How can one suspect development of Hodgkin's disease?
Enlargement of lymph glands (lymph nodes), especially in the neck area, is the most common presentation. Other symptoms may include fatigue, weight loss and night sweats. Such symptoms should be immediately reported to the doctor.
If an enlarged lymph node is found, a biopsy will be taken for analysis. This should establish the diagnosis. The whole process takes only a few days.
Once the diagnosis of Hodgkin's disease is made, what then?
In relative terms, this is a type of cancer with a good prognosis because it responds to treatment. However, most treatment forms are incompatible with pregnancy.
The form of treatment adopted will depend on the stage at which the diagnosis is made. The obstetrician, together with the oncologist (cancer specialist), will explain everything exhaustively for the expectant mother to make an informed choice.
In summary, in the early stages, the disease is best treated with radiotherapy. Termination of pregnancy is necessary, in most cases. However, if the disease is confined to the upper part of the body, a form of shielding of the uterus and its contents is possible. The advanced disease is treated by combined chemotherapy.
Unfortunately, the types of drugs used for this disease are incompatible with pregnancy and therefore termination is mandatory. Some patients insist on waiting until the fetus has reached a viable stage before terminating the pregnancy. This is a risky strategy, as the intervening days or weeks could make the difference between successful treatment and missing the boat. The patient is made aware of all these facts.
What is the effect on fertility after chemotherapy?
There might be reduced fertility following chemotherapy. Hormonal manipulation, sometimes employing the oral contraceptive pill, may help to counteract the adverse effects on the ovary. Combination treatment, where both radiotherapy and chemotherapy have been used, tends to have a more adverse effect on fertility.
Even among those who successfully conceive, the rates of both miscarriage and fetal malformation are increased.