When I have the opportunity to talk to a patient
about their diagnosis with Hodgkin’s disease or non-Hodgkin’s lymphoma, we generally talk
about the process that leads to the correct diagnosis, how that is accomplished with the
assistance of other doctors and how a treatment plan is formulated. For example, many patients who have these
diseases present with a swelling gland or lymph node. To correctly diagnose the patient,
the patient must undergo a lymph node biopsy procedure, which is generally performed by
a surgeon. Once that tissue is obtained, it is submitted to the pathologist who can study
that tissue, make the appropriate test, and render an accurate diagnosis. It is very important
that we know the exact type of Hodgkin’s disease or nonHodgkin’s lymphoma so that we can correctly
formulate a treatment plan. Once we have a diagnosis, the patient will
generally be asked to undergo a series of tests, generally including blood work and
scans and oftentimes an additional invasive test called a bone marrow biopsy and aspiration.
The reason that we perform all these tests is to determine the accurate clinical stage
of the patient. Clinical stage is vitally important to formulating
a treatment plan and will help to determine whether or not additional specialists beyond
the medical oncologist are required to assist in the care of the patient. Once the exact diagnosis is made and the proper
clinical stage established, the patient will have a conference visit with the managing
physician to determine the appropriate treatment plan for their disease. This will generally
include chemotherapy but also may require the assistance of a radiation oncology doctor
to assist in curative treatment plan as most of these diseases can be cured. There are a small number of these diseases
that cannot be cured but can be very favorably treated with proper care so it is important
that the patient have that opportunity to learn and understand about their disease process
so that the proper treatment plan can be undertaken. Many times patients are very apprehensive
about taking chemotherapy and that is because there is a lot of fear and skepticism about
those sorts of treatments. It is very important to understand in patients who have Hodgkin’s
disease or non-Hodgkin’s lymphoma that this chemotherapy treatment can very oftentimes
result in complete resolution of symptoms and sometimes cure. Chemotherapy is generally a medication that
is either administered by the vein, intravenous or orally by the mouth. It is always important
that the patient understand the exact nature of the chemotherapy medications that are to
be prescribed, the side effects to expect and how to manage them. It is also very important
when patients have Hodgkin’s disease or non-Hodgkin’s lymphoma that they receive their treatment
at full dose and on schedule so that the proper result can be obtained. For patients who are going to also be treated
with radiation, they will meet with their radiation cancer doctor to determine the timing,
dose and schedule of that radiation and how it will be added to the chemotherapy. The
one thing it is always important for patients to remember is that their team of Doctors
is looking for them to have the best possible outcome.