Follow-up after treatment for Hodgkin lymphoma

Follow-up after treatment is an important part of cancer care. Follow-up for Hodgkin lymphoma (HL) is often shared among the cancer specialists (oncologists, radiation therapist) and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.

Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:

  • any new lump or swelling
  • fever that won’t go away
  • night sweats
  • weight loss for no reason
  • itchy skin
  • shortness of breath
  • discomfort or pain in the abdomen

The chance that HL will come back (recur) is greatest within 3 years, so you will need close follow-up during this time.

Schedule for follow-up visits

Follow-up visits for HL are usually scheduled:

  • every 2 to 4 months for the first 1to 2 years
  • every 3 to 6 months for the next 3to 5 years
  • at least once each year after 5 years following treatment

During follow-up visits

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping. They may also ask if you have any new symptoms and if your immunizations are up to date.

Your doctor may do a physical exam, including:

  • checking for fever, shortness of breath and rapid heartbeat
  • feeling the neck, under the arms and the groin for any swollen (enlarged) lymph nodes
  • feeling the abdomen for enlarged organs

Tests are often part of follow-up care. You may have:

  • a complete blood count (CBC) to check for abnormal blood cell counts
  • blood chemistry tests to show how well certain organs are working
  • a test to measure thyroid-stimulating hormone (TSH) levels to check how well your thyroid is working (if radiation was given to the neck)
  • imaging tests, such as chest x-rays, CT scans, MRIs, PET scans or ultrasounds, to check if the spleen, liver or lymph nodes are enlarged (you only need to have x-rays or scans if you have new symptoms)
  • regular breast screening tests, such as a mammography (if you have had radiation to the chest, you should begin having mammograms 10 years after the radiation or at age 40, whichever comes first)

Your doctor may order a bone marrow aspiration and biopsy if your blood tests are abnormal or if you have new symptoms.

If the cancer has come back, you and your healthcare team will discuss a plan for your treatment and care.

Questions to ask about follow-up

To make the decisions that are right for you, ask your healthcare team questions about follow-up.

Expert review and references

  • Cancer Research UK. About Hodgkin lymphoma . 2018.
  • Lash, Bradley W. Medscape Reference: Hodgkin Lymphoma Treatment and Management . 2018.
  • Lash, Bradley W. Medscape Reference: Hodgkin Lymphoma Guidelines . 2018: Monday, January 14, 2019.