What is Hodgkin's Disease?
Hodgkin's Disease is one form of lymphoma,
a group of cancers that originate in the lymphatic system. Lymphomas result when a white blood cell
called a lymphocyte undergoes a malignant change and begins to multiply,
eventually creating tumors that enlarge the lymph nodes or other parts of the
immune system.
There are 2 main types of lymphomas. Hodgkin's
Disease (also known as Hodgkin's Lymphoma) is named after Dr. Thomas
Hodgkin, who described it as a new disease in 1832. All other types of lymphoma
are called Non-Hodgkin Lymphomas.
The American Cancer Society estimates that in 2008 there
will be about 8,220 new cases of Hodgkin's Disease in
this country. Each year, 1,350 people will die of the disease. Because of
better treatment, death rates have fallen quite a lot since the early 1970s.
Both children and adults can get Hodgkin's
Disease but it is most common in two age groups: early adulthood (ages
15 to 40) and late adulthood (after age 55).
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Risk Factors
A risk factor is anything that may increase your chance of
developing a disease. Different diseases, including cancer, have different risk
factors. Although these factors may put you at greater risk, they do not
necessarily cause the disease. Some people with one or more risk factors never
develop cancer, while others develop the disease without having any risk
factors.
Some of these risk factors include:
- Epstein-Barr Virus (EBV) Infection/Mononucleosis:
There is a higher risk of Hodgkin's Disease among people who have had
"mono" (infectious mononucleosis), caused by the Epstein-Barr
virus.
- Age: Hodgkin's Disease
is most common in early adulthood (age 15 to 40, especially in a person's
20s) and in late adulthood (after age 55).
- Gender: Hodgkin's Disease occurs slightly more often in males than in females.
- Geography: Hodgkin's Disease is most common in the United
States, Canada, and northern Europe.
- Family History: There is a higher
risk for Hodgkin's Disease in brothers and
sisters of young people with this disease. The risk is very high for an
identical twin of a person with Hodgkin's Disease.
- Socioeconomic Status: The risk of Hodgkin's Disease is greater in people with a higher
socioeconomic background.
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Common Symptoms
These symptoms may indicate that you have a problem but do
not always mean that you have cancer. You should see your doctor as soon as
possible if you experience any of these warning signs:
Enlarged lymph node(s): The most common sign of Hodgkin's Disease
is one or more enlarged lymph nodes. The enlarged lymph node is usually painless
and may be in the neck, upper chest, armpit, abdomen or groin.
- Fever
- Night sweats
- Feeling tired
- Weight loss
- Itchy skin
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Screening and Diagnosis
There are currently no recommendations for regular screenings
for Hodgkin's Disease. If symptoms occur, the following tests should be undertaken.
- Medical history and physical exam
- Your doctor will want to take down your personal and family medical
history to assess the likelihood of your symptoms reflecting that cancer
may be present. You will also be
given a physical examination to locate any enlarged lymph nodes and rule out
infection.
- Lymph node biopsy - A biopsy of the lymph node may be necessary. A
surgeon will remove an enlarged lymph node and have it analyzed by a
pathologist to see if it is cancer that is causing the swelling.
- Blood tests - to look for low red
cells, white cells or platelets and abnormal function of other organs
including the lungs and kidneys.
- Bone marrow aspiration and bone marrow
biopsy - to look for Hodgkin's Disease cells
in the marrow.
- Imaging tests - to create pictures
of the chest and abdomen and see if there are lymphoma masses in the deep
lymph nodes, liver, spleen or lungs. Imaging test will include CT scans
(Computed Tomography), MRI (Magnetic Resonance Imaging), and PET scans
(Positron Emission Tomography).
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Stages of Hodgkin's Disease
Once a diagnosis of Hodgkin's Disease
is made and all of the studies have been completed, doctors will determine how
far the cancer has spread. Staging helps your doctor develop an appropriate
treatment plan.
Stage 1: Hodgkin's Disease is in just one lymph node region.
Stage 2: Hodgkin's Disease is in two or three lymph node regions that
are near each other. For example, the lymphoma is in the upper body regions
(neck, chest and armpit) or the lymphoma is in the lower body regions (abdomen
and groin).
Stage 3: Hodgkin's Disease is in several lymph node regions in the
upper and lower body, such as the neck, chest and abdomen.
Stage 4: Hodgkin's Disease is present in non-lymph node regions of the
body, such as the lungs, liver or bone.
Patients are also divided into either "A" or
"B" categories.
"A" patients don't have fever, a lot of sweating
or weight loss.
"B" patients have fever, a lot of sweating or
weight loss.
Source: The Leukemia &
Lymphoma Society
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Common Treatment Options
Your doctor (a specialist in the treatment of Lymphomas)
will determine the best treatment plan for you. The goal of treatment is to
preserve healthy tissue while destroying the tumor.
Treatment options include:
Chemotherapy is a type of treatment
that uses drugs to kill cells that are malignant and stop the growth of cancer.
Chemotherapy drugs can be taken orally or by injection depending on the type
and stage of the cancer and the type of drug protocol your doctor has
prescribed. It is important to discuss your treatment protocol with your
treatment team so you are aware of any possible side effects.
Radiation therapy is a method of
treatment of cancer using penetrating beams of high-energy waves called x-rays
or gamma rays. Radiation injures or destroys tumor cells by damaging their
genetic material, making it impossible for these cells to continue to grow.
Both chemotherapy and radiation
therapy induce side effects which can be significant including anemia, bleeding
and infections. Late side effects, although unusual, include other cancers,
including leukemia, lymphoma and breast cancer. Conditions of the thyroid gland
are common after radiation therapy.
