What is Hodgkin's Disease and What Are Its Symptoms? Hodgkin's disease is one of a group of cancers called lymphomas. Hodgkin's disease, an uncommon lymphoma, accounts for less than 1 percent of all cases of cancer in this country. In Hodgkin's disease, cells in the lymphatic system become abnormal. They divide too rapidly and grow without any order or control. Because lymphatic tissue is present in many parts of the body, Hodgkin's disease can start almost anywhere. Hodgkin's disease may occur in a single lymph node, a group of lymph nodes, or, sometimes, in other parts of the lymphatic system such as the bone marrow and spleen. This type of cancer tends to spread in a fairly orderly way from one group of lymph nodes to the next group. For example, Hodgkin's disease that arises in the lymph nodes in the neck spreads first to the nodes above the collarbones, and then to the lymph nodes under the arms and within the chest. Eventually, it can spread to almost any other part of the body. At this time, the cause or causes of Hodgkin's disease are not known, and doctors can seldom explain why one person gets this disease and another does not. It is clear, however, that Hodgkin's disease is not caused by an injury, and it is not contagious; no one can "catch" this disease from another person. Risk Factors The following are some of the risk factors associated with this disease:
Symptoms Symptoms of Hodgkin's disease may include the following:
When symptoms like these occur, they are not sure signs of Hodgkin's disease. In most cases, they are actually caused by other, less serious conditions, such as the flu. When symptoms like these persist, however, it is important to see a doctor so that any illness can be diagnosed and treated. Only a doctor can make a diagnosis of Hodgkin's Disease. Do not wait to feel pain; early Hodgkin's Disease may not cause pain. Diagnosis If Hodgkin's disease is suspected, the doctor asks about the person's medical history and performs a physical exam to check general signs of health. The exam includes feeling to see if the lymph nodes in the neck, underarm, or groin are enlarged. The doctor may order blood tests. The doctor may also order tests that produce pictures of the inside of the body. These may include:
The diagnosis depends on a biopsy. A surgeon removes a sample of lymphatic tissue (part or all of a lymph node) so that a pathologist can examine it under a microscope to check for cancer cells. Other tissues may be sampled as well. The pathologist studies the tissue and checks for Reed-Sternberg cells, large abnormal cells that are usually found with Hodgkin's disease. If the biopsy reveals Hodgkin's Disease, the doctor needs to learn the stage, or extent, of the disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. Treatment decisions depend on these findings. The doctor considers the following to determine the stage of Hodgkin's disease:
Staging In staging, the doctor may use some of the same tests used for the diagnosis of Hodgkin's Disease. Other staging procedures may include additional biopsies of lymph nodes, the liver, bone marrow, or other tissue. A bone marrow biopsy involves removing a sample of bone marrow through a needle inserted into the hip or another large bone. Rarely, an operation called a laparotomy may be performed. During this operation, a surgeon makes an incision through the wall of the abdomen and removes samples of tissue. A pathologist examines tissue samples under a microscope to check for cancer cells. Treatment The doctor develops a treatment plan to fit each patient's needs. Treatment for Hodgkin's Disease depends on the stage of the disease, the size of the enlarged lymph nodes, which symptoms are present, the age and general health of the patient, and other factors. Hodgkin's disease is often treated by a team of specialists that may include a medical oncologist, oncology nurse, and/or radiation oncologist. Hodgkin's disease is usually treated with radiation therapy or chemotherapy. The doctors may decide to use one treatment method or a combination of methods. Taking part in a clinical trial (research study) to evaluate promising new ways to treat Hodgkin's Disease is an important option for many people with this disease. Methods of Treatment Radiation therapy and chemotherapy are the most common treatments for Hodgkin's disease, although bone marrow transplantation, peripheral stem cell transplantation, and biological therapies are being studied in clinical trials. Radiation therapy (also called radiotherapy) is the use of high-energy rays to kill cancer cells. Depending on the stage of the disease, treatment with radiation may be given alone or with chemotherapy. Radiation therapy is local therapy; it affects cancer cells only in the treated area. Radiation treatment for Hodgkin's disease usually involves external radiation, which comes from a machine that aims the rays at a specific area of the body. External radiation does not cause the body to become radioactive. Most often, treatment is given on an outpatient basis in a hospital or clinic. Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for Hodgkin's disease usually consists of a combination of several drugs. It may be given alone or followed by radiation therapy. Chemotherapy is usually given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. Most anticancer drugs are given by injection into a blood vessel (IV); some are given by mouth. Chemotherapy is a systemic therapy, meaning that the drugs enter the bloodstream and travel throughout the body. Usually, a patient has chemotherapy as an outpatient (at the hospital, at the doctor's office, or at home). However, depending on which drugs are given and the patient's general health, a short hospital stay may be needed. |