Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.


Hodgkin lymphoma is a cancer that begins in cells called B lymphocytes (B cells). These cells are part of the immune system that guard the body from infection.

Two major types of immune cells are:

  • B lymphocytes
  • T lymphocytes

Hodgkin lymphoma occurs when a B lymphocyte cell develops a genetic mutation that turns into cancerous cells.

Hodgkin lymphoma can usually be cured. Treatment options may include chemotherapy, radiation therapy, and sometimes stem cell transplant.

We know a cancer diagnosis is overwhelming. We will provide you with the best treatment and support available.

Additional References:

Non-Hodgkin Lymphoma

Another type of lymphoma involving B lymphocytes is called “non-Hodgkin lymphoma.” The differences between Hodgkin lymphoma and non-Hodgkin lymphoma are:

  • Cancerous cells of each type look differently under the microscope.
  • Hodgkin lymphoma has large, abnormal white blood cells (lymphocytes) in the lymph nodes (called Reed-Sternberg cells).

Hodgkin lymphoma and non-Hodgkin lymphoma are treated with different types of chemotherapy. 

Both cancers:

  • Affect lymphocytes, so initial symptoms are similar.
  • Are staged in the same way.
  • Respond to chemotherapy, even though treatment is different. 

Stem cell transplantation may be an option if either recurs or doesn’t respond to standard treatment.

Additional References:

Risk Factors

The risks of developing Hodgkin lymphoma are: 

  • Age, between 15 to 40 and over 55.
  • Weakened immune system, such as from HIV, an autoimmune disease, or using drugs to suppress the immune system after organ transplant.
  • Family history, such as a brother or sister (especially an identical twin) with the disease.
  • Epstein-Barr virus infection. If you’ve had mono (mononucleosis), which is caused by the Epstein-Barr virus, you may be at greater risk of developing Hodgkin lymphoma. However, the associated risk is extremely small.

Although viruses may be linked to the development of Hodgkin lymphoma, it’s important to understand that cancer is not contagious.

Having risk factors doesn’t mean you’ll develop Hodgkin lymphoma. Many people with cancer have no known risk factors.

Additional References:


You may not have any symptoms with Hodgkin lymphoma. The most common sign is painless, swollen lymph nodes. They appear as lumps under the skin in your neck, armpit, or groin. Rarely, they might really hurt after you drink alcohol. We’re not sure why this happens. 

Swollen or tender lymph nodes are usually a sign of infection, not cancer. If infected, the lymph nodes return to normal size after the infection goes away, usually within a couple of weeks. 

Additional symptoms of Hodgkin lymphoma include:

  • Fever that doesn’t go away.
  • Unexplained weight loss.
  • Soaking night sweats.
  • Fatigue.
  • Itchy skin.
  • Cough, chest pain, or shortness of breath (caused by Hodgkin lymphoma in the chest).

Often, these symptoms are caused by other less serious illnesses, such as the flu. However, if symptoms last longer than 2 weeks, it’s important that we assess your symptoms.


During routine blood tests, we check: 

  • Red blood cells, which carry oxygen to support body function.
  • Platelets, which help prevent bleeding.
  • White blood cells, the part of the immune system that protect against infection and disease.

If you have swollen lymph nodes or other symptoms of Hodgkin lymphoma, we:

  • Ask about your symptoms and risk factors.
  • Perform a physical examination. We check for swollen lymph nodes in your neck, underarms, and groin, and feel your abdomen for enlarged organs.

We may recommend removing part or all of a swollen lymph node (biopsy) to check for cancer cells. If present, we may recommend additional tests to identify the type and determine how far it’s spread. Tests may include:  

  • Blood tests.
  • Imaging scans, such as chest X-rays, CT scans, and PET scans.
  • Bone marrow tests, to check if the cancer has spread to bone marrow.
Additional References:


Staging means how far the cancer has spread. Your treatment is based on the stage of the cancer. 

  • Stage I. It affects 1 lymph node area (such as under the arm), or a single area of tissue or organ (such as the spleen or lung).
  • Stage II. It affects 2 or more lymph node areas on the same side of the diaphragm, or 1 organ and nearby lymph nodes.
  • Stage III. It affects lymph node areas on both sides of the diaphragm, and possibly the spleen or an organ outside the lymphatic system (such as the liver, lungs, or both).
  • Stage IV. It’s spread to other organs or tissues (such as the liver, lungs, or bone marrow).

We also ask if you have unexplained weight loss, fever, or night sweats. You may need more aggressive treatment with these symptoms.

Additional References:


Once we learn all we can about your Hodgkin lymphoma, we’ll talk together about your treatment options and develop a plan that’s right for you. 

Common treatments include chemotherapy and radiation therapy. Stem cell transplantation and targeted therapy may be used if the cancer doesn’t respond to treatment or comes back after treatment.

Additional References:

Follow-up Care

After completing treatment, you’ll have important follow-up appointments:  

  • Every 3 months for the first few years after treatment.
  • Once a year, usually starting 5 years after treatment. 

During these regular checkups, we:

  • Monitor your recovery.
  • Look for signs of recurrence.
  • Watch for signs of late side effects that can develop years after treatment stops.

Late side effects may include:

  • Fertility problems.
  • Heart disease.
  • Thyroid problems.
  • New cancer caused by earlier treatment (secondary cancer), such as lung or breast cancer from chest radiation. 

We’ll talk about your possible risk of late side effects and ways to reduce your risk. 

One of the most important parts of your care is taking good care of yourself during and after treatment. 

  • Eat a nutritious diet.
  • Get regular physical activity.
  • Attend your follow-up appointments.
  • Join a support group.
Additional References:

Related Health Tools:

Prepare for Your Procedure

See more Health Tools »

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.