VENOUS ACCESS DEVICE (VAD) Chemotherapy usually is needed to treat Hodgkin lymphoma, and there are several line options to help with your child’s treatment. Because treatment for Hodgkin lymphoma often is brief, a temporary catheter called a peripherally inserted central catheter may be used. Sometimes, a surgeon will insert a small plastic tube called a venous access line or device (i.e., a port) into a large blood vessel, usually under your child’s collar bone. These VADs can be used for blood tests and to give medications, chemotherapy, blood products, and nutritional sup- port when needed. You and your child’s treatment team will decide whether a VAD is necessary. A VAD usually is left in place for the duration of treatment and then removed after the completion of therapy.
n HOW IS HODGKIN LYMPHOMA TREATED? Hodgkin lymphoma is one of the most treatable cancers, with a long-term survival rate of more than 90% after treatment. The goal of treatment for Hodgkin lymphoma is to cure the disease while minimizing any treatment-related side effects or adverse reactions. Chemotherapy and radiation therapy are the two most common therapies used to treat Hodgkin lymphoma.
Chemotherapy Chemotherapy is medicine that helps kill cancer cells and prevents the cancer from spreading. Because no single chemotherapy medicine can control the disease by itself, a variety of medications are given in combination to kill the cancer cells. The exact combination of chemotherapy agents your child receives will depend on the stage of the disease and other treatment considerations. Many chemotherapy medications are administered through a vein or VAD, although some are given by mouth. Most chemotherapy treatments are administered in an outpatient clinic; however, some treatments may require hospitalization. Close monitoring of your child will be a priority when they receive chemotherapy. Your child’s treatment team will explain the possible side effects of the specific chemotherapy medicines your child receives. Radiation Therapy Radiation therapy uses a special type of X-ray treatment that kills or damages cancer cells and may be given before or after chemotherapy. When radiation is used to treat Hodgkin lymphoma, it typically is given after the completion of chemotherapy. Because radiation can result in harm to normal tissues and organs, even long after completion of the therapy, the focus has been on avoiding radiation as much as possible in the treatment of Hodgkin lymphoma. The use of PET scans has enabled treatment providers to identify children who respond well to the first two cycles (1 month each cycle) of chemotherapy treatment. Current research has shown that this group of patients may be cured with only chemotherapy (i.e., they do not receive any radiation) or with small doses of radiation in addition to chemotherapy. However, this is still under investigation and may not be the standard practice where your child is receiving treatment. Children who do not respond well to 2 months of chemotherapy may go on to receive radiation. If radiation therapy is necessary for your child, the radiation therapy doctor will explain to you exactly how the radiation will be given and how long the treatments will last. Most children experience very few side effects while they are receiving radiation therapy. However, some children may feel more tired, have a decreased appetite, or experience redness or darkness of the treated skin. The side effects most likely to occur typically depend on the area of the body being treated. In general, most side effects stop after treatment; however, side effects also can occur after treatment stops. Your child’s treatment team will explain any possible late effects in detail.
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