Referral to a specialist for symptoms of Hodgkin lymphoma

Your GP should arrange for you to see a specialist if you have symptoms that could be due to Hodgkin lymphoma. You usually see a haematologist. This is a doctor who specialises in treating blood conditions, including lymphoma. You may see a different specialist first, depending on your symptoms. For example you might see a head and neck specialist if you have a swollen lymph node in your neck.

Depending on your symptoms and other factors, this might be suspected cancer pathway referral. 

You will see a specialist as soon as possible. Ask your GP when this is likely to be.

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

Your GP might arrange for you to have some tests first. This will help them decide if you need to see a specialist.

UK referral guidelines

There are guidelines for GPs to help them decide who needs a referral. These vary slightly between the different UK nations. Your GP will use these guidelines as well as their own experience and judgement.

The Northern Ireland and Scottish guidelines are for all blood cancers, not just Hodgkin lymphoma.

In England and Wales

Your GP will consider a suspected cancer pathway referral if you have swollen lymph nodes and your GP can't explain the cause. Your GP will also take into account any other symptoms you might have such as:

• high temperature (fevers)

• heavy sweating at night

• unexplained weight loss

• itchy skin

• shortness of breath

• pain in your lymph nodes when you drink alcohol

Children or young people (up to the age of 24) should be seen by a specialist within 2 days.

In Scotland

You should have an urgent referral to a specialist if:

• your blood test result suggests that you have acute leukaemia or chronic myeloid leukaemia
• your swollen lymph nodes are larger than 2 cm and have either been swollen for more than 6 weeks or are getting bigger
• you have a swollen (enlarged) liver or spleen but you don’t have any known liver disease
• you have bone pain together with anaemia or an abnormal paraprotein
• a bone x-ray suggests you may have myeloma

You might have an urgent referral if you also have any of the following signs or symptoms:

• extreme tiredness (fatigue)

• heavy sweating, especially at night

• weight loss

• itching

• bruising

• infections that keep coming back

• bone pain

• weeing a lot and feeling very thirsty due to high calcium levels in your blood

In Northern Ireland

Your GP should refer you immediately to see a specialist if:

• your blood test results show you have acute leukaemia
• you have either spinal cord compression  or kidney failure which your GP thinks could be caused by myeloma

Your GP should refer you urgently if you have unexplained enlarged spleen that doesn’t get smaller.

Your GP should do further tests and consider referring you to a specialist if you have a combination of some of the symptoms listed below. The urgency of the referral depends on how severe your symptoms are and your test results. Symptoms include:

• extreme tiredness (fatigue)

• heavy sweating at night

• high temperature (fever)

• losing a lot of weight

• itching all over the whole body

• feeling breathless

• bruising

• bleeding

• infections keep coming back

• bone pain

• pain after drinking alcohol

• tummy (abdominal) pain

• swollen lymph nodes

• enlarged spleen

If swollen lymph nodes are your only symptom, you do not usually need to see a specialist.

Other symptoms

Your GP will consider any other symptoms you are having, so do mention these. They might also take into account whether you have any risk factors that affect your chances of developing Hodgkin lymphoma.

If you’re still worried

Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print this page and the symptoms page. Ask your GP to explain why they don’t think you need a referral.

Contact your GP again if your symptoms don’t get better or you notice any new or unusual symptoms.

What should you do if you don’t get an appointment?

If your GP has referred you, ask them when you should get your appointment. Contact them again if you don’t get one. Or some hospitals have a referral service you could try contacting if you know which hospital you are going to. Explain that you are waiting for an urgent suspected cancer referral.

Waiting times

Your hospital is working towards waiting time targets. For example, a target to find out whether you have cancer or not. And there are targets to start treatment if you are diagnosed with cancer. These are slightly different depending on where you live in the UK.