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Hodgkin's Lymphoma
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Hodgkin's lymphoma is an immune system cancer commonly occurring in young adults. The cells of the immune system grow out of control and can spread to other body areas. It is related to but different from non-Hodgkin's lymphoma. It makes a person less able to fight off infectious disease. Hodgkin's disease used to be mostly lethal but is now completely treatable with advanced detection and early treatment with newer and better-acting drugs.
Symptoms of Hodgkin's lymphoma include having a swelling of the lymph nodes of the groin, armpits or neck. The swelling is usually not painful. The other symptoms include tiredness, chills, fever, night sweats, loss of weight, trouble breathing, a loss of appetite, increased sensitivity to drinking alcohol and somatic itching.
The cause of Hodgkin's lymphoma is not known. There is classical lymphoma and nodular lymphocyte-predominant lymphoma. Classical lymphoma is the most common type of lymphoma. There are four subtypes of classical lymphoma which are treated differently from one another.
Hodgkin's lymphoma starts in the lymph nodes, usually in the upper part of the body. Some are easily seen but some are within the body and cannot be seen without x-ray. The lymph node cancer can then spread to many different parts of the body. Hodgkin's lymphoma involves a cancer of the B cells of the immune system. When the B cells become abnormal, they turn into Reed-Sternberg cells-cells that do not die normally and produce abnormal cells which are cancerous. Other lymph cells are attracted to the lymph nodes, causing overall lymph node enlargement.
Risk factors associated with Hodgkin's lymphoma include being between the ages of 15 and 40. There is an increased incidence of Hodgkin's lymphoma also past the age of 55. Family history of Hodgkin's disease makes one prone to getting Hodgkin's lymphoma. Males get the disease more likely than females. Having had mononucleosis, caused by Epstein-Barr virus, makes one prone to getting Hodgkin's lymphoma later in life. Poor immune system function is associated with getting this disease. It is more common in the US, Europe and Canada than in Asian or South American countries.
The diagnosis of Hodgkin's lymphoma depends on the signs of the disease as well as on the biopsy results. In Hodgkin's disease, there is an orderly pattern to the spread of the disease and rarely "skips" lymph nodes. The biopsy shows B cell enlargement and cancerous changes in the lymph nodes. The physical exam shows multiple areas of lymph node involvement. X-rays can show lymph node enlargement in the mediastinum (anterior central portion of the chest). A CT scan or MRI scan can show the extent of the involvement of Hodgkin's lymphoma in the body. Bone marrow testing can show if the disease has affected the bone marrow.
Hodgkin's disease is staged to define survivability and to gauge treatment. Stage I disease means the disease is found only in a single lymph node region. Stage II disease means the lymphoma cells are found in two different lymph node areas but is limited to a single body area. Stage III cancer involves cancer cells seen in lymph nodes existing both above and below the level of the diaphragm. It can be in the spleen as well as in the chest area. Stage IV disease involves diffuse areas of involvement of cancer in many lymph node areas above and below the diaphragm. The lungs, bone and liver can be involved with cancer.
Treatment of Hodgkin's disease depends on the stage as well as on the person's age at the time of diagnosis, the symptoms involved, whether or not the person is pregnant and the health of the individual. The good news is that 95 percent of those individuals with stage I or stage II disease survive past five years. Even those with widespread disease can survive past five years at a rate of about 60-70 percent.
The treatment of Hodgkin's lymphoma involves the use of chemotherapy, which kills cancerous cells. Chemotherapy works well but can lead to damage to the lungs, heart and liver. Fertility can be permanently impaired. Secondary cancers, including leukemia, can come from having chemotherapy for Hodgkin's lymphoma. Multiple chemotherapy drugs are often used to treat the disease.
Radiation therapy can help kill cancer cells in a specific area. The length of radiation therapy as well as the dose of radiation therapy depends on the particular stage of the disease involved. Radiation can be used first, before chemotherapy, and may be the only treatment used to manage the disease.
If Hodgkin's lymphoma recurs after cancer treatment, a bone marrow transplant or stem cell transplant may be necessary. You can use your own stem cells or your own bone marrow in an autologous transfer after receiving chemotherapy that completely kills the cancerous cells. After the cancer is killed, the cells of the bone marrow or the stem cells are added back to the body and populate the immune system.