Hodgkin Disease

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Treating Hodgkin Disease TOPICS

Treating Hodgkin disease in children

Treatment of Hodgkin disease in children is slightly different from the treatment used for adults. Children’s bodies tend to tolerate chemotherapy better in the short term than adults do. But some side effects are more likely to occur in children. And because some of these side effects could be long-term, children who survive their cancer need careful attention for the rest of their lives.

Since the 1960s, most children and teens with cancer have been treated at special centers designed for them. Being treated in these centers offers them the advantage of having a team of specialists who are experienced with the differences between adult and childhood cancers, as well as the unique needs of children with cancer. This team usually includes pediatric oncologists, surgeons, radiation oncologists, pathologists, pediatric oncology nurses, and nurse practitioners.

Childhood cancer centers also have psychologists, social workers, child life specialists, nutritionists, rehabilitation and physical therapists, and educators who can support and educate the entire family.

Most children with cancer in the United States are treated at a center that is a member of the Children’s Oncology Group (COG). All of these centers are associated with a university or children’s hospital. As we have learned more about treating childhood cancer, it has become even more important that treatment be given by experts in this area.

In these centers, doctors treating children with Hodgkin disease often use treatment plans that are part of clinical trials. The purpose of these studies is to find the most effective treatment that causes the fewest side effects.

Differences from treatment in adults

As in adults, the major goal of treatment is to cure the child without causing long-term problems. If the child is sexually mature and muscles and bones are fully developed, treatment is usually the same as that given to adults. But if the child has not reached his or her full body size, chemotherapy will likely be favored over radiation therapy. Radiation could affect bone and muscle growth and prevent children from reaching their normal size.

When treating children, doctors often combine chemotherapy with low doses of radiation. The chemotherapy often includes combinations of many drugs rather than just the usual adult ABVD regimen, especially for cancers that are unfavorable or are more advanced. This approach has had excellent success rates, even for children with more advanced disease.

Stages IA and IIA, favorable: Treatment generally starts with chemotherapy alone, used at the lowest dose that is likely to result in a cure. If the disease doesn’t go away completely, radiation therapy or more chemotherapy might be added.

If radiation therapy is used, the dose and field are kept as small as possible. If radiation is used below the diaphragm in girls and young women, the ovaries should be protected. Damage to the ovaries might prevent them from ever being able to become pregnant.

Stages I and II, unfavorable: Treatment is likely to consist of more intense chemotherapy combined with radiation therapy, although the dose and field of radiation are kept as small as possible.

Stages III and IV: Treatment includes more intense chemotherapy, either alone or combined with low-dose radiation therapy to areas with bulky disease (areas that contain a lot of Hodgkin disease).

Last Medical Review: 12/10/2012
Last Revised: 02/07/2014