Dr. Hanson explains that diagnoses for Hodgkin's disease and non-Hodgkin's lymphoma begin with a lymph node biopsy procedure performed by a surgeon and passed on to a pathologist. After diagnosis, the clinical stage is determined and treatment can begin through chemotherapy and/or radiation.

David S. Hanson, MD, FACP: When I have the opportunity to talk to a patient about their diagnosis with Hodgkin's disease or non-Hodgkin's lymphoma, we generally talk about the process that leads to the correct diagnosis, how that is accomplished with the assistance of other doctors and how a treatment plan is formulated.

For example, many patients who have these diseases present with a swelling gland or lymph node. To correctly diagnose the patient, the patient must undergo a lymph node biopsy procedure, which is generally performed by a surgeon. Once that tissue is obtained, it is submitted to the pathologist who can study that tissue, make the appropriate test, and render an accurate diagnosis. It is very important that we know the exact type of Hodgkin's disease or nonHodgkin's lymphoma so that we can correctly formulate a treatment plan.

Once we have a diagnosis, the patient will generally be asked to undergo a series of tests, generally including blood work and scans and oftentimes an additional invasive test called a bone marrow biopsy and aspiration. The reason that we perform all these tests is to determine the accurate clinical stage of the patient.

Clinical stage is vitally important to formulating a treatment plan and will help to determine whether or not additional specialists beyond the medical oncologist are required to assist in the care of the patient.

Once the exact diagnosis is made and the proper clinical stage established, the patient will have a conference visit with the managing physician to determine the appropriate treatment plan for their disease. This will generally include chemotherapy but also may require the assistance of a radiation oncology doctor to assist in curative treatment plan as most of these diseases can be cured.

There are a small number of these diseases that cannot be cured but can be very favorably treated with proper care so it is important that the patient have that opportunity to learn and understand about their disease process so that the proper treatment plan can be undertaken.

Many times patients are very apprehensive about taking chemotherapy and that is because there is a lot of fear and skepticism about those sorts of treatments. It is very important to understand in patients who have Hodgkin's disease or non-Hodgkin's lymphoma that this chemotherapy treatment can very oftentimes result in complete resolution of symptoms and sometimes cure.

Chemotherapy is generally a medication that is either administered by the vein, intravenous or orally by the mouth. It is always important that the patient understand the exact nature of the chemotherapy medications that are to be prescribed, the side effects to expect and how to manage them. It is also very important when patients have Hodgkin's disease or non-Hodgkin's lymphoma that they receive their treatment at full dose and on schedule so that the proper result can be obtained.

For patients who are going to also be treated with radiation, they will meet with their radiation cancer doctor to determine the timing, dose and schedule of that radiation and how it will be added to the chemotherapy. The one thing it is always important for patients to remember is that their team of Doctors is looking for them to have the best possible outcome.

BIO: Dr. David Sam Hanson MD practices oncology and internal medicine in Baton Rouge and Zachary, Louisiana. Dr. Hanson graduated with an MD 27 years ago.

Yago Nieto, MD, PhD, The University of Texas MD Anderson Cancer Center, Houston, TX, discusses the use of chemotherapy in Hodgkin lymphoma (HL) treatment, which is typically employed in combination with novel agents such as brentuximab vedotin or checkpoint inhibitors. However, Prof. Nieto highlights that frail patients may require alternative chemotherapy-free approaches. This interview took place at the 64th ASH Annual Meeting and Exposition congress in New Orleans, LA.

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Graham Collins, MA, MBBS, MRCP, FRCPath, DPhil, Oxford University Hospitals NHS Foundation Trust, Oxford, UK, discusses the findings from recent studies investigating treatment options for non-Hodgkin lymphoma. Dr Collins focuses on the POLARIX study (NCT03274492), which compares R-CHOP with polatuzumab vedotin plus R-CHP. Results indicate an increased progression-free survival (PFS) and a reduction in subsequent anti-lymphoma treatments. Dr Collins also discusses factors which may influence the future use of this treatment in diffuse large B-cell lymphoma (DLBCL). This interview took place at the 63rd American Society of Hematology Annual Meeting and Exposition, Atlanta, 2021.