Surgical Procedures: Surgery and Staging for Adult Hodgkin Lymphoma
When there are malignant (cancerous) cells that form in the body’s lymphatic system, it is a type of lymphoma. Hodgkin lymphoma is diagnosed based on the presence of certain characteristics in the cells. There are many types of lymphoma other than Hodgkin lymphoma.
The lymphatic system is made up of lymph fluid, lymph vessels, lymph nodes, the spleen, thymus, tonsils, and the bone marrow, however, vital lymphatic tissue is also located in organs such as the stomach, thyroid, brain and skin.
What is staging and how is it performed?
Staging is a way to find out how far the cancer has spread in your body. Your provider will have you get a few tests to figure out the stage of your cancer. These tests may include:
- Physical Exam: This is a general exam to look at your body and to talk about past health issues.
- Blood Work: Your provider may have you get your blood drawn to check a complete blood count (CBC), blood chemistries and sedimentation rate.
- Radiologic Imaging: Radiology tests can look inside your body to look at the cancer and determine if it has spread. These tests can include:
- CAT scan (CT scan).
- Positron emission tomography scan (PET scan).
- Magnetic resonance imaging (MRI).
- Procedures: These may include:
- Biopsy: A biopsy takes cells from the cancer, or a piece of the cancer, to see what type of cancer it is and how it behaves. A doctor called a pathologist looks at the sample in a laboratory.
- Incisional biopsy: A small part of the lymph node is removed for evaluation.
- Core biopsy: Removal of a larger part of the lymph node tissue using a thick needle.
- Excisional biopsy: Removal of the whole lymph node.
- Bone marrow aspiration & biopsy: A hollow needle is inserted into the breastbone or hipbone to remove (aspirate) bone marrow, blood and bone for evaluation.
Hodgkin lymphoma spreads to other parts of the body through the tissue, lymph and blood systems. These lymphomas are described as stages I-IV, A, B, E and S based on clinical and physical findings. Your healthcare team will discuss with you in greater detail your stage and treatment plan.
Part of your treatment plan may include surgery. Some common surgical procedures to treat Hodgkin lymphoma include:
- Exploratory Laparotomy: This is surgery to look at the organs inside your belly. Biopsy and/or removal of organs may be needed.
- Splenectomy: Removal of the spleen. Please see further information on splenectomy here.
What are the risks associated with surgery to treat Hodgkin Lymphoma?
As with any surgery, there are risks and possible side effects. These can be:
- Reaction to anesthesia (Anesthesia is the medication you are given to help you sleep through the surgery, not remember it and manage pain. Reactions can include wheezing, rash, swelling and low blood pressure.)
- Injury to nearby organs.
- Blood clots.
- Urinary retention (Not being able to pee on your own).
- Damage to nearby organs.
- Scar tissue formation.
- Belly pain.
What is recovery like?
Recovery from surery to treat a Hodgkin lymphoma will depend on the extent and type of the procedure you have had. A hospital stay may be required.
You will be instructed on how to care for your incision before leaving the hospital.
Your medical team will discuss with you the medications you will be taking, such as those for pain, blood clot prevention and/or other conditions.
You may have restrictions on your activity. You provider will discuss these with you.
How can I care for myself?
You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is ok to go back to your normal activity.
Be sure to take your prescribed medications as directed to prevent pain, infection and/or constipation. Call your team with any new or worsening symptoms.
There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation.
Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.
- Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.
This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.
NCI. Adult Hodgkin Lymphoma Treatment (PDQ®)–Patient Version. 2019. Retrieved from https://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq#section/_1
Oncolex: Oncology Encyclopedia. Surgery of Hodgkin’s Lymphoma. Retrieved from http://oncolex.org/Lymphoma/Diagnoses/Hodgkins-lymphoma/Procedures/TREATMENT/Kirurgi
Stanford Health Care. General Surgery: Postoperative Discomforts. Retrieved from https://stanfordhealthcare.org/medical-clinics/surgery-clinic/what-to-expect/complications.html
Mayo Clinic. Tests and Procedures: Splenectomy. (February 24, 2016) Retrieved from http://www.mayoclinic.org/tests-procedures/splenectomy/basics/risks/prc-20014837
Better Health Channel. Laparotomy. Retrieved from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/laparotomy