Surgical Procedures: Surgery and Staging for Adult Hodgkin Lymphoma

Lymphoma is a type of cancer that starts in your lymphatic system, which is part of your immune system.

Your lymphatic system is made up of:

• Lymph fluid, lymph vessels, and lymph nodes.
• Your spleen, thymus, and tonsils.
• Your bone marrow.
• Lymphatic tissue is also found in different organs, including the stomach, thyroid, brain, and skin. 

Your lymph system helps manage fluid volume and fight disease.

What is staging for Hodgkin lymphoma?

Staging helps you learn where your cancer is, how much is in your body, and if it has spread. For Hodgkin Lymphoma (HL), a biopsy is done of the lymph nodes, and the tissue is looked at under a microscope to make the diagnosis of Hodgkin lymphoma. There are two types of HL: classical and nodular lymphocyte-predominant (NLP). You may have other tests done to help determine the stage of your HL.

• Blood tests, like a complete blood count (CBC), liver function tests, kidney function tests, erythrocyte sedimentation rate (ESR, a marker of inflammation), HIV testing, and a pregnancy test if you could be pregnant.
• PET-CT scan (combines a CT scan of the body (a 3D x-ray) with PET scan).
• Bone marrow aspiration and biopsy.
• Echocardiogram.
• Pulmonary Function Test.
• X-Ray.
• MRI.

To learn more about the stages of Hodgkin lymphoma, visit Adult Hodgkin Lymphoma: Staging and Treatment on Oncolink.org

What surgery may be used to treat Hodgkin lymphoma?

Surgery is not used often to treat Hodgkin lymphoma, but it may be used to take out organs that are affected by the cancer. Surgeries that may be part of Hodgkin lymphoma treatment 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. Read more about  splenectomy here.

What are the risks of 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, to not remember it, and to manage pain. Reactions may be wheezing, rash, swelling, and low blood pressure).
• Damage to other organs.
• Bleeding.
• Blood clots.
• Infection.
• Urinary retention (not being able to pee on your own).
• Scar tissue.
• Belly pain.

What is recovery like?                                 

Recovery from surgery to treat Hodgkin lymphoma depends on the extent and type of the procedure you have had. A hospital stay may be needed.

You will be told how to care for your incision (surgical cut) before leaving the hospital.

Your medical team will go over the medications you will be taking, such as those for pain, blood clot prevention, and/or other conditions.

You may have to make changes to your activity level. Your provider will talk about 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.