Hodgkin's lymphoma is an uncommon form of cancer involving lymphatic tissue in the lymph nodes and spleen. Lymph nodes produce lymphocytes, a type of white blood cell that is crucial in regulating and carrying out most of the activities of the immune system. In Hodgkin's disease, cells in the lymphatic tissues grow in a rapid and uncontrolled manner'the defining characteristic of cancer. If not treated in time, the cancer may spread to other organs, such as the lungs, liver, and bone marrow. In addition, the proliferation of abnormal lymphocytes reduces the number of healthy lymphocytes. The resulting impairment of the immune system leaves the body susceptible to serious infection. However, with prompt detection and treatment, prognosis is good (more than 75 percent of adults diagnosed with Hodgkin's are curable). The mortality rate is dropping more rapidly for this disease than for any other type of cancer in the United States, largely because of advances in therapy. Hodgkin's disease is more common among men than women. It most often affects those between ages 15 and 35, and those older than 55.
Symptoms of Lymphoma, Hodgkin's Disease
Painless, gradual swelling of lymph nodes,
especially in the neck, underarms, or groin. (In
a few cases lymph nodes enlarge rapidly and
painfully or may fluctuate in size.)
Fever, chills, or night sweats.
Persistent fatigue.
Weight loss and loss of appetite.
Itching that worsens as the disease progresses.
What Causes Lymphoma, Hodgkin's Disease
The cause of Hodgkin's disease is unknown. Hereditary factors may play a role, as may certain viruses, such as the Epstein-Barr virus. The incidence of the disease appears to be higher among those with immune system disorders or those receiving immunosuppressant drugs (used after organ transplants, for example).
Prevention of Lymphoma, Hodgkin's Disease
There is no way to prevent Hodgkin's lymphoma.
Diagnosis of Lymphoma, Hodgkin's Disease
Patient history and physical examination.
Lymph node biopsy, in which a portion of an enlarged lymph node is removed and examined under the microscope. Presence of a specific type of cell (Reed-Sternberg cell) characteristic of Hodgkin's disease provides a definitive diagnosis.
Other tests, including blood tests; liver, spleen, and bone marrow biopsies; chest x-rays; abdominal CT (computed tomography) scans; and bone or lung scans may be done to determine the extent of lymph node and other organ involvement.
How To Treat Lymphoma, Hodgkin's Disease
Successful treatment is based heavily upon a process known as staging, which depends upon the presence or absence of general symptoms, use of a battery of tests to determine how far the cancer has spread, and the microscopic appearance of the lymphatic tissue.
Patients are also designated as A or B, with B referring to those who exhibit fever, night sweats, and/or weight loss. B patients have a worse prognosis.
In most cases, radiation therapy alone is used for Stage I as well as for Stage II cancers. Stage I is the earliest and least serious stage, involving only one lymph node region or one organ outside the lymph nodes. Stage II involves two or more lymph node regions or one extralymphatic organ and its nearby nodes, grouped on the same side of the diaphragm muscle, which separates the abdominal and chest cavities.
Radiation is used in combination with chemotherapy for Stage III Hodgkin's, in which cancer affects lymph nodes above and below the diaphragm.
Combinations of chemotherapeutic drugs are used for patients with Stage IV disease (in which cancer has spread widely to other organs), as well as those who relapse after radiation alone. Such therapy, while generally producing the worst side effects of all treatment options, often leads to prolonged or even complete remission.
Autologous bone marrow transplantation, in which healthy bone marrow is removed prior to treatment and replaced afterward, may be recommended to preserve bone marrow cells while the rest of the body is subjected to intensive chemotherapy or radiation.
When To Call A Doctor
While most incidences of enlarged glands are not a sign of cancer, see a doctor if the swelling persists longer than two weeks, especially if accompanied by fever or night sweats.
EMERGENCY See a doctor immediately for the sudden onset of a high fever, loss of bladder or bowel control, or numbness in the arms or legs-all potential signs of Hodgkin's disease complications.
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Medical Disclaimer: The information on this page is not intended to substitute for the advice of a physician.
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