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Support Programs Are Vital To Families Of Children With Brain Tumors And Brain Cancer

When a child is diagnosed with a brain tumor or brain cancer, the initial impact that news has on the family is simply overwhelming. This is a crucial time for the patient, parents, and families, as well as friends. Time is often of the essence; quick decisions and fast actions are typically required, and, in a split second, lives are changed forever.Thus begins a journey down a very long and difficult road. Where do parents go for information? Who do they turn to for support? How will they know what’s best for their child? It’s imperative that these families have resources available to them to assist them in making the critical decisions that they now face.Thankfully, there are a number of exceptional family support and outreach programs sponsored by nonprofit organizations focusing on children’s brain tumors and brain cancer. These programs provide valuable resources for education, assistance, and support. While there are many reasons for parents of children with brain tumors to connect with a support group, three of the primary reasons are discussed below.EducationOne of the first questions asked by parents of children newly diagnosed with brain tumors and brain cancer is “What does this mean for my child?”

Family support and outreach programs can answer this and countless other questions by providing resources for general awareness of the disease, treatment options, and even facilities equipped to provide the best treatments available. Support programs can also help families stay abreast of the latest research that’s being done with regard to treatments, survivorship, and long-term effects for the survivors of this deadly disease.AssistanceAssistance for families taking this difficult journey can come in a variety of forms. It may involve locating the right doctors and facilities to care for their child, or perhaps, working through the maze of insurance forms and red tape. Researching options for financial aid, or finding local resources for supplies or services that might be needed for the child’s care and recovery are also ways in which these support groups can offer help to these families.In addition to the assistance provided to individual families, these nonprofit organizations work tirelessly on promoting and servicing the overall mission – finding better treatments for kids suffering from brain tumors and brain cancer, and improving the quality of life for survivors.SupportAbove all else, the parents and loved ones of these kids need emotional support. They need to belong to a community of people who are traveling the same, long road that they find themselves on. They need to know that they are not alone in their journey.The emotional support that is given so freely in these family outreach programs cannot be found anywhere outside these unique groups of fathers, mothers, sisters, and brothers. Who can better understand the grief a mother feels when she learns that her instincts about her child’s health were right? Or the sorrow that consumes a father when he finally allows himself to cry, alone in the shower? And who better to share the joy when a family transitions to survivorship?These family support groups offer not only support for parents and extended families but for the patients, as well. Understanding the toll that this dreadful journey takes on all, most support groups sponsor a variety of conferences, camps, and other events throughout the year as a respite to the families. These events provide opportunities to connect with others in this unique community, while also gaining insight into educational and vocational opportunities.Being very much aware of the needs of bereaved families, and families of survivors, as well, there are also support groups that are geared specifically to their needs. Some of these groups have mentors; parents who have stood in the same shoes, who work with families in a number of ways as they move through the difficult transitions.Education. Assistance. Support. Connecting with the right support group is essential for parents and families facing this difficult journey. Parents, you are not alone. Help is out there, waiting for your call.

Grief – A Universal But Unique Human Experience

My wife was diagnosed with glioblastoma in 2007. She battled stage 4 brain cancer for nearly four years. As her caregiver, I learned about the myriad of issues that family’s face when caring for someone with a life-threatening disease. Understanding human emotion is a difficult area of study. The emotion of grief is no exception. However, experts have provided frameworks that enable discussions about grief.While different grief models exist, proposed by many experts, in 1969, Kübler-Ross published the first, widely accepted model of grief. This work provided insight into the emotions that people experience when facing death. Later, other researchers extended or revised the model to include other people who experience grief, not only those facing death. The Kübler-Ross model includes five stages: 1) shock and denial, 2) anger, 3) bargaining, 4) depression, and 5) acceptance.Most people move through these phases of grief. The length of time a person spends during each phase depends on the circumstances and is unique to each individual. It is very easy to compare ourselves to other people and judge that something might be wrong with us when we do not handle the grief similarly. Just remember, you are unique. Take comfort that your grief recovery is also unique to you. I learned about the grieving process during my studies several years before Lynne’s diagnosis and death. That understanding helped me to recognize my emotions and my feelings as well as to accept that they were normal, and to be expected, during a significant loss.I observed many families over time that lost a loved one. One of the most profound losses a person experience is that of a spouse because of the relationship depth and the additional potential for economic losses. Based on discussions with those losing a spouse, I believe that losing a spouse affects the relationship within the social circles that the couple shared. I believe there are two contributing factors. First, the surviving spouse drawers closer to their own family for support. Second, others within the social circles struggle with the surviving spouse due to a partial loss of identity, that is, the transition from a “couple” to that of a widow or widower. Observations also indicate an increased mortality rate among the surviving spouses, especially in older people due to the major stressor (Gass, 1987, as cited by Harvard Medical School).In our society, most people recognize the inevitable nature of death but many rarely experience the process because societal norms tend to hide death behind the walls of health care facilities. This tends to deemphasize the process of grieving. This potentially decreases our ability to cope. Sometimes during a terminal illness, a struggle exists between health care providers and families, regarding disclosure of all the facts surrounding the illness. Health care facilities and health care providers maintain various and differing ideologies. This is understandable because some people want the facts and others try to avoid the facts. This simply demonstrates the differences in the ability to cope with illness and the potentially impending death.

At some point, each of us will face a significant loss resulting in grief. While this is a universal human experience, each individual experience is unique. My grief recovery was influenced by observing the experiences of other people and training. I hope that by sharing my personal experience that other people will benefit as well. I am writing several articles adapted from a chapter in my upcoming book “Suddenly a Caregiver. The chapter covers a variety of topics about my experience with grief and includes information about grief models, anticipating grief, and preparing for grief.ReferencesHarvard Medical School. (2011). Beyond the five stages of grief. The bereavement process is seldom linear and varies from one person to the next. The Harvard Mental Health Letter / From Harvard Medical School, 28(6), 3.

Grief – Preparing for Loss Through The Living Will

My wife of 31 years, Lynne, lost her life to glioblastoma in 2010 following a battle lasting almost four years against the deadly disease. Glioblastoma is a stage 4 brain tumor, known for its fast-growth and recurring properties. As her family caregiver, I learned about many topics that surface during the care of someone facing a life-threatening illness. This article covers the topic of grief and how preparing a living will help with my grief. I hope that the lessons I learned will encourage you to create a living will.Despite all of the good intentions early in life to prepare a living will, neither Lynne nor I had done so. After her initial brain surgery and recovery, we both prepared a living will and health care power of attorney. Preparing the living will document Lynne’s advanced directives enabled us to discuss Lynne’s decisions regarding the end of her life. The health care power of attorney allowed me to represent Lynne when she could not make decisions herself. The discussions we had and documenting them for legal purposes helped me significantly during the final week of her life and the weeks following her death. Knowing that the decisions I made on Lynne’s behalf were those that she desired lifted a heavyweight from my heart. The doubts that surfaced in my mind following her death eased slightly, as I knew I was following her desires.The many discussions that Lynne and I shared about death and dying during her illness were paramount to my grief recovery. Family members, who openly communicate about death, tend fare better than families with less open communication (Black, as cited in Carmon, Western, Miller, Pearson, & Fowler, 2010). One reaction to grief is personal growth. This reaction seems most predominant in those that openly communicate about their grief. Other reactions to grief include such things as anger, blame, despair, and panic (Carmon, et al., 2010). The discussions between Lynne and me helped to reduce the uneasiness we held about the dying process. In the final months of her life, I began to sense Lynne’s own internal preparation for that day. My selfish nature desired that she live but she showed signs of exhaustion from the three-year battle. As I reflect on those discussions, they are some of my most treasured and valuable memories.

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It is impossible to prepare completely or anticipate all of the emotions and other concerns we face during a loss. I believe that preparing and anticipating the loss causes thinking and actions that help to minimize if only slightly, the grief of the loss. Reminiscing and expressing emotions with family and friends provide effective coping tools after death. For me and my hope for you is that the hopelessness turns into hope, and the grief turns into joy, as you learn to push forward and reflect on the positive memories and the legacy of the life that was lost.ReferencesCarmon, A. F., Western, K. J., Miller, A. N., Pearson, J. C., & Fowler, M. R. (2010). Grieving Those We’ve Lost: An Examination of Family Communication Patterns and Grief Reactions. Communication Research Reports, 27(3),

Symptoms and Signs of Brain Cancer and Treatment

Every individual having brain tumors should receive unique and individual brain cancer treatment. The treatment generally depends on the individual’s age, general health, and the size and location of the tumor.There are several questions surrounding brain cancer treatment. The nature of the treatment, its effects, and the long-term outcomes are some of them. Doctors are best equipped to handle these questions.Overview of brain cancer treatmentBrain cancer treatment is generally complex. Some treatment plans will require multiple doctors.1. The medical team usually comprises neurosurgeons, oncologists, radiation oncologists, and a general practitioner. Individuals may also want to include a dietitian, social worker, and physiotherapists.2. The nature of the treatment will depend on the location, size, and type of the tumor. Existing medical conditions and age are other factors that need considerations when deciding the nature of the treatment.Brain Cancer SurgeryMost individuals who have a brain tumor are required to undergo surgery.

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1. Surgery helps confirm the abnormality seen in the brain scans. The nature of the tumor and method of removal are also determined at the time of surgery. Surgeons will most probably take a sample of the tumor that needs to be removed.2. When it comes to benign tumors, most symptoms vanish with the removal of the tumor.3. A modern method for removal of tumors can be performed without a knife and is called stereotactic surgery. The tumor is removed without opening the skull. MRI and CT scans are used to determine the exact location of the tumor within the brain. Radiation beams are focused on the tumor from different directions. Radiation helps destroy the tumor. This method is also known as the ‘gamma knife’.4. Knifeless surgeries have fewer complications. The recovery time, too, is much shorter.Before surgery, individuals may have to undergo several treatment plans.1. Administration of dexamethasone helps reduce swelling. It is also a steroid drug.2. Treatment with anticonvulsant drugs, such as carbamazepine, relieves seizures. It also prevents its formation.3. Excessive cerebrospinal fluid around the brain can be drained away by a thick plastic tube known as a shunt. One end of the shunt is fixed in the cavity where the fluid gathers. The other end is threaded under the skin to another body part. The fluid drains into a site from where it can be easily eliminated.Brain Cancer Radiation TherapyRadiation therapy, also known as radiotherapy, involves the usage of high-energy rays to destroy cells of the tumor. This prevents tumors from growing and multiplying.3-In-1 Online MegaStore That Sells Physical And Digital Products (Built-in Affiliate Program)ShopZPresso: Shopify Amazon Envato and Clickbank into ONE system…

Grief – A Universal Human Experience

Hi,____, I was able to get a store https://shopzpresso.club/top-nutrition-101/ it is connected to or affiliated to my WordPress blog Top Nutrition Expert (com) it would be nice if you would stop by to give it a look so I could get a review https://g.page/r/CdaKFyal4iKqEAg/reviewMy grieving process started at the point of Lynne’s diagnosis, not her death. The week following her diagnosis, I spent nearly every evening shedding tears and agonizing over the future that lay ahead. Thoughts of unfulfilled dreams and goals circled my mind numerous times throughout each day. As I researched the disease, the certainty of Lynne’s eventual death moved to the forefront of my mind. I tried to balance those thoughts with the hope that Lynne’s case might be different in some way, but it was an internal struggle.Like any couple, we held onto the hope that our plans for the future would remain intact. We discussed goals throughout our marriage about retirement. We shared about the continued ability to travel. We shared thoughts about the enjoyment of watching grandchildren grow up. We discussed our dreams of a slower-paced life hoping to enjoy the simpler things in life. Those kinds of things we tend to take for granted in our younger years as we focus on building our lives and careers. In one day, the plans and dreams we made together seemed to shatter like glass hitting a tile floor. Forever lost with no possibility of ever putting the glass back together.About six years earlier because of my responsibilities as a deacon at the Sun Valley Church of Christ, I enrolled in a course to help me enhance my skills and abilities as a people helper. As a people helper, people often approached me to share personal struggles. I desired a better foundation of knowledge to help me guide them through their struggles. A few of the classes within that course of study helped me to prepare for what was ahead in my own life. One class covered forgiveness, letting go of the past and the pain. Another covered marriage and keeping love alive. Another covered pain and suffering, for learning to help people in a hurting world. Yet another covered managing stress and anxiety. The most important class that would bear on my own future was a class about grief and loss. While my intent was to learn about these topics to assist others, the importance of that learning helped me to understand the emotional turmoil that I was facing and some techniques to help me manage my way through the pain.

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Grief is a universal human experience. However, the experience is unique to every individual. In some ways, my grief recovery was assisted by learning from other people and I hope that by sharing my personal experience that others will also benefit. I am writing several articles covering various aspects of the grieving process including grief models, anticipating grief, and preparing for grief.

Grief – Preparing for Loss

Lynne, my wife of 31 years, battled glioblastoma for nearly four years. Glioblastoma is a stage 4 brain cancer and is recognized for its ability to recur and its fast-growth. While caring for someone with a life-threatening illness, I learned about grief and some steps that help to ease the grief slightly by preparing for loss.Preparation for grief was an important piece of recovery from my loss. When I say, preparation, you might think that it started during Lynne’s illness. I believe that for me, it started much earlier and demonstrated itself in various ways. Because my dad served as a preacher, exposure to death occurred earlier and more often to me than for most young people. Like most, I lived life as if it were going to last forever; however, the exposure to death created an impression on me. Exposure to death helped me to realize that this life is temporary. This mindset helped me to share my appreciation of others before it was too late. Too many times, I heard others speak about their regrets concerning not sharing how much they loved someone or appreciated his or her example until after the death. I feel that is a pity. I decided to ensure that I tried to share my appreciation with those I cared about while they were still living.Preparation for loss also included setting aside any grudges, anger, bad feelings, and other things that most of us would regret holding onto after the loss of someone close to us. This also includes apologizing to someone for some wrong that we caused. I discovered that stepping up and apologizing when I was wrong was much better than holding onto that wrong eventually causing a regret following the loss of that special person. Avoiding the apology for the wrong might cause regret eventually, following the loss of that special person. This type of preparation averts the regrets we often feel during a loss, whether the loss is sudden, or resulting from a long illness.3-In-1 Online MegaStore That Sells Physical And Digital Products (Built-in Affiliate Program)ShopZPresso: Shopify Amazon Envato and Clickbank into ONE system…

Grief – Moving Toward Acceptance

Lynne, my wife of 31 years, lost her life to glioblastoma in 2010. Her death followed a battle lasting almost four years against the deadly disease. Glioblastoma is a stage 4 brain tumor, known for its fast-growth and recurring properties. As her primary caregiver, I learned the issues surrounding the care of someone facing a life-threatening illness. This article covers grief and one lesson that I learned. I hope this will help someone else when faced with a significant loss.About six years prior to Lynne’s illness, I enrolled in a course covering counseling topics because of my responsibilities as a deacon at the Sun Valley Church of Christ. As a people helper, people often approached me to share personal struggles. I desired a better foundation of knowledge to help me guide them through their struggles. Some of the classes helped to prepare me for what was ahead in my own life. The importance of that learning helped me to understand the emotional turmoil that I was facing and some techniques to help me manage my way through the pain.

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Grief is a process that causes psychological pain, creating emotional turmoil with feelings of guilt, depression, anger, sadness, helplessness, rage, loneliness, resentment, and hopelessness. I learned that the emotions that swirled within me were a normal part of the grieving process. Recognizing that early, helped me to be easy on myself as I worked through the grieving process. I believed that I moved to the acceptance phase of the process more quickly than most, in part because of the training I had received.Another source of strength at that time was my spiritual upbringing and lifestyle. This was also a big part of Lynne’s life. With this similar outlook on life, we were able to be in tune with one another. I reflected on one biblical passage frequently, “For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future” (Jeremiah 29:11, New International Version). Despite this tragedy, I believed that God had a plan. His eternal nature, unrestricted by time, enables Him to see what we refer to as the past, as well as into what we refer to as the future. Time limits me, by allowing me to see only the past and the immediate. Because I cannot see into the future, I reasoned that God could see some future event in Lynne’s life that might be much worse than glioblastoma. To me, there could be no worse event but that might simply be due to the limitations placed on me by time and the inability to see into the future.After Lynne’s death, I read a grief recovery book that helped me understand why the depth of grief for one person might be different when compared to the depth experienced by another person. Recovery from grief suggests the ability to recall the good memories you hold fondly while minimizing those feelings of remorse or holding on to the regrets that you are harboring (James & Russell, 2009). I see this as key to understanding the relatively short duration of my personal grieving period.Lynne and I were very compatible and truly enjoyed our 31 years together as a married couple. We had our fair share of disagreements and disputes along the way. However, we did enjoy a marriage that others recognized in positive ways. The enjoyment of our marriage increased dramatically during Lynne’s illness. This may seem very strange to you, so please allow me to explain this phenomenon.Throughout the early years of our marriage, I appreciated and was grateful for Lynne’s concern for others, her willingness to help others, and her support and care for me and our children. Lynne impressed me with her ability to run our home, her industrious nature and attention to detail, and a slew of other traits. Yet in the last four years of Lynne’s life, I witnessed a sign of courage, vision, and personal strength that I had underestimated in our earlier years together. During those final years, we also discussed topics that most people try to avoid such as death and dying. We discussed what we hoped for one another. She shared her desire that I find another woman to love and care for after she passed. A topic like that may seem like a ridiculous discussion when in health, but it is not whenever someone faces the last stages of life. Lynne shared her appreciation of my care and love for her and her acceptance that I would love and care for another woman in the future. Even before her death, she released me from the anxiety of the considerations concerning moving on with life, after she passed. In that discussion, she released me from the anxiety or guilt associated with moving forward in life.ReferencesJames, John W. and Friedman, Russel. (2009). The grief recovery handbook (20th anniversary expanded edition). HarperCollins e-books.3-In-1 Online MegaStore That Sells Physical And Digital Products (Built-in Affiliate Program)ShopZPresso: Shopify Amazon Envato and Clickbank into ONE system…

Returning to School After a Cancer Diagnosis

“Back to normal” means “back to school” for most children who have been treated for a brain or spinal tumor. When your child returns to school, you want him or her to be treated as normally as possible and it will take the cooperation of both the school and the health care professionals working with your child to make this happen… To make the transition back to school an easy one the teachers and school nurse should be encouraged to prepare classmates by providing them with information about the disease and treatment and answering any questions they may have. Let the teachers and classmates know what to expect and give them an opportunity to express their concerns and feelings. It is important for teachers to communicate to other students that cancer cannot be caught and that radiation treatments do not make a child who has them “radioactive.” These types of open conversations may eliminate children’s curiosity and make it easier for them to accept your child back into the class and help them to accept the differences in their classmates and make them more empathetic and willing to help. Some medical centers provide an education team consisting of a child life worker and health care practitioner who can help prepare the class for your child’s return, which in some cases may be helpful.In order to make the re-entry into the scholastic environment less abrupt for your child, the students, and the teachers, a slow, transitional approach to reentering school can be helpful, perhaps only having lunch, attending specific classes, or going on a field trip with the class prior to a full-time return to school. It is important to update your child’s teachers and the school nurse with whatever medical information will help them help your child in school. The more knowledgeable and familiar the teachers are with how your child functions, the more the classroom environment can be adapted to your child’s special needs, no matter what level of school they may be returning to.

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Before your child returns to school, set up a meeting with the teacher, school nurse, and principal. This meeting will give you an opportunity to discuss any special requests or concerns you might have. Suggest that the meeting also include health care professionals such as neuropsychologists familiar with brain tumor treatments, including surgery, radiation therapy, chemotherapy, and shunts, and give your child’s teacher a copy of Cancervive Teacher’s Guide for Kids with Cancer. You might want to meet or speak with the teacher on a weekly basis to monitor your child’s progress; it might also be helpful to connect with your other children’s teachers as well. Remember to keep an open line of communication with your child’s school. The role the teacher plays is very significant to your child’s developmental adjustment and recovery. The teacher and/or school nurse must inform you of any communicable diseases, such as chickenpox, that any class member has contracted. If your child is still in treatment and has not had chickenpox, exposure to this virus can be dangerous, and you should contact your physician immediately. (Chickenpox is worrisome primarily after chemotherapy; doctors rarely worry after radiation therapy.) If informed, teachers can deal successfully with problems concerning your child’s self-image and relationships with peers as they arise.Holding a meeting prior to your child’s return to school can be helpful in determining any accommodations that may be needed to meet your child’s special needs. Check to see if your school has wheelchair accessibility for both the classrooms and toilet facilities, as special bathroom privileges may be needed. Your child may need a playground or gym exemption if he or she is easily fatigued or has coordination problems. Seating arrangements in the classroom may need to be adapted if your child has suffered permanent or temporary hearing or visual impairment. You may want to discuss modifying homework assignments with the classroom teacher. If your child needs to take medications during the day, it is very important that you inform the teacher and the school’s principal, and nurse what the medications are for and what their side effects may be. All of these procedures, if reviewed beforehand, will make a child’s return to school much smoother.The level of parental involvement wanted by a child varies by age, gender, and individual personality. It is important to discuss returning to school with children no matter what age to be sure everyone is on the same page and children are allowed to have a voice in the involvement of their parents in their school.3-In-1 Online MegaStore That Sells Physical And Digital Products (Built-in Affiliate Program)ShopZPresso: Shopify Amazon Envato and Clickbank into ONE system…

How To Lower The Risk Of Brain Cancer Recurrence And Secondary Brain Cancer

Conventional therapy can be effective at destroying brain tumor. However, it is a healthy body and immune system that provide ongoing surveillance and destruction of cancer tumor regrowth. An important part of a post-treatment healing program is to support optimal health and to employ brain cancer prevention strategies. These strategies will support the innate healing capacities within each of us. Optimal health rests upon a foundation of healthy eating, adequate exercise, sufficient sleep, and meaningful as well as the joyful living.In addition to food, movement is also healing. Our bodies are meant to move. The research on the importance of exercise in preventing brain cancer and its recurrence is substantial. At a minimum, 30 minutes of moderately difficult exercise (brisk walking, jogging, bicycling, swimming, dancing, and so on) done every day is associated with a reduced risk of cancer and of dying from cancer. For instance, compared with a man who was inactive both before and after a diagnosis of brain cancer, a man who increased physical activity after diagnosis had a 45 percent lower risk of death, and the man who decreased physical activity after diagnosis had a four-fold greater risk of death.The idea is to change the environment to be the least hospitable to cancer. We do this with exercise but we also do this with sleep. Sleep is critical to optimal health. Sleep is critical for a well-functioning immune system. In fact, several key anti-cancer immune actions are most active during sleep. Stress reduction is also a big part of the anti-cancer plan. Finding ways to manage stress is of utmost importance. Elevated levels of stress-induced chemicals and hormones unravel immunity, cripple cell repair, and increase the susceptibility of our cells to cancer-causing DNA damage. While we cannot eliminate all the stress in our lives, we can certainly change the way we perceive stress. Meditation, yoga, tai chi, and hobbies are just a few ways to create more inner calm and less stress. It is important to make relaxation a part of your daily routine.3-In-1 Online MegaStore That Sells Physical And Digital Products (Built-in Affiliate Program)ShopZPresso: Shopify Amazon Envato and Clickbank into ONE system…

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Fertility Preservation in Women and Men With Hodgkin Lymphoma

Lymphoma is a cancer of lymphocytes, the cells that are part of the human immune system. The disease was first described in 1832 and can start anywhere lymphocytes are found (lymph nodes, spleen, bone marrow, or digestive tracts). Two types are recognized; Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). The American Cancer Society estimates that approximately 3800 women and 4600 men will be diagnosed with HL in 2010. The majority of those diagnosed with HL are children and young adults (age 15 to 40 years). Modern treatment carries high survival rates. (>80%). HD, however, by virtue of the disease itself or its treatment poses considerable risk to fertility in women and men, especially if it recurs after treatment.When HD is suspected usually because of enlarged lymph nodes or other symptoms such as a fever, weight loss, or night sweating, a biopsy of lymph nodes is required for the diagnosis. Biopsy require special stains (CD15, CD 30) for proteins on the surface of the characteristic cell. Once confirmed certain imaging studies (especially PET scan) to detect the extent of the disease.3-In-1 Online MegaStore That Sells Physical And Digital Products (Built-in Affiliate Program)ShopZPresso: Shopify Amazon Envato and Clickbank into ONE system…

Hi, I was able to get a store https://shopzpresso.club/top-nutrition-101/ it is connected to or affiliated to my WordPress blog Top Nutrition Expert (com) it would be nice if you would stop by to give it a look so I could get a review https://g.page/r/CdaKFyal4iKqEAg/reviewChemotherapy for Hodgkin Lymphoma; combination chemotherapy is used either ABVD, BEACOPP, or MOPP-ABV. Each of the letters represents one medication. The combination of drugs is used for several cycles usually 3 to 6. This is the principal treatment for HL.Radiation therapy using an external beam is sometimes combined with chemotherapy. Radiation is usually localized to the area of the body that harbors enlarged lymph nodes.Hematopoietic stem cell transplantation (HSCT). This treatment is used for resistant HL or HL that recurred after successful treatment in the past (relapse). This treatment requires 1. very high dose of chemotherapy and possibly total body radiation then 2. transplantation of the mother cells of the bone marrow that produce our blood cells. The sources of these cells could be the person himself (autologous) a donor person (allogenic).Effects of Hodgkin Lymphoma and treatment on future fertility. It has been shown that men and women attempting conception after treatment for HL had lower chances of becoming pregnant than the general population (Aisner 1993).Men: There is evidence to suggest that HL itself can affect sperm production in 50 to 70% of boys and men, probably due to the disturbance of the immune cells. Chemotherapy also can be harmful to sperm production. Alkylating agents especially cyclophosphamide can cause prolonged or permanent azospermia (no sperm production). The other agents may have a reversible effect with some prospects of recovery after months to years. The final effect of chemotherapy is difficult to predict and is related to the type of regimen and doses used. For example, the old MOPP regimen for 6 or more cycles results in a very high rate of azospermia while the newer ABVD regimen usually causes reversible azospermia.HSCT entails the use of a high dose of alkylating agents and sometimes radiation. It commonly results in prolonged azospermia. HL or its treatment may also affect sperm quality (sperm shape and motility) in addition to concentration. Suppression of sperm production in the testes using a group of medication called gonadotropin-releasing hormone agonists (GnRHa) has been suggested but there is no proof that they protect the gonads from the effects of treatment in men and women. The testes should be shielded from the radiation field whenever possible.Women: Chemotherapy for HL can result in a reduction of ovarian reserve and may reduce future fertility depending on the medication used, dose, frequency, intensity, age, and associated radiation treatment. Multiple studies suggested that the risk of loss of fertility is related to 1. Age > 30 years (or > 25years with high dose therapy) 2. Type of chemotherapy. MOPP was associated with loss of fertility than ABVD and BEACOPP. 3. Dose and frequency of chemotherapy. Dose escalation BEACOPP used in more advanced HL was associated more with ovarian failure. 4. Exposure of the ovaries to radiation. In a large study about 20% of women experienced menopause. In another study, about 40% of women were able to conceive after treatment. In general published literature is not accurate in reporting fertility potential because they used menses as their endpoint. Resumption of menses after chemotherapy does not accurately reflect fertility potential. The high dose of chemotherapy used prior to HSCT is associated with ovarian failure in the vast majority of women and girls.Options for the preservation of fertility in men. 1. Sperm cryopreservation: This is a widely available and safe option in adults. One or multiple sperm samples are obtained and frozen for later use. After remission, the sample is thawed and used for intrauterine insemination or in vitro fertilization. If IVF is used a single sperm is injected directly into a partner oocyte (ICSI) and the rest of the sperm is refrozen. ICSI is a very powerful tool that can compensate for lower quality sperm encountered in men with HL. In prepubertal boys, sperm may be found in the ejaculate as early as 12 years. Asking prepubertal boys to produce a sperm sample may carry some ethical consideration. The majority of cancer patients are interested in knowing their options about the preservation of genetic parenthood in the future. In spite of that, only about one-quarter freeze their sperm, mainly because of a lack of information about sperm freezing (Schover et al 2002). A survey of over 700 oncologists indicated that less than half offer this option to their patients diagnosed with cancer. 2. Surgical sperm retrieval (TESE). Testicular sperm extraction is a surgical procedure where a small amount of tissue is harvested directly from the testes to obtain sperm. It is used in men with azospermia before starting treatment. The specimen is frozen for future use with IVF-ICSI. This is a common procedure in adults and has been reported in prepubertal boys. 3. Testicular stem cell freezing; either within testicular biopsy or separated cells. This is an experimental method with no reported human pregnancy. It is considered for prepubertal boys. The cells or tissue is later transplanted back for sperm production.Options for the preservation of fertility in women.1. Embryo freezing. This technology is widely available and suitable for women with a partner (or accepting donor sperm) and treatment can be delayed for 3 weeks. It requires stimulation of the ovaries and egg retrieval (an outpatient procedure under sedation). Embryos can be frozen for a long time and transferred after remission when fertility is desired.

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2. Egg freezing. Used in women with no partner and declining the use of donor sperm. It also requires ovarian stimulation and a treatment delay for 3 weeks. It’s generally less successful than embryo freezing, although the use of the vitrification method can yield comparable results to embryo freezing.3. Ovarian tissue freezing. This method is experimental. It’s used in prepubertal girls or in women that need to start treatment urgently and do not have the time to undergo ovarian stimulation. Its also considered in women or girls before undergoing HSCT since it is associated with a very high rate of ovarian failure. One ovary is harvested usually using minimally access surgery (laparoscopy). The patient is discharged the same day and can start treatment immediately. The ovary is processed so that the outer part (2mm thin) is isolated and frozen. The inner part of the ovary (does not bear eggs) is submitted for pathological examination. After remission, the ovary is transplanted back in the abdomen or under the skin.Women and men diagnosed with Hodgkin Lymphoma experience a high chance of cure. Counseling about fertility issues before treatment can enable them to preserve their sperm, eggs, or embryos for future use after treatment.

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