Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies

Continue

Navigation

Hodgkin lymphoma

Hodgkin lymphoma is a type of cancer that affects your lymphatic system (your lymphatic system helps to fight infections). It’s also known as Hodgkin disease. Like all cancers, it’s caused by an abnormal and uncontrolled growth of cells. In the UK, around 2,000 people are diagnosed with Hodgkin lymphoma every year. It’s a relatively uncommon cancer and mostly affects young people. The main treatments include chemotherapy and radiotherapy.

There are two types of lymphoma – Hodgkin lymphoma and non Hodgkin lymphoma. We have a separate topic on non-Hodgkin lymphoma.

How cancer develops
Cells begin to grow in an uncontrolled way

Details

  • The lymphatic system The lymphatic system

    Your lymphatic system includes your bone marrow, spleen, thymus and lymph glands (nodes). Your lymph glands make and store white blood cells called lymphocytes, ready to fight any infections you might get. Your lymphatic system also includes lymph vessels, which carry and recycle fluid (known as lymph fluid) in your body.

    The image below shows where the main glands, organs and vessels of your lymphatic system are. There are groups of lymph glands in your neck, armpit and groin. You may be able to feel some of them under your skin. There are deeper lymph glands in other areas of your body, such as in your abdomen (tummy), pelvis and chest, though you can’t feel these.

    An image showing the lymphatic system 

  • What is Hodgkin lymphoma? What is Hodgkin lymphoma?

    There are many different types of cancer that can develop in the lymphatic system. These are called lymphomas. Hodgkin lymphoma is just one type of these cancers, and you get it in a group of lymph glands in one area of your body.

    Sometimes, the cancer cells can spread through your lymph vessels to lymph glands in other parts of your body. The cancer cells may also spread further in your body to your spleen, liver, lungs or bone marrow.

  • Types Types of Hodgkin lymphoma

    Doctors separate Hodgkin lymphomas into two main groups according to how the cells look under a microscope.

    • Classical type. Most people with Hodgkin lymphoma have this one.
    • Nodular lymphocyte predominant Hodgkin lymphoma. This is rare and affects young adults more than older people.
  • Symptoms Symptoms of Hodgkin lymphoma

    Often, the first symptom of Hodgkin lymphoma that you’ll notice is a swelling in your neck, chest, armpit or groin. This is a swollen lymph gland, which doesn’t usually hurt. It will feel firm (like rubber) rather than hard, and these lumps can appear slowly over time. Other symptoms can include:

    • sweating at night
    • a fever
    • unexplained weight loss
    • an itchy feeling all over your body
    • feeling tired
    • pain in your lymph glands after you drink alcohol
    • a cough
    • shortness of breath
    • pain in your chest or tummy

    These symptoms aren't always caused by Hodgkin lymphoma, but if you have them, contact your GP.

  • Diagnosis Diagnosis of Hodgkin lymphoma

    To diagnose Hodgkin lymphoma, your GP will ask about your symptoms and examine you. They’ll also ask you questions about your medical history. Some of the symptoms of Hodgkin lymphoma are non-specific, which means they could be caused by something else. Depending on your symptoms, your GP may organise some initial tests such as blood tests and a chest X-ray to check for other possible causes. If your GP then suspects you could have Hodgkin lymphoma, they’ll refer you to a hospital specialist for further tests.

    If you have swollen glands and your GP suspects it could be Hodgkin lymphoma, it’s likely that they’ll refer you to a specialist at hospital for further tests straightaway. You’ll usually get an appointment within two weeks (or two days for children).

    Further tests may include having scans (such as a CT scan or positron emission tomography (PET) that look at the inside of your body). You may have a biopsy, where a sample of skin tissue, lymph gland or bone marrow is taken to look at under a microscope. If you have a biopsy taken, this may be done under local or general anaesthesia.

    If you’re diagnosed with Hodgkin lymphoma, tests will look at whether or not the cancer has spread and how big it is. This is described by the ‘stage’ of the disease; from stage 1(the cancer has stayed within the organ it started in) to stage 4 (the cancer has spread from where it started to another part of the body). See Related information for explanations of the terminology used in cancer.

  • Treatment Treatment of Hodgkin's lymphoma

    Your treatment will depend on the type of Hodgkin lymphoma you have, whether or not it has spread, and your general health. Most people have chemotherapy, and some may have radiotherapy too.

    Your healthcare team

    A team of professionals, called a multidisciplinary team (MDT), will guide you through your treatment. This team may include:

    • a haematologist (a doctor who specialises in treating conditions that affect the blood)
    • an oncologist (a doctor who specialises in cancer care)
    • a radiologist (a doctor who specialises in using imaging to diagnose conditions)
    • a radiation oncologist (or clinical oncologist) who uses radiation to treat conditions
    • a specialist nurse
    • a counsellor

    They’ll explain your treatment options and help you decide that treatment is best for you.

    After treatment, your team will assess whether or not there are any remaining signs of cancer. If there are, you’ll need more treatment. You’ll have regular check-ups with your doctor to check for any signs of the cancer returning. You’ll have check-ups every three months for the first couple of years, and gradually, you’ll go less often.

    About eight or nine out of every 10 people with Hodgkin lymphoma go into remission after their treatment and it goes away for good. Remission means the signs and symptoms of cancer have decreased or disappeared. Your cancer can be in complete or partial remission. Complete remission means there are no signs of your cancer. Partial remission means some but not all signs have disappeared.

    Chemotherapy

    Chemotherapy uses medicines to destroy cancer cells. You’ll usually have these medicines through a drip into a vein in your arm. Your team may give you a few different medicines over a few months. You won’t have the medicines everyday – you’ll have breaks to allow your body to recover from the side-effects of the medicines. See our information on chemotherapy to learn about the side-effects of the treatment.

    Your doctor may give you steroid medicines (e.g. prednisolone) alongside your chemotherapy. These medicines help the chemotherapy to work and you usually take them as tablets.

    Radiotherapy

    Radiotherapy uses X-rays to destroy cancer cells. A radiotherapy treatment takes less than 10 minutes. Your radiologist will target a beam of radiation to the cancer to shrink it. Depending on the type of Hodgkin lymphoma you have and its stage, you might have radiotherapy after chemotherapy.

    You’ll need to go to the hospital for radiotherapy treatment, usually from Monday to Friday, and then have a rest over the weekend. How long your course of treatment lasts will depend on the area you’re having it on. Your doctor will let you know how long they expect you’ll need treatment for.

    Monoclonal antibodies

    Monoclonal antibodies are medicines that can recognise and target cancer cells. They aren’t used very often for people with Hodgkin lymphoma. But you may be given a monoclonal antibody medicine called rituximab if you have the nodular lymphocyte predominant type.

    If you’ve already had treatment for Hodgkin lymphoma but it comes back, your doctor may give you an antibody treatment called brentuximab.

    Stem cell transplant

    If you’ve had chemotherapy to treat Hodgkin lymphoma and it hasn’t worked, or the cancer comes back, you might need a higher dose of chemotherapy. This will kill off your stem cells, which your body needs to make new blood cells.

    To stop you becoming unwell, you’ll be offered a stem cell transplant. This is an injection of stem cells into your body to replace the ones you lost. Your body will use the stem cells to make new blood cells to replace the ones the high-dose chemotherapy destroys. For more information about this treatment option, see our FAQ Stem cell transplant.

  • Prompt access to quality care

    From treatment through to aftercare, with our health insurance we aim to get you the help you need, as quickly as possible. Find out more today.

  • Causes Causes of Hodgkin lymphoma

    Doctors don’t know exactly why people develop Hodgkin lymphoma yet, but there are some things that increase your chance of getting it. These include if you:

    • have a weakened immune system (for example, if you have HIV/AIDS, or you’re taking medicines that suppress your immune system)
    • have the Epstein–Barr virus (which causes glandular fever)
    • have previously had non-Hodgkin lymphoma
    • are a man, as it’s slightly more common in men than women
    • are around 25, or 50 to 60, as it’s more common in these age groups (although it can affect people of all ages)
    • are a smoker
  • FAQ: Stem cell transplant Where do the cells come from?

    Your doctor will usually take the stem cells from your own blood before you begin high-dose chemotherapy or, much less frequently, from your bone marrow. If for some reason this isn’t possible, the stem cells will need to come from another person. This will usually be from a close family member, such as your brother or sister, because their cells are most likely to match your own. If you don’t have any siblings, or they aren’t a good match, you might have stem cells from a donor who’s unrelated to you. For information about what happens, see Bone marrow (stem cell) transplant.

  • FAQ: Stem cell transplant effects How will a stem cell transplant affect me?

    This treatment affects everyone differently and the length of time it takes to recover varies. But the side-effects usually come from the high-dose chemotherapy you have before the transplant, not the transplant itself.

    After having a stem cell transplant, you’ll be in hospital for around three weeks. At first, you’ll probably have a sore mouth, feel sick and have diarrhoea. You’ll have fewer white blood cells in your body after your stem cell transplant so will be more at risk of getting infections. You’ll need to take antibiotics to prevent these. And your red blood cell count will be down too, which might make you feel tired and breathless. You’ll need to have blood transfusions to top up your red blood cells.

    Once you leave hospital and go home, you’ll continue to make a steady recovery but might still feel tired and weak. It can take about three to six months to recover fully and go back to work.

    You’ll need to have new vaccinations against diseases, because you will have lost any immunity you previously had. You’ll also be offered the annual flu vaccine.

    See our information on chemotherapy and bone marrow (stem cell) transplant to learn more about the side-effects of both.

  • FAQ: Having children Will I be able to have children after treatment?

    Both chemotherapy and radiotherapy can reduce your chances of having children or cause infertility.

    Some chemotherapy medicines can cause infertility, particularly if you have very high doses. Radiotherapy may also affect your fertility if you have it in your pelvic or abdominal area (tummy).

    You might be able to freeze your eggs or sperm before you start treatment. But remember it’s not always possible to do this before you start treatment, and infertility treatments don’t always work. Ask your doctor about your treatment and what your options are.

  • Other helpful websites Other helpful websites

    Further information

    Sources

    • Eichenauer DA, Engert A, André M, et al. Hodgkin's lymphoma: ESMO clinical practice guidelines. Ann Oncol 2014; 25(suppl 3):iii70–iii75. doi:10.1093/annonc/mdu181
    • Hodgkin's lymphoma. PatientPlus. patient.info/patientplus, last checked 14 May 2014
    • Mckay P, Fielding P, Gallop-Evans E, et al. Guidelines for the investigation and management of nodular lymphocyte predominant Hodgkin lymphoma. Br J Haematol 2015; 172:32–43. doi:10.1111/bjh.13842
    • Haematological cancers – recognition and referral. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised November 2015
    • Hodgkin's lymphoma. BMJ Best Practice. bestpractice.bmj.com, last updated 26 January 2017
    • Lymphatic system anatomy. Medscape. emedicine.medscape.com, updated 19 September 2013
    • The lymphatic system and cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 29 October 2014
    • Overview of the lymphatic system. The MSD Manuals. www.msdmanuals.com, last full review/revision October 2015
    • Haematological malignancies. Oxford handbook of oncology (online). Oxford Medicine Online. oxfordmedicine.com, published September 2015
    • Map of medicine. Lymphoma. International view. London: Map of medicine; 2016 (issue 4)
    • Suspected cancer: recognition and referral. National Institute for Health and Care Excellence (NICE), 23 June 2015. www.nice.org.uk
    • Bone marrow test. Cancer Research UK. www.cancerresearchuk.org, last reviewed 13 April 2015
    • Treatment decisions. Cancer Research UK. www.cancerresearchuk.org, last reviewed 29 December 2014
    • NCI dictionary of cancer terms. National Cancer Institute. www.cancer.gov, accessed 27 February 2017
    • Hodgkin lymphoma. National Comprehensive Cancer Network. www.nccn.org, published 2015
    • Radiotherapy treatment. Cancer Research UK. www.cancerresearchuk.org, last reviewed 6 January 2015
    • Brentuximab vedotin. NICE British National Formulary. www.evidence.nhs.uk/formulary/bnf/current, reviewed 28 April 2017
    • Hematopoietic stem cell transplantation. Medscape. emedicine.medscape.com, updated 23 April 2016
    • Side effects of bone marrow and stem cell transplants. Cancer Research UK. www.cancerresearchuk.org, last reviewed 17 March 2015
    • Autologous stem cell transplant. Lymphoma Association. www.lymphomas.org.uk, last reviewed July 2016
    • The green book immunisation of individuals with underlying medical conditions. Gov.UK. www.gov.uk, last updated 29 September 2016
    • Radiation therapy for Hodgkin disease. American Cancer Society. www.cancer.org, last revised 23 May 2016
  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
    Ask us a question
  • Related information Related information

  • Author information Author information

    Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, May 2017
    Expert reviewer, Dr Prem Mahendra, Consultant Haematologist
    Next review due May 2020

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.

    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information:
    verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Nick Ridgman

Nick Ridgman
Head of Health Content







  • Dylan Merkett – Lead Editor
  • Graham Pembrey - Lead Editor
  • Natalie Heaton – Specialist Editor, User Experience
  • Pippa Coulter – Specialist Editor, Content Library
  • Alice Rossiter – Specialist Editor, Insights (on Maternity Leave)
  • Laura Blanks – Specialist Editor, Quality
  • Michelle Harrison – Specialist Editor, Insights

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.

Readable

In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.

Reliable

We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.

Relevant

We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: healthinfo@bupa.com. Or you can write to us:

Health Content Team
Battle Bridge House
300 Grays Inn Road
London
WC1X 8DU

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.