Hodgkin's Disease
Also known as: Hodgkin's Lymphoma
What is it?
Hodgkin's Disease is one of a group of cancers called "lymphomas." Lymph tissue is part of the body's immune system, which sends out white blood cells and antibodies to fight infection. Lymphoma refers to cancers that develop in the lymphatic system. In Hodgkin's disease, cells in the lymphatic system become abnormal. The disease usually spreads from the lymph nodes in the neck, chest, and armpits to the spleen, and then to the liver or nodes bordering the aorta.
Who gets it?
Hodgkin's Disease is a rare lymphoma that accounts for less than 1 percent of all cases of cancer in the United States.
Hodgkin’s lymphoma can occur at any age, but the
majority of those affected are young adults
between 15 and 35 years of age, and older adults
over age 50. The disease affects between 8,000 and
10,000 Americans each year, and is more common in men than in women. If you have a brother or sister with Hodgkin's Disease, you may have a higher-than-average chance of developing the disease. Those with the Epstein-Barr virus may also have an increased chance of getting Hodgkin's disease.
What causes it?
Doctors do not know what causes Hodgkin’s
lymphoma, though some suspect genetic factors are
involved along with environmental exposures and
exposure to infectious agents. Immune system
deficiencies may also be involved.
What are the symptoms?
As many as 75 percent of patients diagnosed
with Hodgkin’s lymphoma experience no symptoms of
the disease. Common symptoms in its early stages
include fever, night sweats, chills, fatigue, loss
of appetite and weight loss, loss of bladder
and/or bowel control, itching numbness in the arms
and legs and loss of strength, pain after drinking
alcoholic beverages and swelling of one or more
lymph nodes.
As lymph nodes swell, they may push on other
structures, causing a variety of symptoms such as
pain due to pressure on nerve roots; loss of
function in muscle groups served by compressed
nerves; coughing or shortness of breath due to
compression of the windpipe and/or airways; kidney
failure from compression; swelling in the face,
neck, or legs due to pressure on veins; and
paralysis in the legs due to pressure on the
spinal cord.
As Hodgkin's lymphoma progresses, the immune
system becomes less effective at fighting
infection and patients become more susceptible to
both common infections caused by bacteria and
unusual infections. Tumors may also begin to form.
How is it diagnosed?
To diagnose Hodgkin’s lymphoma, the doctor may
examine the patient for signs of tender, swollen
lymph nodes. The lymph nodes that are most often
affected by Hodgkin's
lymphoma are those in the neck, above the
collarbone, under the arms, and in the chest above
the diaphragm. The doctor may want to remove an
enlarged lymph node, remove a small portion of it,
or take fluid from it to determine whether giant
cells called Reed-Sternberg cells are present to
confirm diagnosis. A bone marrow biopsy may also
be performed to see if the disease has spread to
the bone marrow.
The doctor will then determine what stage of
the disease the patient has. This is important,
because Hodgkin’s lymphoma usually progresses in a
predictable pattern. The doctor may order tests
such as a CT or CAT scan, chest x-ray or MRI to
identify other areas of enlarged lymph nodes and
abnormalities in the spleen or other organs. The
patient may undergo an operation to check the
abdominal lymph nodes and other organs for cancer
and to remove small pieces of tissue to examine
further.
In stage I of Hodkin’s lymphoma, one lymph node
region is involved; in stage II, two lymph node
areas on one side of the diaphragm are involved;
in stage III, lymph node regions are involved on
both sides of the diaphragm; in stage IV, cancer
is also detected in the bone marrow or liver. In
addition, patients are designated stage A if they
lack any symptoms and stage B if the patient has
lost ten percent of his or her body weight over
the last six months and experiences fever or night
sweats.
What is the treatment?
To treat Hodkin’s lymphoma, the patient may be
referred to a medical oncologist (a physician
specializing in cancer). Treatment may depend on
the stage of the cancer and whether or not
symptoms are present to minimize possible side
affects. Radiation therapy and/or chemotherapy
(drug therapy) are the standard treatments for
Hodgkin's lymphoma.
You may also need to be vaccinated against the
flu, pneumonia, and meningitis because the disease
interferes with your ability to fight off
infections. Hodgkin's is one of the most curable
forms of cancer because its spread is so
predictable and it responds so dramatically to
treatment. Children have a particularly high rate
of cure from the disease. Adults with the most
severe form of the disease have about a 50% cure
rate.
If the disease is confined to one area of the
body, such as in stage I or II, radiotherapy may
be used. This treatment is also used when the
disease is in bulky areas such as the chest, where
chemotherapeutic drugs cannot reach all of the
cancer.
If the Hodgkin's lymphoma has progressed to
additional lymph nodes or other organs, or if
there is a recurrence of the disease within two
years of radiation treatment, chemotherapy may be
used. Treatment for higher-stage Hodgkin's disease
often involves a combination of radiotherapy and
chemotherapy. Following three or four chemotherapy
regimens, involved field radiation may be directed
at the most affected areas of the body.
Self-care tips
While there are no preventive measures for Hodgkin's Disease, early diagnosis is important to a full recovery. Report any Hodgkin's-like symptoms that persist to your health care provider and be sure to follow the full course of treatment that is recommended.
After being treated for Hodgkin’s lymphoma, the
doctor may recommend follow-up examinations for
several years to detect a return of the disease or
the development of another cancer, a possible side
affect of treatment. Advances in radiation therapy
and chemotherapy are enabling many patients to
survive this once dreaded disease.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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