Hodgkin's Disease - Outlook

Prognosis

Hodgkin’s disease is considered one of the most curable forms of cancer, especially if it is diagnosed and treated early. Unlike other cancers, Hodgkin's disease is even potentially curable in late stages Five-year survival rates for patients diagnosed with stage I or stage II Hodgkin’s disease are 90 - 95%. With advances in treatment, recent studies indicate that even patients with advanced Hodgkin’s disease have 5-year survival rates of 90%, although it is not yet certain if their disease will eventually return. Patients who survive 15 years after treatment are more likely to later die from other causes than from Hodgkin’s disease.

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Survival rates are poorest for patients who:

• Relapse within a year of treatment
• Do not respond to the first-line therapy and have signs of disease progression

Factors that Influence Prognosis

The International Prognostic Factors Project on Advanced Hodgkin's Disease uses seven factors to help determine which patients with advanced Hodgkin's disease have a more serious prognosis and could benefit from more aggressive chemotherapy. These factors are also used to predict success in patients with relapsed or persistent HD who are undergoing stem cell transplantation.

The more of these factors that are present, the worse the outlook and the more likely the patient needs to be treated aggressively:

• Being male
• Age of 45 years or older
• Stage IV disease
• Low blood albumin level (less than 4g/dL; albumin is a type of protein.)
• Low hemoglobin level (less than 10.5g/dL; hemoglobin is the oxygen-carrying component of red blood cells)
• High white blood cell count (more than 15,000)
• Low lymphocyte count (less than 600)

Long-Term Effects of Treatments

The good news about Hodgkin's disease is that treatment can cure the disease. The bad news is that survivors face a higher than average risk for long-term complications of these treatments, some very serious.

Many patients experience chronic fatigue that can sometimes last for years. The most serious complications are secondary cancers and heart disease, which may develop over the 20 - 30 years following treatments. Secondary cancers include non-Hodgkin's lymphoma, leukemia, melanoma, stomach and lung cancers, and breast and uterine cancers. Heart disease complications include coronary artery disease, stroke, heart valve problems, and cardiomyopathy (weakening of the heart muscle). Thyroid disorders are also a potential complication. Combinations of radiation and chemotherapies pose the highest risk of these problems.