Hodgkin Lymphoma

What is Hodgkin lymphoma?

Hodgkin lymphoma is a kind of cancer that starts in the lymph system. The lymph system includes the lymph nodes, lymph vessels, and other parts of the body's immune and blood-forming systems, such as the spleen and bone marrow. The lymph system makes and stores infection-fighting white blood cells called lymphocytes. It carries these cells to places in the body where there is infection. Lymph nodes and lymph vessels are found throughout the body.

Hodgkin lymphoma, also called Hodgkin disease, is one of the most curable cancers.

How does it occur?

When you have Hodgkin lymphoma, your body makes too many abnormal lymphocytes. It is not known why this happens. These cancer cells crowd into the lymph nodes and may also go to other parts of the body. Tumors may grow and interfere with normal body functions.

Hodgkin lymphoma can occur in children or adults. The chance of having this disease is greatest in young adults.

No major risk factors have been found. You may have a slightly higher risk for Hodgkin lymphoma if:

• You have had infectious mononucleosis (mono), an infection caused by the Epstein-Barr virus.
• You have close relatives (parent, brother, or sister) with Hodgkin lymphoma.
• You have acquired immunodeficiency syndrome (AIDS) or other problems causing a weak immune system.

Most people who have known risk factors do not get Hodgkin lymphoma. On the other hand, people who do get the disease often have no known risk factors. If you think you may be at risk, you should discuss this concern with your healthcare provider.

What are the symptoms?

Symptoms of Hodgkin lymphoma are:

• painless swelling of lymph nodes, most often in the neck, but also in the armpits or groin
• fever
• night sweats
• weight loss for no known reason
• itching
• tiredness.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. A sample of tissue will be taken from a swollen lymph node and examined under a microscope. This removal of a sample of tissue is called a biopsy. If you have Hodgkin lymphoma, unusual cells called Reed-Sternberg cells will be found in the tissue.

If Hodgkin lymphoma is found, more tests will be done to determine the stage of the disease and to see if it has spread. Some of the tests that tests that may be done are:

• blood tests
• chest X-ray
• scans, such as a CT, MRI, or PET scan
• biopsy of your bone marrow
• biopsies of the liver or lymph nodes in the abdomen

How is it treated?

The diagnosis of Hodgkin lymphoma is graded in 4 stages. The stage depends on the parts of the body the cancer has spread to. Treatment will depend on the stage of the disease, as well as your general health.

Radiation therapy, anticancer drugs (chemotherapy), or both will be used to shrink tumors and kill cancer cells. If you need very high doses of chemotherapy, stem cells (young blood cells) may be taken from your bone marrow or blood before treatment and kept frozen. The chemotherapy might severely damage your bone marrow and its ability to make blood cells. If this happens, the blood-forming stem cells can be given back to you after chemotherapy.) This is called a stem cell transplant.) Stem cells can also be given to you from a healthy person (donor).

You may be more at risk for serious infections during and after your treatment.

How long will the effects last?

Hodgkin lymphoma can be cured in most cases. When treatment begins in the early stages, radiation therapy can cure 80 to 90% of people. When the disease is found in a later stage, a combination of radiation and chemotherapy has about a 40% chance of cure.

How can I take care of myself?

• Follow the full course of treatment your healthcare provider recommends.
• If you have a fever above 100°F (37.8°C), call your provider and stay in bed. Ask your provider if you can take aspirin or acetaminophen to control your fever. After your temperature has fallen below 100°F (37.8°C), become as active as you comfortably can.
• Learn about side effects you may have from radiation or chemotherapy. It helps to be prepared for side effects such as nausea or vomiting. Besides the short-term side effects, some side effects last for weeks or months, like losing your hair during treatment. Find where you can get hats or wigs and remember that your hair will grow back when therapy stops. You may also become temporarily or permanently sterilized by the treatment.
• Consider joining a cancer support group during your illness and recovery.
• Do not try unproven cancer treatments.
• For more information, contact national and local self-help organizations such as:

  American Cancer Society, Inc.
  Phone: 1-800-ACS-2345 (1-800-227-2345)
  Web site: http://www.cancer.org

  AMC Cancer Research Center and Foundation
  Phone: 1-800-321-1557
  Web site: http://www.amc.org

  Cancer Information Service
  Phone: 1-800-4-CANCER (1-800-422-6237)
  Web site: http://cis.nci.nih.gov

How can I help prevent Hodgkin lymphoma?

Because the cause of Hodgkin lymphoma is not understood and there are no clear risk factors, doctors do not know how to prevent it.