National Cancer Institute

What You Need 

To Know About TM

Hodgkin

Lymphoma

U.S. DEPARTMENT OF 

HEALTH AND HUMAN SERVICES

National Institutes of Health

U.S. DEPARTMENT OF

HEALTH AND HUMAN SERVICES

National Institutes of Health

National Cancer Institute

Contents

About This Booklet 1

What Is Hodgkin Lymphoma? 2

Risk Factors 5

Symptoms 6

Diagnosis 6

Staging 9

Treatment 11

Second Opinion 19

Nutrition and Physical Activity 20

Follow-up Care 21

Sources of Support 22

Taking Part in Cancer Research 23

Dictionary 25

National Cancer Institute Information Resources 35

National Cancer Institute Publications 36
About This Booklet

This National Cancer Institute (NCI) booklet is

about Hodgkin lymphoma,* a cancer that starts in the

immune system. This type of cancer is also called

Hodgkin disease. Every year in the United States, more

than 8,000 people learn they have this disease.

Cancer research has led to real progress against

Hodgkin lymphoma. Most people diagnosed with

Hodgkin lymphoma can now be cured, or their disease

can be controlled for many years. Continuing research

offers hope that, in the future, even more people with

this disease will be treated successfully. 

This booklet tells about diagnosis, staging,

treatment, and follow-up care. Learning about the

medical care for Hodgkin lymphoma can help you take

an active part in making choices about your own care. 

This booklet has lists of questions to ask your

doctor. Many people find it helpful to take a list of

questions to a doctor visit. To help remember what

1

*Words in italics are in the Dictionary on page 25. The Dictionary

explains these terms. It also shows how to pronounce them.

This booklet is only about Hodgkin lymphoma.

It is not about non-Hodgkin lymphoma (also

called NHL). 

People with non-Hodgkin lymphoma have

different treatment options. Instead of this

booklet, they may want to read What You Need To

Know AboutTM Non-Hodgkin Lymphoma. Page 36

tells how to get NCI booklets.
your doctor says, you can take notes or ask whether

you may use a tape recorder. You may also want to

have a family member or friend go with you when you

talk with the doctor—to take part in the discussion, to

take notes, or just to listen. 

For the latest information about Hodgkin

lymphoma, please visit our Web site at

http://www.cancer.gov/cancertopics/types/

hodgkin. We have materials on Hodgkin lymphoma in

adults and children. Or, contact our Cancer Information

Service. We can answer your questions about cancer.

We can send you NCI booklets and fact sheets. Call

1–800–4–CANCER (1–800–422–6237) or instant

message us through the LiveHelp service at

http://www.cancer.gov/help. 

What Is Hodgkin Lymphoma? 

Hodgkin lymphoma is a cancer that begins in cells

of the immune system. The immune system fights

infections and other diseases. 

The lymphatic system is part of the immune system.

The lymphatic system includes the following:

• Lymph vessels: The lymphatic system has a network

of lymph vessels. Lymph vessels branch into all the

tissues of the body.

• Lymph: The lymph vessels carry clear fluid called

lymph. Lymph contains white blood cells, especially

lymphocytes such as B cells and T cells. 

• Lymph nodes: Lymph vessels are connected to

small, round masses of tissue called lymph nodes.

Groups of lymph nodes are found in the neck,

underarms, chest, abdomen, and groin. Lymph

nodes store white blood cells. They trap and remove

bacteria or other harmful substances that may be in

the lymph.

2
• Other parts of the lymphatic system: Other parts

of the lymphatic system include the tonsils, thymus,

and spleen. Lymphatic tissue is also found in other

parts of the body including the stomach, skin, and

small intestine. 

3

Tonsil

Diaphragm

Lymph

nodes

Lymph

vessels

Spleen

Thymus

This picture shows lymph nodes above and below the

diaphragm. It also shows the lymph vessels, tonsils,

thymus, and spleen.
Because lymphatic tissue is in many parts of the

body, Hodgkin lymphoma can start almost anywhere.

Usually, it’s first found in a lymph node above the

diaphragm, the thin muscle that separates the chest

from the abdomen. But Hodgkin lymphoma also may

be found in a group of lymph nodes. Sometimes it

starts in other parts of the lymphatic system. 

Hodgkin Lymphoma Cells

Hodgkin lymphoma begins when a lymphocyte

(usually a B cell) becomes abnormal. The abnormal

cell divides to make copies of itself.

Hodgkin lymphoma cells are called Reed-Sternberg

cells. (See photo below.) They don’t protect the body

from infections or other diseases. They also don’t die

when they should.

The lymph node that contains Reed-Sternberg cells

becomes enlarged, and the abnormal cells can spread

throughout the body. See the Staging section on page 9

for information about Hodgkin lymphoma that has

spread.

4

Reed-Sternberg cells are much larger than normal

cells.

Normal

lymphocyte

ReedSternberg 

cell
Risk Factors

Doctors seldom know why one person develops

Hodgkin lymphoma and another does not. But research

shows that certain risk factors increase the chance that

a person will develop this disease. 

The risk factors for Hodgkin lymphoma include the

following: 

• Certain viruses: Having an infection with the

Epstein-Barr virus (EBV) or the human

immunodeficiency virus (HIV) may increase the risk

of developing Hodgkin lymphoma. However,

lymphoma is not contagious. You can’t catch

lymphoma from another person. 

• Weakened immune system: The risk of developing

Hodgkin lymphoma may be increased by having a

weakened immune system (such as from an

inherited condition or certain drugs used after an

organ transplant). 

• Age: Hodgkin lymphoma is most common among

teens and adults aged 15 to 35 years and adults aged

55 years and older. (For information about this

disease in children, call the NCI’s Cancer

Information Service at 1–800–4–CANCER.)

• Family history: Family members, especially

brothers and sisters, of a person with Hodgkin

lymphoma or other lymphomas may have an

increased chance of developing this disease. 

Having one or more risk factors does not mean that

a person will develop Hodgkin lymphoma. Most

people who have risk factors never develop cancer. 

5
Symptoms

Hodgkin lymphoma can cause many symptoms: 

• Swollen lymph nodes (that do not hurt) in the neck,

underarms, or groin 

• Becoming more sensitive to the effects of alcohol or

having painful lymph nodes after drinking alcohol

• Weight loss for no known reason 

• Fever that does not go away

• Soaking night sweats 

• Itchy skin

• Coughing, trouble breathing, or chest pain 

• Weakness and tiredness that don’t go away 

Most often, these symptoms are not due to cancer.

Infections or other health problems may also cause

these symptoms. Anyone with symptoms that last more

than 2 weeks should see a doctor so that problems can

be diagnosed and treated. 

Diagnosis

If you have swollen lymph nodes or another

symptom that suggests Hodgkin lymphoma, your

doctor will try to find out what’s causing the problem.

Your doctor may ask about your personal and family

medical history. 

You may have some of the following exams and

tests: 

• Physical exam: Your doctor checks for swollen

lymph nodes in your neck, underarms, and groin.

Your doctor also checks for a swollen spleen or

liver.

6
• Blood tests: The lab does a complete blood count to

check the number of white blood cells and other

cells and substances. 

• Chest x-rays: X-ray pictures may show swollen

lymph nodes or other signs of disease in your chest. 

• Biopsy: A biopsy is the only sure way to diagnose

Hodgkin lymphoma. Your doctor may remove an

entire lymph node (excisional biopsy) or only part of

a lymph node (incisional biopsy). A thin needle (fine

needle aspiration) usually cannot remove a large

enough sample for the pathologist to diagnose

Hodgkin lymphoma. Removing an entire lymph

node is best.

The pathologist uses a microscope to check the

tissue for Hodgkin lymphoma cells. A person with

Hodgkin lymphoma usually has large, abnormal

7
cells known as Reed-Sternberg cells. They are not

found in people with non-Hodgkin lymphoma. See

page 4 for a photo of a Reed-Sternberg cell.

Types of Hodgkin Lymphoma

When Hodgkin lymphoma is found, the pathologist

reports the type. There are two major types of Hodgkin

lymphoma:

• Classical Hodgkin lymphoma: Most people with

Hodgkin lymphoma have the classical type. The

Reed-Sternberg cell looks like the photo on page 4.

• Nodular lymphocyte-predominant Hodgkin

lymphoma: This is a rare type of Hodgkin

lymphoma. The abnormal cell is called a popcorn

cell. It may be treated differently from the classical

type.

8

You may want to ask your doctor these

questions before having a biopsy:

• How will the biopsy be done? 

• Will I have to stay in the hospital?

• Will I have to do anything to prepare for it?

• How long will it take? Will I be awake? Will it

hurt?

• Are there any risks? What are the chances of

swelling, infection, or bleeding after the

procedure?

• How long will it take me to recover? 

• How soon will I know the results? Who will

explain them to me?

• If I do have cancer, who will talk to me about

next steps? When?
Staging

Your doctor needs to know the extent (stage) of

Hodgkin lymphoma to plan the best treatment. Staging

is a careful attempt to find out what parts of the body

are affected by the disease. 

Hodgkin lymphoma tends to spread from one group

of lymph nodes to the next group. For example,

Hodgkin lymphoma that starts in the lymph nodes in

the neck may spread first to the lymph nodes above the

collarbones, and then to the lymph nodes under the

arms and within the chest. 

In time, the Hodgkin lymphoma cells can invade

blood vessels and spread to almost any other part of

the body. For example, it can spread to the liver, lungs,

bone, and bone marrow.

Staging may involve one or more of the following

tests:

• CT scan: An x-ray machine linked to a computer

takes a series of detailed pictures of your chest,

abdomen, and pelvis. You may receive an injection

of contrast material. Also, you may be asked to

drink another type of contrast material. The contrast

material makes it easier for the doctor to see swollen

lymph nodes and other abnormal areas on the x-ray. 

• MRI: A powerful magnet linked to a computer is

used to make detailed pictures of your bones, brain,

or other tissues. Your doctor can view these pictures

on a monitor and can print them on film. 

• PET scan: You receive an injection of a small

amount of radioactive sugar. A machine makes

computerized pictures of the sugar being used by

cells in your body. Lymphoma cells use sugar faster

than normal cells, and areas with lymphoma look

brighter on the pictures.

9
• Bone marrow biopsy: The doctor uses a thick

needle to remove a small sample of bone and bone

marrow from your hipbone or another large bone.

Local anesthesia can help control pain. A

pathologist looks for Hodgkin lymphoma cells in the

sample. 

Other staging procedures may include biopsies of

other lymph nodes, the liver, or other tissue. 

The doctor considers the following to determine the

stage of Hodgkin lymphoma:

• The number of lymph nodes that have Hodgkin

lymphoma cells 

• Whether these lymph nodes are on one or both sides

of the diaphragm (see picture on page 3)

• Whether the disease has spread to the bone marrow,

spleen, liver, or lung.

The stages of Hodgkin lymphoma are as follows:

• Stage I: The lymphoma cells are in one lymph node

group (such as in the neck or underarm). Or, if the

lymphoma cells are not in the lymph nodes, they are

in only one part of a tissue or an organ (such as the

lung). 

• Stage II: The lymphoma cells are in at least two

lymph node groups on the same side of (either

above or below) the diaphragm. Or, the lymphoma

cells are in one part of a tissue or an organ and the

lymph nodes near that organ (on the same side of

the diaphragm). There may be lymphoma cells in

other lymph node groups on the same side of the

diaphragm. 

• Stage III: The lymphoma cells are in lymph nodes

above and below the diaphragm. Lymphoma also

may be found in one part of a tissue or an organ

(such as the liver, lung, or bone) near these lymph

node groups. It may also be found in the spleen.

10
• Stage IV: Lymphoma cells are found in several

parts of one or more organs or tissues. Or, the

lymphoma is in an organ (such as the liver, lung, or

bone) and in distant lymph nodes. 

• Recurrent: The disease returns after treatment.

In addition to these stage numbers, your doctor may

also describe the stage as A or B:

• A: You have not had weight loss, drenching night

sweats, or fevers.

• B: You have had weight loss, drenching night

sweats, or fevers. 

Treatment

Your doctor can describe your treatment choices and

the expected results. You and your doctor can work

together to develop a treatment plan that meets your

needs. 

Your doctor may refer you to a specialist, or you

may ask for a referral. Specialists who treat Hodgkin

lymphoma include hematologists, medical oncologists,

and radiation oncologists. Your doctor may suggest

that you choose an oncologist who specializes in the

treatment of Hodgkin lymphoma. Often, such doctors

are associated with major academic centers. Your

health care team may also include an oncology nurse

and a registered dietitian.

The choice of treatment depends mainly on the

following:

• The type of your Hodgkin lymphoma (most people

have classical Hodgkin lymphoma)

• Its stage (where the lymphoma is found)

• Whether you have a mass or tumor that is more than

4 inches (10 centimeters) wide

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• Your age

• Whether you’ve had weight loss, drenching night

sweats, or fevers. 

People with Hodgkin lymphoma may be treated with

chemotherapy, radiation therapy, or both. 

If Hodgkin lymphoma comes back after treatment,

doctors call this a relapse or recurrence. People with

Hodgkin lymphoma that comes back after treatment

may receive high doses of chemotherapy, radiation

therapy, or both, followed by stem cell transplantation.

You may want to know about side effects and how

treatment may change your normal activities. Because

chemotherapy and radiation therapy often damage

healthy cells and tissues, side effects are common. Side

effects may not be the same for each person, and they

may change from one treatment session to the next.

Before treatment starts, your health care team will

explain possible side effects and suggest ways to help

you manage them. The younger a person is, the easier

it may be to cope with treatment and its side effects. 

At any stage of the disease, you can have supportive

care. Supportive care is treatment to prevent or fight

infections, to control pain and other symptoms, to

relieve the side effects of therapy, and to help you cope

with the feelings that a diagnosis of cancer can bring.

You can get information about coping on NCI’s Web

site at http://www.cancer.gov/cancertopics/coping

and from NCI’s Cancer Information Service at

1–800–4–CANCER or LiveHelp

(http://www.cancer.gov/help).

You may want to talk to your doctor about taking

part in a clinical trial, a research study of new

treatment methods. See the Taking Part in Cancer

Research section on page 23.

12
13

You may want to ask your doctor these

questions before you begin treatment:

• What type of Hodgkin lymphoma do I have?

May I have a copy of the report from the

pathologist?

• What is the stage of my disease? Where are the

tumors?

• What are my treatment choices? Which do you

recommend for me? Why? 

• Will I have more than one kind of treatment?

• What are the expected benefits of each kind of

treatment?

• What are the risks and possible side effects of

each treatment? What can we do to control the

side effects?

• How long will the treatment last?

• What can I do to prepare for treatment?

• Will I need to stay in the hospital? If so, for

how long?

• What is the treatment likely to cost? Will my

insurance cover the cost?

• How will treatment affect my normal

activities? 

• Would a clinical trial be right for me?

• How often should I have checkups after

treatment?
Chemotherapy

Chemotherapy for Hodgkin lymphoma uses drugs to

kill lymphoma cells. It is called systemic therapy

because the drugs travel through the bloodstream. The

drugs can reach lymphoma cells in almost all parts of

the body. 

Usually, more than one drug is given. Most drugs

for Hodgkin lymphoma are given through a vein

(intravenous), but some are taken by mouth. 

Chemotherapy is given in cycles. You have a

treatment period followed by a rest period. The length

of the rest period and the number of treatment cycles

depend on the stage of your disease and on the

anticancer drugs used.

You may have your treatment in a clinic, at the

doctor’s office, or at home. Some people may need to

stay in the hospital for treatment.

The side effects depend mainly on which drugs are

given and how much. The drugs can harm normal cells

that divide rapidly: 

• Blood cells: When chemotherapy lowers the levels

of healthy blood cells, you are more likely to get

infections, bruise or bleed easily, and feel very weak

and tired. Your health care team gives you blood

tests to check for low levels of blood cells. If levels

are low, there are medicines that can help your body

make new blood cells.

• Cells in hair roots: Chemotherapy may cause hair

loss. If you lose your hair, it will grow back, but it

may be somewhat different in color and texture.

• Cells that line the digestive tract: Chemotherapy

can cause poor appetite, nausea and vomiting,

diarrhea, or mouth and lip sores. Ask your health

care team about medicines and other ways to help

you cope with these problems.

14
Some types of chemotherapy can cause infertility: 

• Men: Chemotherapy may damage sperm cells.

Because these changes to sperm may be permanent,

some men have their sperm frozen and stored before

treatment (sperm banking). 

• Women: Chemotherapy may damage the ovaries.

Women who may want to get pregnant in the future

should ask their health care team about ways to

preserve their eggs before treatment starts.

Some of the drugs used for Hodgkin lymphoma may

cause heart disease or cancer later on. See the Followup Care section on page 21 for information about

checkups after treatment.

You may find it helpful to read NCI’s booklet

Chemotherapy and You. Page 36 tells how to get NCI

booklets.

15

You may want to ask your doctor these

questions before having chemotherapy:

• Which drugs will I have? What are the

expected benefits?

• When will treatment start? When will it end?

How often will I have treatments? 

• Where will I go for treatment? Will I be able to

drive home afterward?

• What can I do to take care of myself during

treatment?

• How will we know the treatment is working?

• What side effects should I tell you about? Can

I prevent or treat any of these side effects?

• Will there be lasting side effects?
Radiation Therapy

Radiation therapy (also called radiotherapy) for

Hodgkin lymphoma uses high-energy rays to kill

lymphoma cells. It can shrink tumors and help control

pain. 

A large machine aims the rays at the lymph node

areas affected by lymphoma. This is local therapy

because it affects cells in the treated area only. Most

people go to a hospital or clinic for treatment 5 days a

week for several weeks. 

The side effects of radiation therapy depend mainly

on the dose of radiation and the part of the body that is

treated. For example, radiation to your abdomen can

cause nausea, vomiting, and diarrhea. When your chest

and neck are treated, you may have a dry, sore throat

and some trouble swallowing.

In addition, your skin in the area being treated may

become red, dry, and tender. You also may lose your

hair in the treated area. 

Many people become very tired during radiation

therapy, especially in the later weeks of treatment.

Resting is important, but doctors usually advise people

to try to stay as active as they can. 

Although the side effects of radiation therapy can be

distressing, they can usually be treated or controlled.

You can talk with your doctor about ways to ease these

problems. 

It may also help to know that, in most cases, the

side effects are not permanent. However, you may

want to discuss with your doctor the possible long-term

effects of radiation treatment. After treatment is over,

you may have an increased chance of developing a

second cancer. Also, radiation therapy aimed at the

chest may cause heart disease or lung damage.

16
Radiation therapy aimed at the pelvis can cause

infertility. Loss of fertility may be temporary or

permanent, depending on your age: 

• Men: If radiation therapy is aimed at the pelvic area,

the testes may be harmed. Sperm banking before

treatment may be a choice. 

• Women: Radiation aimed at the pelvic area can

harm the ovaries. Menstrual periods may stop, and

women may have hot flashes and vaginal dryness.

Menstrual periods are more likely to return for

younger women. Women who may want to get

pregnant after radiation therapy should ask their

health care team about ways to preserve their eggs

before treatment starts. 

You may find it helpful to read NCI’s booklet

Radiation Therapy and You. Page 36 tells how to get

NCI booklets.

17

You may want to ask your doctor these

questions before having radiation therapy:

• Why do I need this treatment?

• When will the treatments begin? When will

they end?

• How will I feel during treatment?

• How will we know if the radiation treatment is

working?

• Are there any lasting side effects?
Stem Cell Transplantation

If Hodgkin lymphoma returns after treatment, you

may receive stem cell transplantation. A transplant of

your own blood-forming stem cells (autologous stem

cell transplantation) allows you to receive high doses

of chemotherapy, radiation therapy, or both. The high

doses destroy both Hodgkin lymphoma cells and

healthy blood cells in the bone marrow. 

Stem cell transplants take place in the hospital.

Before you receive high-dose treatment, your stem

cells are removed and may be treated to kill lymphoma

cells that may be present. Your stem cells are frozen

and stored. After you receive high-dose treatment to

kill Hodgkin lymphoma cells, your stored stem cells

are thawed and given back to you through a flexible

tube placed in a large vein in your neck or chest area.

New blood cells develop from the transplanted stem

cells.

You may find it helpful to read NCI’s fact sheet

Bone Marrow Transplantation and Peripheral Blood

Stem Cell Transplantation: Questions and Answers.

Page 36 tells how to get NCI fact sheets.

18

You may want to ask your doctor these

questions before having a stem cell transplant:

• What are the possible benefits and risks of a

stem cell transplant?

• How long will I need to be in the hospital?

Will I need special care? How will I be

protected from germs?

• What can we do about side effects?

• How will having a stem cell transplant affect

my normal activities?

• What is my chance of a full recovery?
Second Opinion

Before starting treatment, you might want a second

opinion about your diagnosis and your treatment plan.

Many insurance companies cover a second opinion if

you or your doctor requests it. 

It may take some time and effort to gather your

medical records and see another doctor. In most cases,

a brief delay in starting treatment will not make

treatment less effective. To make sure, you should

discuss this delay with your doctor. Sometimes people

with Hodgkin lymphoma need treatment right away. 

There are many ways to find a doctor for a second

opinion. You can ask your doctor, a local or state

medical society, a nearby hospital, or a medical school

for names of specialists. Other sources can be found in

the NCI fact sheet How To Find a Doctor or Treatment

Facility If You Have Cancer. 

19
Nonprofit groups with an interest in lymphoma may

be of help. Many such groups are listed in the NCI fact

sheet National Organizations That Offer Services to

People With Cancer and Their Families. Page 36 tells

how to get NCI fact sheets.

Nutrition and Physical Activity 

It’s important for you to take care of yourself by

eating well and staying as active as you can. 

You need the right amount of calories to maintain a

good weight. You also need enough protein to keep up

your strength. Eating well may help you feel better and

have more energy.

Sometimes, especially during or soon after

treatment, you may not feel like eating. You may be

uncomfortable or tired. You may find that foods do not

taste as good as they used to. In addition, the side

effects of treatment (such as poor appetite, nausea,

vomiting, or mouth sores) can make it hard to eat well.

Your doctor, a registered dietitian, or another health

care provider can suggest ways to deal with these

problems. Also, the NCI booklet Eating Hints for

Cancer Patients has many useful ideas and recipes.

Page 36 tells how to get NCI booklets.

Many people find they feel better when they stay

active. Walking, yoga, swimming, and other activities

can keep you strong and increase your energy. Exercise

may reduce nausea and pain and make treatment easier

to handle. It also can help relieve stress. Whatever

physical activity you choose, be sure to talk to your

doctor before you start. Also, if your activity causes

you pain or other problems, be sure to let your doctor

or nurse know about it.

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Follow-up Care

You’ll need regular checkups after treatment for

Hodgkin lymphoma. Even when there are no longer

any signs of cancer, the disease sometimes returns

because undetected lymphoma cells may remain

somewhere in your body after treatment. 

Also, checkups help detect health problems that

can result from cancer treatment. People treated for

Hodgkin lymphoma have an increased chance of

developing heart disease; leukemia; melanoma; nonHodgkin lymphoma; and cancers of the bone, breast,

lung, stomach, and thyroid. Checkups help ensure that

any changes in your health are noted and treated if

needed. Checkups may include a physical exam, blood

tests, chest x-rays, CT scans, and other tests. 

After treatment, people with Hodgkin lymphoma

may receive the flu vaccine and other vaccines. You

may want to talk with your health care team about

when to get certain vaccines.

If you have any health problems between checkups,

you should contact your doctor. 

You may wish to get the NCI booklet Facing

Forward: Life After Cancer Treatment. It answers

questions about follow-up care and other concerns.

Page 36 tells how to get NCI booklets.

21

You may want to ask your doctor these

questions after you have finished treatment:

• How often will I need checkups?

• Which follow-up tests do you suggest for me? 

• Between checkups, what health problems or

symptoms should I tell you about?
Sources of Support

Learning you have Hodgkin lymphoma can change

your life and the lives of those close to you. These

changes can be hard to handle. It’s normal for you,

your family, and your friends to have many different

and sometimes confusing feelings. 

Concerns about treatments and managing side

effects, hospital stays, and medical bills are common.

You may also worry about caring for your family,

keeping your job, or continuing daily activities. 

Here’s where you can go for support:

• Doctors, nurses, and other members of your health

care team can answer many of your questions about

treatment, working, or other activities. 

• Social workers, counselors, or members of the

clergy can be helpful if you want to talk about your

feelings or concerns. Often, social workers can

suggest resources for financial aid, transportation,

home care, or emotional support.

• Support groups can also help. In these groups,

patients or their family members meet with other

patients or their families to share what they have

learned about coping with the disease and the effects

of treatment. Groups may offer support in person,

over the telephone, or on the Internet. You may want

to talk with a member of your health care team

about finding a support group. 

• Information specialists at 1–800–4–CANCER and

at LiveHelp (http://www.cancer.gov/help) can help

you locate programs, services, and publications.

They can give you names of national organizations

that offer services to people with cancer and their

families.

22
For tips on coping, you may want to read the NCI

booklet Taking Time: Support for People With Cancer.

Page 36 tells how to get NCI booklets.

23

Taking Part in Cancer Research

Doctors all over the country are conducting many

types of clinical trials (research studies in which people

volunteer to take part). Clinical trials are designed to

answer important questions and to find out whether

new approaches are safe and effective. 

Research already has led to advances, and doctors

continue to search for more effective methods for

treating Hodgkin lymphoma. Doctors are studying

methods of new and better ways to treat it, and ways to

improve quality of life.
People who join clinical trials may be among the

first to benefit if a new approach is effective. And even

if people in a trial do not benefit directly, they still

make an important contribution by helping doctors

learn more about Hodgkin lymphoma and how to

control it. Although clinical trials may pose some risks,

doctors do all they can to protect their patients.

If you are interested in being part of a clinical trial,

talk with your doctor. You may want to read the NCI

booklet Taking Part in Cancer Treatment Research

Studies. This booklet describes how treatment studies

are carried out and explains their possible benefits and

risks. Page 36 tells how to get NCI booklets.

NCI’s Web site includes a section on clinical trials

at http://www.cancer.gov/clinicaltrials. It has

general information about clinical trials as well as

detailed information about specific ongoing studies

of Hodgkin lymphoma. Information specialists

at 1–800–4–CANCER or at LiveHelp at

http://www.cancer.gov/help can answer questions

and provide information about clinical trials. 

24
Dictionary

Definitions of thousands of terms are on the NCI

Web site in the NCI Dictionary of Cancer Terms. You

can access it at http://www.cancer.gov/dictionary. 

Abdomen (AB-doh-men): The area of the body that

contains the pancreas, stomach, intestines, liver,

gallbladder, and other organs.

Autologous stem cell transplantation (aw-TAH-luhgus stem sel tranz-plan-TAY-shun): A procedure in

which blood-forming stem cells (cells from which all

blood cells develop) are removed, stored, and later

given back to the same person.

B cell: A white blood cell that comes from bone

marrow. As part of the immune system, B cells make

antibodies and help fight infections. Also called 

B lymphocyte.

Bacteria (bak-TEER-ee-uh): A large group of singlecell microorganisms. Some cause infections and

disease in animals and humans. The singular of

bacteria is bacterium.

Biopsy (BY-op-see): The removal of cells or tissues for

examination by a pathologist. The pathologist may

study the tissue under a microscope or perform other

tests on the cells or tissue. When only a sample of

tissue is removed, the procedure is called an incisional

biopsy. When an entire lump or suspicious area is

removed, the procedure is called an excisional biopsy.

When a sample of tissue or fluid is removed with a

needle, the procedure is called a needle biopsy, core

biopsy, or fine-needle aspiration.

Bone marrow (MAYR-oh): The soft, sponge-like

tissue in the center of most bones. It produces white

blood cells, red blood cells, and platelets.

25
Bone marrow biopsy (MAYR-oh BY-op-see): The

removal of a sample of tissue from the bone marrow

with a needle for examination under a microscope.

Cancer (KAN-ser): A term for diseases in which

abnormal cells divide without control. Cancer cells can

invade nearby tissues and can spread to other parts of

the body through the blood and lymph systems.

Cell (sel): The individual unit that makes up the tissues

of the body. All living things are made up of one or

more cells.

Chemotherapy (KEE-moh-THAYR-uh-pee):

Treatment with drugs that kill cancer cells.

Classical Hodgkin lymphoma (KLA-sih-kul HOJ-kin

lim-FOH-muh): The most common type of Hodgkin

lymphoma, which is a cancer of the immune system.

Classical Hodgkin lymphoma is marked by the

presence of a type of cell called the Reed-Sternberg

cell. 

Clinical trial: A type of research study that tests how

well new medical approaches work in people. These

studies test new methods of screening, prevention,

diagnosis, or treatment of a disease. Also called a

clinical study.

Complete blood count: CBC. A test to check the

number of red blood cells, white blood cells, and

platelets in a sample of blood. Also called blood cell

count.

Contrast material: A dye or other substance that helps

show abnormal areas inside the body. It is given by

injection into a vein, by enema, or by mouth. Contrast

material may be used with x-rays, CT scans, MRI, or

other imaging tests.

CT scan: Computed tomography scan (kum-PYOO-ted

tuh-MAH-gruh-fee skan). A series of detailed pictures

of areas inside the body taken from different angles;

26
the pictures are created by a computer linked to an 

x-ray machine. Also called computerized tomography

and computerized axial tomography (CAT) scan.

Diaphragm (DY-uh-fram): The thin muscle below the

lungs and heart that separates the chest from the

abdomen.

Digestive tract (dy-JES-tiv): The organs through which

food and liquids pass when they are swallowed,

digested, and eliminated. These organs are the mouth,

esophagus, stomach, small and large intestines, and

rectum and anus.

Epstein-Barr virus (ep-stine-BAR VY-rus): EBV.

A common virus that remains dormant in most people.

It causes infectious mononucleosis and has been

associated with certain cancers, including Burkitt

lymphoma, immunoblastic lymphoma, and

nasopharyngeal carcinoma. 

Excisional biopsy (ek-SIH-zhun-al BY-op-see):

A surgical procedure in which an entire lump or

suspicious area is removed for diagnosis. The tissue is

then examined under a microscope.

Fine needle aspiration (as-per-AY-shun): The removal

of tissue or fluid with a needle for examination under a

microscope. Also called needle biopsy.

Groin: The area where the thigh meets the abdomen.

Hematologist (HEE-muh-TAH-loh-jist): A doctor who

specializes in treating blood disorders.

Hodgkin lymphoma (HOJ-kin lim-FOH-muh): A

cancer of the immune system that is marked by the

presence of a type of cell called the Reed-Sternberg

cell. Symptoms include the painless enlargement of

lymph nodes, spleen, or other immune tissue. Other

symptoms include fever, weight loss, fatigue, or night

sweats. Also called Hodgkin disease.

27
Human immunodeficiency virus (HYOO-mun

ih-MYOO-noh-dih-FIH-shun-see VY-rus): HIV. The

cause of acquired immunodeficiency syndrome

(AIDS).

Immune system (ih-MYOON SIS-tem): The complex

group of organs and cells that defends the body against

infections and other diseases.

Incisional biopsy (in-SIH-zhun-al BY-op-see): A

surgical procedure in which a portion of a lump or

suspicious area is removed for diagnosis. The tissue is

then examined under a microscope.

Infection: Invasion and multiplication of germs in the

body. Infections can occur in any part of the body and

can spread throughout the body. The germs may be

bacteria, viruses, yeast, or fungi. They can cause a

fever and other problems, depending on where the

infection occurs. When the body’s natural defense

system is strong, it can often fight the germs and

prevent infection. Some cancer treatments can weaken

the natural defense system.

Infertility (IN-fer-TIH-lih-tee): The inability to

produce children.

Inherited (in-HAYR-it-ed): Transmitted through genes

that have been passed from parents to their offspring

(children).

Intravenous (IN-truh-VEE-nus): IV. Within a blood

vessel.

Leukemia (loo-KEE-mee-uh): Cancer that starts in

blood-forming tissue such as the bone marrow and

causes large numbers of blood cells to be produced and

enter the bloodstream.

Local anesthesia (A-nes-THEE-zhuh): Drugs that

cause a temporary loss of feeling in one part of the

body. The patient remains awake but has no feeling in

the part of the body treated with the anesthetic.

28
Local therapy (THAYR-uh-pee): Treatment that affects

cells in the tumor and the area close to it.

Lymph (limf): The clear fluid that travels through the

lymphatic system and carries cells that help fight

infections and other diseases. Also called lymphatic

fluid.

Lymph node (limf): A rounded mass of lymphatic

tissue that is surrounded by a capsule of connective

tissue. Lymph nodes filter lymph (lymphatic fluid), and

they store lymphocytes (white blood cells). They are

located along lymphatic vessels. Also called a lymph

gland.

Lymph vessel (limf): A thin tube that carries lymph

(lymphatic fluid) and white blood cells through the

lymphatic system. Also called lymphatic vessel.

Lymphatic system (lim-FA-tik SIS-tem): The tissues

and organs that produce, store, and carry white blood

cells that fight infections and other diseases. This

system includes the spleen, thymus, lymph nodes, and

lymphatic vessels (a network of thin tubes that carry

lymph and white blood cells). Lymphatic vessels

branch, like blood vessels, into all the tissues of the

body.

Lymphocyte (LIM-foh-site): A type of white blood cell.

Lymphocytes have a number of roles in the immune

system, including the production of antibodies and

other substances that fight infections and other

diseases.

Lymphoma (lim-FOH-muh): Cancer that begins in

cells of the immune system. There are two basic

categories of lymphomas. One kind is Hodgkin

lymphoma, which is marked by the presence of a type

of cell called the Reed-Sternberg cell. The other

category is non-Hodgkin lymphomas, which includes a

large, diverse group of cancers of immune system

cells. Non-Hodgkin lymphomas can be further divided

29
into cancers that have an indolent (slow-growing)

course and those that have an aggressive (fast-growing)

course. These subtypes behave and respond to

treatment differently. Both Hodgkin and non-Hodgkin

lymphomas can occur in children and adults, and

prognosis and treatment depend on the stage and the

type of cancer.

Medical oncologist (MEH-dih-kul on-KAH-loh-jist):

A doctor who specializes in diagnosing and treating

cancer using chemotherapy, hormonal therapy, and

biological therapy. A medical oncologist often is the

main health care provider for someone who has cancer.

A medical oncologist also gives supportive care and

may coordinate treatment given by other specialists.

Melanoma (MEH-luh-NOH-muh): A form of skin

cancer that begins in melanocytes (the cells that make

the pigment melanin). Melanoma usually begins in a

mole.

MRI: Magnetic resonance imaging (mag-NEH-tik

REH-zuh-nunts IH-muh-jing). A procedure in which

radio waves and a powerful magnet linked to a

computer are used to create detailed pictures of areas

inside the body. These pictures can show the difference

between normal and diseased tissue. MRI makes better

images of organs and soft tissue than other scanning

techniques, such as computed tomography (CT) or

x-ray. MRI is especially useful for imaging the brain,

the spine, the soft tissue of joints, and the inside of

bones. Also called nuclear magnetic resonance imaging

(NMRI).

Nodular lymphocyte-predominant Hodgkin

lymphoma (NAH-juh-ler LIM-foh-site preh-DAH-mihnunt HOJ-kin lim-FOH-muh): A rare type of Hodgkin

lymphoma, which is a cancer of the immune system. 

It is marked by the presence of a type of cell called a

popcorn cell, which is different from the typical ReedSternberg cell found in classical Hodgkin lymphoma.

30
This type of Hodgkin lymphoma may change into

diffuse large B-cell lymphoma. Also called NLPHL.

Non-Hodgkin lymphoma (non-HOJ-kin lim-FOHmuh): NHL. Any of a large group of cancers of the

immune system. NHLs can occur at any age and are

often marked by enlarged lymph nodes, fever, and

weight loss. There are many different types of NHL,

which can be divided into aggressive (fast-growing)

and indolent (slow-growing) types and can be

classified as either B-cell or T-cell NHL. Prognosis and

treatment depend on the stage and type of disease.

Oncology nurse (on-KAH-loh-jee): A nurse who

specializes in treating and caring for people who have

cancer.

Pathologist (puh-THAH-loh-jist): A doctor who

identifies diseases by studying cells and tissues under a

microscope.

Pelvis: The lower part of the abdomen, located

between the hip bones.

PET scan: Positron emission tomography scan

(PAH-zih-tron ee-MIH-shun toh-MAH-gruh-fee skan).

A procedure in which a small amount of radioactive

glucose (sugar) is injected into a vein, and a scanner is

used to make detailed, computerized pictures of areas

inside the body where the glucose is used. Because

cancer cells often use more glucose than normal cells,

the pictures can be used to find cancer cells in the

body.

Radiation oncologist (RAY-dee-AY-shun on-KAHloh-jist): A doctor who specializes in using radiation to

treat cancer.

31
Radiation therapy (RAY-dee-AY-shun THAYR-uhpee): The use of high-energy radiation from x-rays,

gamma rays, neutrons, and other sources to kill cancer

cells and shrink tumors. Radiation may come from a

machine outside the body (external beam radiation

therapy), or it may come from radioactive material

placed in the body near cancer cells (internal radiation

therapy). Systemic radiation therapy uses a radioactive

substance, such as a radiolabeled monoclonal antibody,

that circulates throughout the body. Also called

radiotherapy and irradiation. 

Radioactive (RAY-dee-oh-AK-tiv): Giving off

radiation.

Recurrence: Cancer that has returned after a period of

time during which the cancer could not be detected.

The cancer may come back to the same place as the

original (primary) tumor or to another place in the

body. Also called recurrent cancer.

Reed-Sternberg cell: A type of cell that appears in

people with Hodgkin disease. The number of these

cells increases as the disease advances.

Registered dietitian (dy-eh-TIH-shun): A health

professional with special training in the use of diet and

nutrition to keep the body healthy. A registered

dietitian may help the medical team improve the

nutritional health of a patient.

Relapse: The return of signs and symptoms of cancer

after a period of improvement.

Risk factor: Something that may increase the chance of

developing a disease. Some examples of risk factors

for cancer include age, a family history of certain

cancers, use of tobacco products, certain eating habits,

obesity, lack of exercise, exposure to radiation or other

cancer-causing agents, and certain genetic changes. 

32
Side effect: A problem that occurs when treatment

affects healthy tissues or organs. Some common side

effects of cancer treatment are fatigue, pain, nausea,

vomiting, decreased blood cell counts, hair loss, and

mouth sores.

Sperm banking: Freezing sperm for use in the future.

This procedure can allow men to father children after

loss of fertility.

Spleen: An organ that is part of the lymphatic system.

The spleen produces lymphocytes, filters the blood,

stores blood cells, and destroys old blood cells. It is

located on the left side of the abdomen near the

stomach.

Stem cell: A cell from which other types of cells

develop. Blood cells develop from blood-forming stem

cells.

Stem cell transplantation: A method of replacing

immature blood-forming cells that were destroyed by

cancer treatment. The stem cells are given to the

person after treatment to help the bone marrow recover

and continue producing healthy blood cells.

Supportive care: Care given to improve the quality of

life of patients who have a serious or life-threatening

disease. The goal of supportive care is to prevent or

treat as early as possible the symptoms of the disease,

side effects caused by treatment of the disease, and

psychological, social, and spiritual problems related to

the disease or its treatment. Also called palliative care,

comfort care, and symptom management.

Systemic therapy (sis-TEH-mik THAYR-uh-pee):

Treatment using substances that travel through the

bloodstream, reaching and affecting cells all over the

body.

33
T cell: One type of white blood cell that attacks virusinfected cells, foreign cells, and cancer cells. T cells

also produce a number of substances that regulate the

immune response. Also called T lymphocyte.

Testis (TES-tis): One of two egg-shaped glands found

inside the scrotum that produce sperm and male

hormones. Also called a testicle.

Thymus: An organ that is part of the lymphatic system,

in which T lymphocytes grow and multiply. The

thymus is in the chest behind the breastbone.

Tissue (TISH-oo): A group or layer of cells that work

together to perform a specific function.

Tonsil: One of two small masses of lymphoid tissue on

either side of the throat.

Tumor (TOO-mer): An abnormal mass of tissue that

results when cells divide more than they should or do

not die when they should. Tumors may be benign (not

cancerous), or malignant (cancerous). Also called

neoplasm.

Virus (VY-rus): A microorganism that can infect cells

and cause disease.

White blood cell: WBC. Refers to a blood cell that

does not contain hemoglobin. White blood cells

include lymphocytes, neutrophils, eosinophils,

macrophages, and mast cells. These cells are made by

bone marrow and help the body fight infections and

other diseases.

X-ray: A type of high-energy radiation. In low doses,

x-rays are used to diagnose diseases by making

pictures of the inside of the body. In high doses, x-rays

are used to treat cancer.

34
National Cancer Institute Information

Resources

You may want more information for yourself, your

family, and your doctor. The following NCI services

are available to help you.

Telephone

NCI’s Cancer Information Service (CIS) provides

accurate, up-to-date information about cancer to

patients and their families, health professionals, and the

general public. Information specialists translate the

latest scientific information into plain language and

respond in English or Spanish. Calls to the CIS are

confidential and free.

Telephone: 1–800–4–CANCER (1–800–422–6237)

TTY: 1–800–332–8615 

Internet

NCI’s Web site provides information from numerous

NCI sources. It offers current information about cancer

prevention, screening, diagnosis, treatment, genetics,

supportive care, and ongoing clinical trials. It has

information about NCI’s research programs, funding

opportunities, and cancer statistics. 

Web site: http://www.cancer.gov

Spanish Web site: http://www.cancer.gov/espanol

If you’re unable to find what you need on the Web

site, contact NCI staff. Use the online contact form at

http://www.cancer.gov/contact or send an email to

cancergovstaff@mail.nih.gov. 

Also, information specialists provide live,

online assistance through LiveHelp at

http://www.cancer.gov/help.

35
National Cancer Institute Publications

NCI provides publications about cancer, including

the booklets and fact sheets mentioned in this booklet.

Many are available in both English and Spanish. 

You may order these publications by telephone, on

the Internet, or by mail. You may also read them online

and print your own copy.

• By telephone: People in the United States and its

territories may order these and other NCI

publications by calling the NCI’s Cancer

Information Service at 1–800–4–CANCER. 

• On the Internet: Many NCI publications may be

viewed, downloaded, and ordered from

http://www.cancer.gov/publications on the

Internet. People in the United States and its

territories may use this Web site to order printed

copies. This Web site also explains how people

outside the United States can mail or fax their

requests for NCI booklets.

• By mail: NCI publications may be ordered by

writing to the address below: 

Publications Ordering Service

National Cancer Institute

Suite 3035A

6116 Executive Boulevard, MSC 8322

Bethesda, MD 20892–8322

Cancer Treatment

• Chemotherapy and You (also available in Spanish:

La quimioterapia y usted)

• Radiation Therapy and You (also available in

Spanish: La radioterapia y usted)

• Biological Therapy: Treatments That Use Your

Immune System to Fight Cancer 

36
• Bone Marrow Transplantation and Peripheral Blood

Stem Cell Transplantation: Questions and Answers

(also available in Spanish: El trasplante de médula

ósea y el trasplante de células madre de sangre

periférica: preguntas y respuestas)

• How To Find a Doctor or Treatment Facility If You

Have Cancer (also available in Spanish: Cómo

encontrar a un doctor o un establecimiento de

tratamiento si usted tiene cáncer) 

Clinical Trials

• Taking Part in Cancer Treatment Research Studies

Living With Cancer

• Eating Hints for Cancer Patients (also available in

Spanish: Consejos de alimentación para pacientes

con cáncer: Antes, durante y después del

tratamiento)

• Pain Control (also available in Spanish: Control del

dolor)

• Follow-up Care After Cancer Treatment: Questions

and Answers

• Facing Forward: Life After Cancer Treatment (also

available in Spanish: Siga adelante: la vida después

del tratamiento del cáncer)

• Facing Forward: Ways You Can Make a Difference

in Cancer

• Taking Time: Support for People with Cancer 

• Cancer Support Groups: Questions and Answers

• National Organizations That Offer Services to

People With Cancer and Their Families (also

available in Spanish: Organizaciones nacionales que

brindan servicios a las personas con cáncer y a sus

familias) 

37
• Coping With Advanced Cancer

• When Cancer Returns

Complementary Medicine

• Thinking about Complementary & Alternative

Medicine: A guide for people with cancer

• Complementary and Alternative Medicine in Cancer

Treatment: Questions and Answers (also available in

Spanish: La medicina complementaria y alternativa

en el tratamiento del cáncer: preguntas y

respuestas)

Caregivers

• When Someone You Love Is Being Treated for

Cancer: Support for Caregivers

• When Someone You Love Has Advanced Cancer:

Support for Caregivers

• Facing Forward: When Someone You Love Has

Completed Cancer Treatment

• Caring for the Caregiver: Support for Cancer

Caregivers

38
¿Necesita información en español?

Llame al Servicio de Información sobre el

Cáncer y hable en español con un especialista en

información de cáncer. El número es

1–800–422–6237.

O visite el sitio de Internet del Instituto

Nacional del Cáncer en

http://www.cancer.gov/espanol. 

The National Cancer Institute

The National Cancer Institute (NCI) is part of the

National Institutes of Health. NCI conducts and supports

basic and clinical research in the search for better ways to

prevent, diagnose, and treat cancer. NCI also supports 

the training of scientists and is responsible for

communicating its research findings to the medical

community and the public.

Copyright permission

The written text of NCI material is in the public

domain. It is not subject to copyright restrictions. You do

not need our permission to reproduce or translate NCI

written text. However, we would appreciate a credit line

and a copy of your translations. 

Private sector designers, photographers, and illustrators

retain copyrights to artwork they develop under contract to

NCI. You must have permission to use or reproduce these

materials. In many cases, artists will grant permission, but

they may require a credit line and/or usage fees. To inquire

about permission to reproduce NCI artwork, please write

to: Office of Communications and Education, Publications

Support Branch, National Cancer Institute, 6116 Executive

Boulevard, Room 3066, MSC 8323, Rockville, MD

20892–8323.
NIH Publication No. 07-1555

Revised September 2007

Printed September 2007