How should I manage a patient with Hodgkin Lymphoma who presents with significant symptoms affecting their quality of life?

Management of a patient with Hodgkin lymphoma presenting with significant symptoms affecting quality of life involves prompt specialist referral and comprehensive supportive care.

Firstly, such patients should be referred urgently via a suspected cancer pathway for specialist assessment, especially if they have symptoms like fever, night sweats, weight loss, pruritus, or alcohol-induced lymph node pain, as these are red flags for Hodgkin lymphoma requiring timely diagnosis and treatment initiation ²,³.

Once diagnosed, management includes systemic chemotherapy tailored to the patient's fitness and disease stage, often combined with radiotherapy, as per haematology specialist protocols (not detailed in the provided context but standard practice).

Supportive and palliative care is essential to address symptoms impacting quality of life. This includes systematic assessment of physical symptoms at key points during the illness, prompt treatment of symptoms (e.g., pain, pruritus, fatigue), and psychological support to manage distress ⁵.

Symptom management should be pragmatic and straightforward, avoiding unnecessary medications, and regular prophylactic treatment should be considered for persistent symptoms rather than as-needed dosing ⁵.

Communication with the patient and their family is crucial, providing clear information about the disease, treatment options, side effects, and supportive care services, including psychological and wellbeing support ¹.

Referral to specialist palliative care services should be considered if symptoms are complex or refractory to primary care management ⁵.