Care and mobility considerations
The majority of people will undergo standard chemotherapy as their first line treatment for Hodgkin lymphoma; some people will not respond to the treatment and move on to ‘salvage chemotherapy’ followed by high dose chemotherapy and Peripheral Blood Stem Cell Transplant (PBSCT) or bone marrow transplant. Care and mob guidance is divided into two groups-:
- Relapsed Hodgkin lymphoma
- First line treatment of Hodgkin Lymphoma
First line treatment of Hodgkin Lymphoma
A return to health is expected in the typical case. There are unlikely to be any long term care and mobility needs after treatment. The exception to this are the enduring but rare side effects of chemotherapy
Relapsed Hodgkin lymphoma
This group are likely to under go salvage chemotherapy followed by high dose chemotherapy and Peripheral Blood Stem Cell Transplant (PBSCT) or bone marrow transplant. Treatment and recovery for those who successfully undergo this treatment is likely to take 18 months to 2 years. During this period they are likely to have periods of being immunosuppressed and be advised to avoid crowded public places. Episodes of severe fatigue may endure for many months related to chemotherapy treatment and anaemia.
Some will be unwell and have care or mobility needs for about 3-6 months - during the transplant and transplant recovery period. Others will develop needs related to chemotherapy side effects during standard chemotherapy, if this happens and they progress straight to high dose chemotherapy needs are likely to last through the first course and into the transplant period. Recovery from the transplant is likely to be more prolonged in this group and may take a year. The main cause of needs is likely to be severe chemotherapy related fatigue.
If high dose chemotherapy has already been used then other types of chemotherapy may be to be given to control disease and symptoms, in this case ongoing needs may relate to symptoms of disease as well as treatment.
Mobility
Severe fatigue and reduced exercise tolerance related to any of the following may reduce the ability to walk
- Chemotherapy treatment
- Anaemia
- Disease effects e.g. lung involvement causing breathlessness
People who are immunosuppressed may be advised to avoid public places at busy times.
Care
Severe fatigue may make activities of daily living difficult. Help with activities of daily living from someone else may be required because of pain, fatigue or breathlessness.
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Amended February 2009
