Hodgkin lymphoma treatment in Israel: how the diagnosis is confirmed and staged, which chemotherapy and radiotherapy regimens are used, what is offered at relapse and what to ask a clinic before you travel.
What to know about Hodgkin lymphoma
Hodgkin lymphoma is a cancer of the lymphatic system that is distinguished from other lymphomas by Reed-Sternberg cells in the biopsy. It is one of the most treatable cancers: most patients reach long-term remission, although the outlook depends on the stage, age and response to therapy. Symptoms, stages and prognosis are covered in detail in our article on Hodgkin lymphoma; this page explains how treatment is organised in Israel.
When to see a doctor
The typical sign is a painless swelling of lymph nodes in the neck, armpit or groin that does not settle within a few weeks. Night sweats, unexplained fever, weight loss, itching, fatigue, cough or breathlessness may also occur. The same complaints are common with infections, so the diagnosis is made only after testing.
Diagnosis and staging
- Lymph node biopsy, preferably removal of a whole node; samples taken at home are usually reviewed again by Israeli pathologists.
- PET-CT, the main method for staging and for assessing response to treatment.
- Blood tests and heart and lung function tests before chemotherapy.
- Bone marrow biopsy, now rarely needed because PET-CT replaces it in most cases.
There are four stages, from involvement of a single group of lymph nodes (I) to spread to organs outside the lymphatic system (IV). The letter B means fever, night sweats or weight loss are present; A means they are absent.
Treatment methods
Chemotherapy
Combination chemotherapy is the backbone of treatment at every stage, most often ABVD, with more intensive protocols or regimens containing brentuximab vedotin for advanced disease. Cycles are given as an outpatient every two weeks. PET-CT is repeated after the first cycles, and treatment is reduced or intensified according to the result.
Radiotherapy
Radiotherapy is added after chemotherapy in early stages or to sites of bulky disease. Only the involved areas are irradiated, which reduces the dose to the heart, lungs and breast tissue.
Treatment of relapse
If the disease returns or does not respond to first-line therapy, options include second-line chemotherapy followed by high-dose therapy with autologous stem cell transplant, as well as brentuximab vedotin and immune checkpoint inhibitors (nivolumab, pembrolizumab). For how transplants are organised, see our article on bone marrow transplant cost.
Side effects and late effects
During treatment, nausea, fatigue, hair loss and a higher risk of infection are possible. Because most patients are young and live for decades after treatment, doctors discuss late risks in advance: effects on fertility, the heart and lungs, and the chance of a second cancer. Ask about fertility preservation, such as sperm or egg freezing, before therapy starts.
Planning treatment in Israel
Send the haematology department your reports, the pathology report and PET-CT discs. The work-up and biopsy review take about a week. Chemotherapy lasts several months, so ask whether some cycles can be given at home under an agreed protocol, with visits for interim PET-CT. Request a written plan and an estimate listing what is included.
Frequently asked questions
Can Hodgkin lymphoma be cured?
Most patients achieve long-term remission, especially at early stages, but no result can be guaranteed.
How long does treatment take?
Usually two to six months, depending on the stage and the response to therapy.
Does the biopsy have to be repeated?
A review of the existing slides and blocks is usually enough; a new biopsy is ordered if there is too little material or the diagnosis is in doubt.
Is Hodgkin lymphoma contagious?
No. It is not passed from person to person.
Need a second opinion or lymphoma treatment abroad? Send a request and Clinics Direct medical coordinators will help you choose a clinic and find out the cost of tests and treatment free of charge.
