Hodgkin's Disease and Pregnancy: What You Should Know

Real talk—finding out you have Hodgkin's disease while pregnant can feel like a punch to the gut. You're dealing with your health and your baby's, and suddenly, everything gets a lot more complicated.

So what actually happens if Hodgkin's disease shows up during pregnancy? It's rare, but it does happen. Most women are in their 20s or 30s, which is right in the age range when people are thinking about starting families. Doctors have actually been able to treat Hodgkin's during pregnancy safely. But the timing—how far along you are—matters. Your healthcare team will look at both your health and your baby’s when figuring out what to do next.

If you're searching for honest answers about treatment options, symptoms to watch for, and what’s safest for your baby, you’re in the right place. Even with Hodgkin’s, there are ways to protect both you and your growing family. If you’re worried about fertility or planning for another pregnancy, new treatments have made things a lot better than they used to be.

It’s normal to have questions, and nobody expects you to have all the answers. Let’s dive into what you really need to know—without the fluff, just the facts that actually matter for your health and your baby’s future.

• Understanding Hodgkin's Disease in Pregnancy
• Recognizing Symptoms and Getting a Diagnosis
• Treatment Options During Pregnancy
• Risks to Mother and Baby
• Fertility, Planning, and Support

Understanding Hodgkin's Disease in Pregnancy

Here’s the deal with Hodgkin's disease: it’s a type of lymphoma, which means it’s a cancer that affects the lymphatic system. The lymphatic system is basically part of your body’s immune defense, helping fight infections. When you throw pregnancy into the mix, things get more complicated, not just for the mother, but for the baby, too.

So how common is it? Most cases of Hodgkin's disease happen in people aged 20 to 40. That’s right in the age range when lots of folks are having kids or planning families, so it’s not unheard of to see these conditions together. It’s not super common, but it’s also not something doctors look at like a one-in-a-million thing. Doctors usually pick up on it when a pregnant woman develops symptoms like swollen lymph nodes (usually in the neck or armpits), night sweats, or unexplained weight loss.

The big question is: Does pregnancy make Hodgkin's disease worse? The good news is, research shows the disease usually acts the same, whether you’re pregnant or not. It doesn’t get more aggressive just because you’re expecting, and it’s not likely to pass on to your baby.

Here are a few things to know right up front:

• Diagnosis sometimes gets delayed during pregnancy because symptoms can be mistaken for normal pregnancy changes (tiredness, sweating, and swelling can all overlap).
• Doctors often use less risky scans at first. MRI (without contrast) and ultrasound are safer during pregnancy than CT scans or X-rays that use radiation.
• Your care might involve a bigger team—hematologists, obstetricians, and specialists who know about both cancer and pregnancies.
• Treatment plans are designed with both you and your baby in mind, and sometimes, if the Hodgkin's disease isn’t aggressive and you’re early in pregnancy, doctors may watch and wait until it's safer for you or the baby to get certain treatments.

Here’s a quick look at who tends to face this situation:

If you hear “Hodgkin’s lymphoma” and think it’s a life sentence, know this: survival rates are high, even with a pregnancy in the mix. Treatments have come a long way, with over 80% of women seeing good results. The main thing is getting the right team who understands the ins and outs of both Hodgkin's disease and pregnancy.

Recognizing Symptoms and Getting a Diagnosis

Here’s the tricky part: the symptoms of Hodgkin's disease during pregnancy can sneak up on you, because they often feel like everyday stuff that comes with being pregnant. You might just chalk up being tired, sweating at night, or losing weight to pregnancy, hormones, or stress. But some signs should make you take a step back and check in with your doctor.

• Painless swelling of lymph nodes: Often in your neck, armpits, or groin. Not every lump is cancer, but if it lasts more than two weeks, definitely mention it.
• Unexplained fever: We’re not talking about catching a cold. These fevers go up and down and don’t seem to have a clear cause.
• Night sweats: Like, really soaked sheets, not just feeling warm.
• Unintentional weight loss: Losing over 10% of your body weight in a few months without trying is a red flag.
• Persistent fatigue: Way beyond regular pregnancy tiredness, this knocks you out even with plenty of rest.

If you have any of these symptoms, let your OB-GYN know. Don’t shrug them off. They’ll probably check things out and might refer you to a hematologist (that’s a blood and lymphoma doctor) if something seems off.

Now, about getting a diagnosis: some tests are different or tweaked for safety during pregnancy. Here’s how it usually goes:

• Physical exam: They’ll feel the lymph nodes and check for swelling in your abdomen or elsewhere.
• Blood tests: Simple bloodwork can show clues like abnormal white blood cell counts.
• Imaging: Instead of X-rays and CT scans, doctors mostly use ultrasounds and sometimes MRIs since they don’t use radiation. Very rarely, if there’s no other way, a low-dose CT may be considered, but only when absolutely necessary.
• Biopsy: Taking out a swollen lymph node (with local anesthesia) is the only way to be 100% sure it’s Hodgkin’s disease. The tissue goes to a lab for a close look under the microscope.

One helpful stat: about 10% of all women diagnosed with Hodgkin's disease are pregnant or become pregnant after treatment. So yes, you’re not alone, and your medical team will know the safest, most up-to-date ways to figure out what’s going on and get you the help you need, without risking your baby’s health.

Treatment Options During Pregnancy

Treating hodgkin's disease during pregnancy is tricky, but there are clear paths that doctors use, depending on when you’re diagnosed and how severe your case is. They balance what’s best for you with what’s safe for your baby. There’s no one-size-fits-all solution, but here’s what you’ll usually hear.

If you’re in early pregnancy (think first trimester), doctors may try to put off starting chemo for a few weeks until the second trimester if your situation allows. This is because the first 12 weeks are when the baby’s organs are developing, and most cancer treatment—especially chemotherapy—can be risky then. If waiting just isn’t safe for you, your medical team might suggest starting treatment right away, but they’ll walk you through the risks.

Chemotherapy becomes a safer bet in the second and third trimesters. The most-used chemo combo for hodgkin's disease is ABVD (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine). Research shows ABVD can work pretty well in pregnant women and doesn't lead to more birth defects or pregnancy problems compared to women without cancer treatment during pregnancy. Radiation isn't used much, but if it’s necessary, they use shields to keep the baby out of the radiation field and try it only after the first trimester.

• Surgery: Usually only for biopsy or if there’s a complication—rarely a main option.
• Chemotherapy: Most common, especially ABVD. Safer in later trimesters. Doctors check your blood counts and watch for side effects the whole time.
• Radiation: Very rare during pregnancy, but when used, care is taken to protect the baby as much as possible.
• Close Monitoring: Both you and the baby get extra checkups and ultrasounds, so any possible issues are caught fast.

If you’re diagnosed late in pregnancy, your team might recommend having the baby a little early if it’s safe—then start or continue treatment after delivery. This is sometimes an option if the hodgkin's disease isn’t super aggressive. Every bit of your care is handled by a team: oncology, OB-GYN, and sometimes neonatology if you’re close to delivery.

One more thing—hospitals now keep detailed records of outcomes for pregnant women with hodgkin's disease. Actual numbers? Around 80% of women treated with ABVD during pregnancy see successful outcomes for both mom and baby.

Always ask your care team about what’s right for you. Real-life decisions may look different, but these basics will help you feel more in control.

Risks to Mother and Baby

If you’re pregnant and dealing with Hodgkin's disease, one of your first questions is probably, “Is my baby going to be okay? What about me?” It’s totally normal to worry. The risks do exist, but a lot depends on how far along you are in pregnancy, how aggressive the disease is, and what kind of treatment you need.

For moms, most women with hodgkin's disease during pregnancy do about as well in the long run as women who aren’t pregnant, especially if they’re diagnosed early and doctors act fast. If the disease is advanced or spreads quickly, things get trickier. That’s why keeping up with checkups and following your treatment plan matters even more than usual right now.

Now about risks for the baby—this is where things feel even scarier. Treatments like chemotherapy and radiation can hurt a developing fetus, especially in the first trimester. That’s the stage when the baby's organs are forming, so most doctors try to avoid aggressive treatment before week 14 if they can. After that, some forms of chemotherapy have actually been shown to be safer, but there’s still a watchful eye on the baby at every step.

• If treatment can wait, doctors often hold off until the second or third trimester.
• If it can’t wait, they use the safest drugs and lowest possible doses.
• Radiation is pretty much a last resort during pregnancy, and only if it’s absolutely needed. When it can’t be avoided, doctors use lead shields to protect the uterus as much as possible.

There are also some risks like early labor, low birth weight, or needing a C-section. Most babies born to moms going through cancer treatment are healthy, but they’re usually checked more often throughout the pregnancy—lots of ultrasounds, extra doctor visits, and sometimes early delivery if the treatment just can’t be postponed.

For the mom, there’s also more risk of infection and anemia during cancer treatment, so you’ll probably have extra blood tests and maybe even need supplements or transfusions. Doctors keep a close eye out for anything unusual. If you ever start feeling more tired than normal, super short of breath, or have a fever, don’t wait—call your doctor right away.

The bottom line? The risks are real, but doctors know how to handle this. The main goal is to keep both mom and baby healthy, even if that means balancing some tough choices along the way.

Fertility, Planning, and Support

This is the part nobody loves to talk about, but believe me, it's on everyone's mind: can you have kids after Hodgkin's disease treatment? The short answer—often, yes, but it depends on the type of treatment and your personal health before you started.

Chemotherapy is a game-changer for treating Hodgkin’s, but it can lower fertility, especially with certain drugs. For women, some chemo drugs can mess with the ovaries, which might make getting pregnant harder later. Radiation near the belly or pelvis can also affect things. The risk really depends on what specific treatment you get and how long it goes on. One recent study showed about 60% of women under 35 who had Hodgkin's disease treatment could still get pregnant naturally afterward, which is way higher than people expect.

If fertility is something you want to hang on to, make sure to ask about it. Some folks freeze eggs or embryos before starting treatment. Here’s what you can do before and after:

• Bring it up early: Don’t wait—ask your oncologist before treatment starts if you want to protect your options.
• See a fertility specialist: Even one quick appointment can help you make a plan.
• Freeze eggs/embryos: This is possible before starting chemo. Some clinics can get you started in just a couple weeks.
• Ask about drug choices: Some chemo options are less risky for fertility. If that fits your case, your doctor will know.

Let’s talk support. Facing cancer and pregnancy at the same time is no picnic, and getting help matters. Hospitals usually have social workers or counselors who know exactly what this is like. Online groups—especially those for young cancer survivors—are another lifeline. And a lot of women say it made all the difference to connect with someone who’s gone through Hodgkin’s during pregnancy and come out the other side.

If you’re thinking about having more kids after treatment, it’s smart to wait a bit—most doctors suggest at least 2 years, since that’s when there’s the highest risk of recurrence for Hodgkin’s disease. Always run family planning by your oncology and OB/GYN teams. They will work together to keep you healthy and help you plan safely.

Here’s a fast look at some things to ask at your next appointment:

• How does my treatment affect future fertility?
• What are my fertility preservation options?
• What’s a safe timeline for trying to get pregnant again?
• Are there any red flags I should watch for in my health?

Having Hodgkin’s disease during pregnancy is so much more than just surviving—it’s about making real plans for your life after, too. There are more options, better treatments, and stronger support systems than ever before.

Your medical team is your best resource, and so are other women who’ve been there. Don’t be shy about asking questions, and remember there’s usually more hope than you think.

by Amelia Cranthorpe