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.

Cancer Care

Fremont and San Leandro Medical Centers


Hodgkin lymphoma is cancer in cells that are part of the immune system. The immune system contains many different cells to protect the body from infection, such as: 

  • B lymphocytes
  • T lymphocytes

Hodgkin lymphoma occurs when B-lymphocyte cells develop a genetic mutation that turns into cancerous cells.

Once we learn everything we can about your disease, we’ll talk about the best treatment plan for you. Hodgkin lymphoma can usually be cured.  

Common treatments include chemotherapy and radiation therapy. We may recommend stem cell transplantation and targeted therapy if the cancer:

  • Gets worse during treatment.
  • Returns after treatment.

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


Chemotherapy uses drugs to kill cancer cells. You’ll probably receive a combination of different types of drugs. 

Most chemotherapy is given through intravenous (IV) infusion, although sometimes it’s a pill. 

Typically, chemotherapy circulates throughout your entire body (systemic). It can destroy cancer cells that travel outside the lymphatic system.

Chemotherapy is given in cycles, which:

  • Means you’ll receive treatment and then have a rest period.
  • Gives your body time to recover from the potent effects of chemotherapy. 

The number of cycles you have depends on the stage of your cancer and other factors.

The most common treatment for Hodgkin lymphoma is a combination of chemotherapy drugs called ABVD. It’s given by IV injections once every 2 weeks. 

We may use another chemotherapy regimen called Stanford V. It’s usually given once a week, but over a shorter amount of time.

Side effects

Chemotherapy works by killing rapidly dividing cancer cells. It can also affect normal cells and cause side effects, such as:  

  • Hair loss
  • Nausea and vomiting
  • Loss of appetite
  • Mouth sores
  • Fatigue
  • Diarrhea
  • Low blood cells count

We can help you manage all side effects. Most side effects typically go away when treatment ends. However, some may continue years after treatment ends (late side effects), such as:

  • Fertility problems (difficulty getting pregnant or having children).
  • Heart and lung damage, especially after radiation therapy to the chest.
  • Secondary cancers from treatment (such as acute myelogenous leukemia).

Before treatment, we’ll talk about possible side effects. After treatment, we’ll watch you for signs of late side effects.

Radiation Therapy

Radiation therapy uses high-energy beams to kill tumor cells. The most common type is external-beam radiation therapy. 

A machine outside the body delivers radiation directly to the tumor and nearby tissue. 

We use a CT scan to find the precise location. The radiation beam is aimed at the lymph node areas affected by Hodgkin lymphoma. 

You may have radiation: 

  • 5 days a week for up to 5 weeks. 
  • After chemotherapy ends to remove any remaining cancer cells. 

Radiation therapy may be the only treatment needed for a rare, slow-growing type of Hodgkin lymphoma (nodular lymphocyte predominant type).

Side effects

Radiation side effects depend on the area treated. These include:

  • Hair loss
  • Skin changes, such as redness
  • Fatigue
  • Nausea or vomiting
  • Bowel discomfort or diarrhea
  • Dry, sore throat and mouth, loss of taste and difficulty swallowing
  • Tooth decay

We can treat your side effects, so be sure to let us know.

Depending on the area receiving radiation, you may also have side effects years after treatment ends (late effects), such as:   

  • Fertility problems (difficulty getting pregnant or having children)
  • Heart disease and stroke
  • Thyroid problems
  • Secondary cancer (such as lung or breast cancer)

We take special care to limit radiation exposure to the surrounding healthy tissue and organs. We’ll monitor you for signs of late effects during your follow-up care.

Stem Cell Transplant

When standard treatment doesn’t kill the cancer, or if it returns, we may recommend stem cell transplantation.

Stem cells are usually obtained from: 

  • Circulating blood
  • A newborn’s umbilical cord and placenta

First, you’re given high doses of chemotherapy or whole-body radiation therapy. This destroys cancer cells throughout the body. It also destroys healthy cells in bone marrow. 

Next, we’ll replace stem cells in bone marrow to help with blood cell production.

The type of transplant you have depends on the source of the stem cells. These include:

  • Autologous transplant. Stem cells from your own blood are frozen and stored. After high-dose chemotherapy, we’ll put them back into your bloodstream. This type causes fewer side effects.
  • Allogeneic transplant. Blood stem cells come from a donor with a matching tissue type. Outcomes are better if the donor is a full match. This is rarely used for Hodgkin lymphoma.
Side effects

To prepare for stem cell transplantation, your bone marrow is treated with high-dose chemotherapy or radiation. This can temporarily leave your body without its natural defenses. 

It can take several months for the bone marrow to recover. During this time, you’re at an increased risk of infection and bleeding. We may recommend: 

  • Antibiotics to prevent infections
  • Platelet transfusions to reduce bleeding risk
  • Other treatments to boost blood cell counts

A possible complication of donor (allogeneic) stem cell transplantation is graft-versus-host disease (GVHD). This happens when donor stem cells start attacking tissues of your skin, digestive tract, and liver. 

Symptoms of GVHD include:

  • Skin rash
  • Yellowing of the skin and eyes
  • Nausea
  • Diarrhea
  • Fatigue and weakness

We’ll talk about possible side effects and how we plan to prevent or manage them.

Targeted Therapy

Targeted therapy uses drugs (such as antibody-drug conjugate) to target specific parts of the cancer cell. 

It combines these 2 drugs:

  • A man-made drug that uses the body’s immune system to fight cancer (antibody).
  • A traditional chemotherapy drug. 

When the antibody drug reaches the target (a protein) on the cancer cell, it releases the chemotherapy. 

We might recommend targeted therapy when your Hodgkin lymphoma:

  • Doesn’t respond to standard chemotherapy.
  • Relapses after stem cell transplant.
Side effects

Because these drugs target cancer cells, there’s less damage to healthy cells. Side effects may include:

  • Fatigue
  • Nausea and vomiting
  • Nerve damage
  • Diarrhea
  • Fever
  • Cough
  • Low blood cell counts
  • Birth defects if taken during pregnancy

We’ll monitor you closely for side effects. Let us know as soon as you notice symptoms.

Clinical Trials

We’re always looking for new and better ways to treat Hodgkin lymphoma. Clinical trials are research studies that test new treatments or procedures. We can talk about any clinical trials that may be right for you.

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