Pregnancy Bliss | Reproductive Health Answers
Delta Goldrem, an Australian actress and singer, was diagnosed with Hodgkin's lymphoma at the age of 18. She was successfully treated.
Hodgkin's disease and pregnancy
Why is Hodgkin's disease (Hodgkin’s lymphoma) important in relation to pregnancy?'
Only because Hodgkin’s lymphoma is a type of cancer relatively common in young people. The peak incidence of this disease is in the early to mid-thirties. Pregnancy itself has no effect on the disease.
How can one suspect development of Hodgkin's disease?
Enlargement of lymph glands (lymph nodes), especially in the neck area, is the most common presentation. Other symptoms may include fatigue, weight loss and night sweats. Such symptoms should be immediately reported to the doctor.
If an enlarged lymph node is found, a biopsy will be taken for analysis. This should establish the diagnosis. The whole process takes only a few days.
Once the diagnosis of Hodgkin's disease is made, what then?
In relative terms, this is a type of cancer with a good prognosis because it responds
to treatment. However, most treatment 
forms are incompatible with pregnancy.
The form of treatment adopted will depend on the stage at which the diagnosis is made. The obstetrician, together with the oncologist (cancer specialist), will explain everything exhaustively for the expectant mother to make an informed choice.
In summary, in the early stages, the disease is best treated with radiotherapy. Termination of pregnancy is necessary, in most cases. However, if the disease is confined to the upper part of the body, a form of shielding of the uterus and its contents is possible. The advanced disease is treated by combined chemotherapy.
Unfortunately, the types of drugs used for this disease are incompatible with pregnancy and therefore termination is mandatory. Some patients insist on waiting until the fetus has reached a viable stage before terminating the pregnancy. This is a risky strategy, as the intervening days or weeks could make the difference between successful treatment and missing the boat. The patient is made aware of all these facts.
If a woman is treated with radiotherapy, that is surely the end of her fertile days?
No. The ovaries will be shielded effectively against radiation and fertility after treatment is not usually affected. (Preserving fertility after cancer treatment is discussed in more detail here).
What is the effect on fertility after chemotherapy?
There might be reduced fertility following chemotherapy. Hormonal manipulation, sometimes employing the oral contraceptive pill, may help to counteract the adverse effects on the ovary. Combination treatment, where both radiotherapy and chemotherapy have been used, tends to have a more adverse effect on fertility.
Even among those who successfully conceive, the rates of both miscarriage and fetal malformation are increased.
What is the advice regarding future pregnancy after successful treatment of Hodgkin's disease?
It is considered wise to wait for at least two years before trying to conceive again. This is because if there is a recurrence in this period, it would inevitably require very aggressive treatment, which will be incompatible with pregnancy.