health risks. The details about the drugs and radiation treatment given should be written down with a recommendation for lifelong follow-up care.