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Hodgkin lymphoma

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Follow-up after treatment for Hodgkin lymphoma

Hodgkin lymphoma (HL) behaves differently in each person, and a standard follow-up schedule would not work for everyone. People with HL should talk to their doctor about a follow-up plan that suits their individual situation. Follow-up care is often shared among the cancer specialists (oncologists) and the family doctor.

After treatment has ended, new symptoms and symptoms that don’t go away should be reported to the doctor without waiting for the next scheduled appointment. These may include:

  • swollen (enlarged) lymph nodes
  • fatigue
  • unexplained fever
  • night sweats
  • weight loss
  • itchy skin
  • shortness of breath
  • cough
  • abdominal discomfort

The chance of HL recurring is greatest within 3 years, so close follow-up is needed during this time.

Schedule

Follow-up after HL treatment varies. Follow-up visits are usually scheduled:

  • every 3–6 months for 2 years after initial treatment
  • every 6–12 months for the next 3 years
  • every 1–2 years thereafter

Procedures

During a follow-up visit, the doctor usually asks questions about any new symptoms, new medications, the side effects of treatment and how the person is coping. The doctor may do a complete physical examination, including:

  • feeling the lymph nodes
  • examining the abdomen, thyroid gland and skin

People with HL are encouraged to keep their immunizations up-to-date:

  • the flu vaccine each year
  • the pneumococcal vaccine every 5 years

Tests may be ordered as part of follow-up or if the doctor suspects the cancer has come back (has relapsed).

  • Blood tests, including a complete blood count (CBC), lactate dehydrogenase (LDH) and alkaline phosphatase, are usually done at each visit. Thyroid-stimulating hormone (TSH) is done yearly to check thyroid function if the neck (where the thyroid gland is located) received radiation.
  • A chest x-ray is usually done at each visit if the HL was in the chest. Otherwise, a chest x-ray is done yearly.
  • A CT scan may be done as part of follow-up.
  • For women, mammography is done starting either 10 years after their diagnosis of HL or at age 40, whichever comes first.
  • For women, Pap tests are usually done yearly.

If a relapse is found during follow-up, the oncology team will assess the person with cancer to determine the best treatment options.

See a list of questions to ask your doctor about follow-up after treatment.

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