Treatment for Stage 4 Hodgkin's Disease
Dear OncoLink "Ask The Experts,"
My daughter was diagnosed last March with Hodgkin's, stage 4. She had extensive tumors in the lungs, liver, and spleen. After 6 months of ABVD chemo they now show no activity on a PET scan. I have searched but have been unable to find much info on what might come next. She goes back next month for more. Unfortunately, she seems to be developing itchy skin and sight flushing of her skin. If the cancer is active again would another course of chemo be recommended or a bone marrow transplant?
I really appreciate your attention to this matter.
Selina M. Luger, MD, Director of the Leukemia Program and Assistant Professor of Medicine at the University of Pennsylvania, responds:
The answer to this question really depends on why your daughter is having the symptoms you describe. Generally once primary therapy is completed and the patient is found to be in remission, patients undergo routine follow-up with scheduled visits, examinations and CT scans. There is not usually any additional therapy unless there is evidence of residual or recurrent disease. If indeed her disease is back, then you are correct that stem cell transplantation may be one of her treatment options, but when it would be done depends on what they find in her evaluation and her response to any additional chemotherapy should they feel that she needs some at this point.