Hodgkin's disease (Hodgkin's lymphoma)

Overview

Hodgkin's disease is one of a group of cancers called lymphomas a general term for cancers that develop in the lymphatic system which includes bone marrow the lymph nodes spleen liver tonsils appendix and a few other organs.

Hodgkin's disease accounts for less than 1 per cent of all cases of cancer in North America with fewer than 1000 cases each year in Canada. The majority of people with Hodgkin's disease are children and young adults.

Causes

The cause of Hodgkin's disease is unknown. However there are a few factors that may make a person more likely to get the disease including:

Heredity

If you have a brother or sister with Hodgkin's disease you may have a higher-than-average chance of developing the disease .

Infectious mononucleosis

The Epstein-Barr virus (EBV) which causes mononucleosis may be linked to an increase in the risk of developing Hodgkin's disease. However because more than half of all Hodgkin's patients have no evidence of a previous EBV infection a definitive relationship has not been established.

Compromised immune system

Some people who have reduced immune systems for example those with AIDS and organ transplant patients are at a higher risk of Hodgkin's disease.

Symptoms

The first sign of Hodgkin's disease is often an enlarged lymph node (swollen glands) in the neck armpits or groin with associated:

  • Fatigue
  • Fever and chills
  • Night sweats
  • Weight loss Loss of appetite
  • Generalized itching  


Additional symptoms that may be associated with this disease:

  • Excessive sweating
  • Skin blushing or flushing
  • Neck pain
  • Hair loss
  • Flank pain
  • Clubbing of the fingers or toes
  • Enlargement of the spleen


It is important to remember the vast majority of people with enlarged lymph nodes do not have Hodgkin's or other serious disease. Lymph nodes enlarge for a variety of reasons most commonly as a result of the body fighting an infection. Only your doctor can make an accurate diagnosis.

Treatment

Treatment varies with the stage of the disease:

  • Stage 1 indicates one lymph node region is involved (for example the right side of the neck).
  • Stage 2 indicates involvement of 2 lymph nodes on the same side of the diaphragm (for example both sides of the neck).
  • Stage 3 indicates lymph node involvement on both sides of the diaphragm (for example groin and armpit).
  • Stage 4 involves the spread of cancer outside the lymph nodes (for example to bone marrow lungs or liver).

Stages 1 and 2 can be treated with localized radiation therapy with chemotherapy or with a combination of both. Stages 3 and 4 are treated with a combination of radiation therapy and chemotherapy. The best treatment for an individual patient depends on many factors and should be discussed fully with a doctor who has experience treating Hodgkin's disease.

With appropriate treatment some 90 per cent of people with stage 1 or 2 Hodgkin's survive for at least 10 years. With widespread disease the treatment is more intense and the 5-year survival rate is about 60%.

Call your doctor if you are being treated for Hodgkin's lymphoma and experience adverse effects of radiation and chemotherapy including nausea loss of appetite vomiting diarrhea fever or bleeding.

Additional Resources

Canadian Cancer Society