Hodgkin Lymphoma

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After Hodgkin Lymphoma Treatment

For many people, treatment cures Hodgkin lymphoma. Finishing treatment can be both stressful and exciting. You may be relieved, but you might also find it hard not to worry about the lymphoma coming back (recurring).

This is a very common concern if you’ve had cancer.

For some people, Hodgkin lymphoma may never go away completely. You may get regular treatments with chemotherapy, radiation therapy, or other therapies to help relieve your symptoms and control the lymphoma for as long as possible. Learning to live with cancer that doesn't go away can be difficult and very stressful.

No matter what your situation is, there are steps you can take to live well, both physically and emotionally.

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Follow-up care after Hodgkin lymphoma

After finishing treatment for Hodgkin lymphoma, you’ll still see your cancer care team regularly. You may have tests to look for signs that the cancer has come back. Let your care team know about any new symptoms or problems, because these could be caused by the lymphoma coming back, by a new disease, or by second cancer. 

What is a survivorship care plan?

Talk with your doctor about developing a survivorship care plan for you. This plan can guide your next steps after treatment, including follow-up appointments and ways to stay healthy.

A survivorship plan might include:

  • A suggested schedule for follow-up exams and tests
  • A timeline for other tests, such as screening for other cancers or monitoring for long-term health effects from your cancer or treatment
  • A list of possible late- or long-term side effects from your treatment, including what to watch for and when to contact your doctor
  • Diet and physical activity suggestions

Many people with Hodgkin lymphoma are cured, but treatment can lead to health problems in the future. See your doctor regularly, get the recommended cancer screening tests, and tell your health care team about any changes you notice in how you feel.

What is the follow-up schedule after Hodgkin lymphoma?

Your cancer care team will still watch you closely, even after you finish treatment. It’s very important to go to all your follow-up appointments because Hodgkin lymphoma can sometimes come back many years after treatment.

Follow-up visits are usually recommended every 3 to 6 months for the first several years after treatment.

  • After a while, you probably won’t need to meet with your cancer care team as often. But even after 5 years, you may be advised to see your oncologist once a year.
  • If your Hodgkin lymphoma doesn’t go away with treatment, your cancer care team will create a follow-up schedule based on your specific situation.

Exams and imaging tests

During follow-up visits, your cancer care team will do physical exams and ask about your symptoms. They may also do blood tests or imaging tests such as PET or CT scans.

Watching for late or long-term side effects

Some treatment side effects might last a long time. Other side effects might not show up until years after treatment.

Your follow-up appointments are a good time to ask questions about these side effects. Talk to your cancer care team about any changes or problems you notice or concerns you have.

See Late and Long-term Side Effects below to learn more.

Questions to ask your care team

  • What type of follow-up will I need after treatment?
  • What side effects should I watch for?
  • How will we know if the lymphoma comes back? What should I watch for?
  • What will my options be if the cancer comes back?

Staying prepared and organized

Even after treatment, it’s very important to stay organized and on top of your health. Keeping your records and health insurance coverage in order makes it easier to manage your follow-up care, future checkups, and any new concerns that may come up.

Keep your health insurance

It’s very important to keep health insurance as a Hodgkin lymphoma survivor. Insurance can help cover the cost of follow-up visits, tests, and any care you may need in the future. No one wants to think about their cancer coming back, but it’s best to be prepared.

Save your medical records

At some point, you might see a new doctor who doesn’t know your cancer history. Keep copies of your medical records so you can easily share the details of your diagnosis and treatment when needed.

Can I lower my risk of Hodgkin lymphoma progressing or coming back?

You might want to know if there are things you can do to lower your risk of Hodgkin lymphoma coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements.

Adopting healthy behaviors

At this time, we don’t know for sure if there are things you can do to lower this risk. There are some things that might be helpful, but more research is needed to know for sure.

  • Adopting healthy behaviors like not smoking, eating well, getting regular physical activity, and staying at a healthy weight might help, but no one knows for sure.
  • However, we do know that these types of changes can have positive effects on your health that extend beyond your risk of Hodgkin lymphoma or other cancers.

About dietary supplements

So far, no dietary supplements have been shown to clearly help lower the risk of Hodgkin lymphoma progressing or coming back. This includes vitamins, minerals, and herbal products. This doesn’t mean that no supplements will help. But it’s important to know that none have been proven to do so.

In the United States, dietary supplements aren’t regulated like medicines. They don't have to be proven effective (or even safe) to be sold, although there are limits on what they’re allowed to claim they can do.

Talk to your health care team before taking any type of nutritional supplement. They can help you decide which ones are safe and which ones might be harmful.

If the cancer comes back

If your Hodgkin lymphoma comes back (recurs) at some point, your treatment options will depend on:

  • Where the lymphoma is
  • What treatments you had before
  • How long it’s been since treatment
  • Your current health and preferences

For more on how recurrent Hodgkin lymphoma is treated, see Treating Classic Hodgkin Lymphoma, by Stage.

For general information, see Understanding Recurrence.

Second cancers after Hodgkin lymphoma

Some cancer survivors develop another type of cancer later, usually more than 10 years after treatment. This is called a second cancer.

Hodgkin lymphoma survivors can get any type of second cancer, but research shows they have an increased risk of certain cancers. These tend to be linked to the treatments used for Hodgkin lymphoma.

The cancers include:

Screening for second cancers

Women who were treated with radiation therapy to the chest, such as mantle field radiation therapy, before age 30 have an increased risk of breast cancer.

  • The American Cancer Society recommends yearly breast cancer screening with breast MRIs along with mammograms and clinical breast exams beginning at age 30 for these women.
  • Some experts recommend that screening start 8 to 10 years after treatment or at age 40, whichever is earlier.

Survivors of Hodgkin lymphoma should also follow the American Cancer Society guidelines for the early detection of cancer, such as those for colorectal and lung cancer. Most experts don’t recommend any other testing to look for second cancers unless you have symptoms.

The Children’s Oncology Group has screening guidelines for cancer survivors who were treated as children, teens, or young adults. These can be found at www.survivorshipguidelines.org.

Why are survivors at increased risk of a second cancer?

Some treatments for Hodgkin lymphoma are linked to second cancers.

The increased risk of many of these cancers is linked to treatment with radiation. For example:

  • Women who had chest radiation, especially before age 30, have a higher risk of breast cancer.
  • Radiation to the neck is linked to a higher risk of thyroid cancer.
  • Radiation to the chest is linked to a higher risk of lung cancer.

In recent decades, the use of radiation to treat Hodgkin lymphoma has changed a lot. Radiation is now given in lower doses, and often only to areas directly affected by the lymphoma. The risks with modern radiation treatment are likely to be lower. Still, long-term studies are needed to be sure.

Chemotherapy

Chemo is linked with a higher risk of several types of cancer, including leukemias. This is especially true for chemo drugs called alkylating agents, such as dacarbazine and cyclophosphamide.

Today, alkylating agents are used less often and at much lower doses, so these risks are probably not as high as they were in the past. But again, long-term follow-up studies are needed to be sure.

Can I lower my risk of getting a second cancer?

There are steps you can take to help lower your risk of a second cancer and stay as healthy as possible.

For example, it’s important to stay away from tobacco products. Smoking increases the risk of many cancers, including some of the second cancers seen in people who’ve had Hodgkin lymphoma.

To help maintain good health, it’s also important to:

  • Get to and stay at a healthy weight.
  • Keep physically active and limit the time you spend sitting or lying down.
  • Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains.
  • Limit red and processed meats, sugary drinks, and highly processed foods.
  • Avoid alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men.

These steps may also lower the risk of other health problems, including heart disease.

See Second Cancers in Adults for more information.

Getting emotional support

Some amount of feeling depressed, anxious, or worried is normal when lymphoma is a part of your life. Some people are affected more than others, but everyone can benefit from help and support, whether this is from friends and family, religious groups, support groups, professional counselors, or others.

Learn more in Life After Cancer.

Late and long-term side effects of Hodgkin lymphoma treatment

Each type of treatment for Hodgkin lymphoma has side effects that could last for months or longer. Some might not show up until long after treatment ends. Some side effects can be permanent, including heart damage, low thyroid hormones, and loss of fertility (the ability to have children).

Ask your cancer care team what late and long-term side effects you might have so you know what to watch for. Be sure to tell them if you have any side effects.

Developing a second type of cancer is an uncommon but very serious side effect of Hodgkin lymphoma treatment. People who've had Hodgkin lymphoma have a higher risk for many types of cancer.

Chemotherapy and radiation therapy, especially in younger people, can cause reduced or lost fertility.

For men

Some chemo drugs can affect your ability to make sperm. This might be short-term or permanent. If a person is old enough, sperm banking should be considered before starting chemo with drugs that can affect fertility.

For women

You may stop having menstrual periods with chemo. This may or may not go back to normal; some women go into early menopause after treatment.

Radiation to the lower abdomen (belly) can cause infertility unless your ovaries are surgically moved outside the radiation field beforehand. Moving the ovaries does not affect cure rates because Hodgkin lymphoma almost never spreads to the ovaries.

To learn more, see Fertility Problems.

For unknown reasons, the immune systems of people with Hodgkin lymphoma often don’t work the way they should. Chemo, radiation, or surgery to remove the spleen (splenectomy) can add to this problem.

Splenectomy was once commonly done but is now rarely needed. If your spleen is removed, you should get vaccinated against certain bacteria.

Anyone who’s had Hodgkin lymphoma should keep up with their flu shots. It’s very important to get vaccinations and treat infections right away.

Radiation to the chest or neck to treat Hodgkin lymphoma can affect your thyroid gland, causing it to make less thyroid hormone. This is known as hypothyroidism. If you have this condition, you may need to take thyroid medicine every day for the rest of your life.

Anyone who got radiation to the neck or upper chest should have their thyroid function checked with blood tests at least once a year.

Radiation to the chest increases your risk of heart disease and heart attack, although this has become less of a problem with more modern radiation techniques.

Some chemo drugs, such as doxorubicin (Adriamycin®), can also cause heart damage. Sometimes the damage isn't seen until more than 10 years after treatment. Your health care team might check your heart function for many years.

Radiation to the neck increases your risk of stroke because it can damage the blood vessels in your neck that supply your brain. Your health care team may use ultrasound to check the health of the blood vessels in your neck.

Lowering your risk of heart disease and stroke

Smoking, high cholesterol, and high blood pressure (hypertension) also increase your risk of heart disease and stroke.

It’s important to do what you can to help lower your risk, including not smoking, staying at a healthy weight, being active, and eating a healthy diet. It’s also important to have regular checkups with your health care team and get treated if you have high blood pressure.

The chemo drug bleomycin can damage your lungs. So can radiation therapy to your chest.

This can lead to problems like shortness of breath, which might not show up until years after treatment. Smoking can also seriously damage your lungs, so it’s important to avoid smoking if you’ve had these treatments.

Special concerns for childhood Hodgkin lymphoma survivors

Just as treating childhood Hodgkin lymphoma requires a very specialized approach, so does follow-up after treatment. Your child’s cancer care team will watch closely for relapse (the cancer coming back) and for late effects of treatment.

Lifelong follow-up

Careful follow-up after treatment is very important. It should be done for the rest of your child's life. The earlier a problem is found, the more likely it can be treated effectively.

Emotional effects after treatment

Survivors of childhood Hodgkin lymphoma may also face emotional or psychological issues and some problems with day-to-day functioning and schoolwork.

These can often be managed with support and encouragement. Your child’s health care team can also recommend special support programs and services to help after treatment.

Guidelines for follow-up care

The Children’s Oncology Group (COG) has developed long-term follow-up guidelines for survivors of childhood cancers. These guidelines can help you know what to watch for, what types of screening tests your child needs, and how late effects may be treated.

It’s very important to discuss possible long-term problems with your child’s health care team. Make sure a plan is in place to watch for these problems and treat them if needed.

You can ask your child’s cancer care team about the COG survivor guidelines or download them for free on the COG website: www.survivorshipguidelines.org.

These guidelines are written for health care professionals. Patient versions of some of the guidelines are available on the site as well. They can be found in the Health Links section of the site. But it’s best if you discuss them with a doctor.

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Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).

Bartlett NL, Foyil KV. Chapter 105: Hodgkin lymphoma. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa. Elsevier: 2014.

Children’s Oncology Group. Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers. 2023. Accessed at www.survivorshipguidelines.org on July 5, 2025.

National Cancer Institute. Adult Hodgkin Lymphoma Treatment (PDQ®)–Patient Version. Feb 27, 2025. Accessed at www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq on July 10, 2025.

National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Hodgkin Lymphoma, Version 2.2025 -- Jan 30, 2025. Accessed at www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf on July 10, 2025.

Younes A, Carbone A, Johnson P, Dabaja B, Ansell S, Kuruvilla J. Chapter 102: Hodgkin’s lymphoma. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.

Last Revised: October 6, 2025

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.

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