Treatment and care of children with cancer is usually provided by a team of health professionals called a multidisciplinary team. Members of this team are specialists in children’s cancers – they understand the differences between children’s cancer and adult cancer, and each team member brings different skills in managing care to meet the needs of both you and your child.
The team will be led by a childhood cancer specialist (paediatric oncologist). Other members of the team depend on the age of your child and their type of disease, and may change over time as your child’s needs change. A list of team members who might make up the multidisciplinary team can be found in The treatment team.
Treatment for Hodgkin disease depends on the age of your child, the stage of the disease, the biological features of the cancer and other factors identified during diagnosis. Treatment will be tailored to your child’s particular situation, and may involve one or more of the following (see How is cancer treated for more detail).
Surgery is rarely used to treat Hodgkin disease, but can sometimes be used to remove tumours in certain types of Hodgkin disease. Usually, no further therapy is needed after surgery, and the child will be under careful observation.
Chemotherapy uses anti-cancer medicines to destroy cancer cells. It is often given as a combination of medicines to try to prevent the cancer cells from becoming resistant to just one or two medicines.
Chemotherapy medicines are given together in courses, often over a few days. Once the body has recovered from the side effects, the next course is given. Most children receive multiple courses of chemotherapy.
Hodgkin disease is usually treated with combination chemotherapy.
Radiation therapy (also called radiotherapy) uses high-energy X-rays or other types of radiation to destroy cancer cells or stop them from growing. A type of radiation therapy called external beam radiation may be used if Hodgkin disease is only in one part of the body. It can be used in combination with chemotherapy.
Radiation therapy can have long-term side effects in children. If radiation therapy is included in your child’s treatment, special care will be taken to reduce these risks.
Some medicines can target the specific changes in cancer cells that make them different from normal cells. This means that they work differently from standard chemotherapy, and they usually have fewer side effects, or the side effects are not as severe.
Drugs called rituximab and brentuximab vedotin are monoclonal antibodies that may be used to treat Hodgkin disease. These drugs find the abnormal cells and attach to them. They can deliver chemotherapy that either directly destroys the cells or stops the cells from dividing.
Targeted therapies are usually given in combination with other types of treatment.
Stem cell transplant
Some children may be treated using a stem cell transplant (also known as a bone marrow transplant), in combination with high-dose chemotherapy or radiation therapy. However, this is usually only done for children whose Hodgkin disease has come back (relapsed) after initial treatment with chemotherapy and/or radiation therapy.