General Information / Anatomy / Function / Statistics

• A form of lymphoma that now has approximately a 90% cure rate
• The malignant cell is called the Reed-Sternberg cell
• It is uncommon
• For statistics on this cancer, please click here.

Symptoms / Signs

• Painless enlarged lymph nodes in neck, groin or armpit
• Fatigue
• Shortness of breath
• Itchiness on the trunk of the body
• Unusual back or abdominal pain
• Abdominal swelling
• The following symptoms are called "B symptoms"
• Persistent fever whose cause is unknown
• Unexplained night sweats, sometimes so severe the bedclothes have to be changed
• Unexplained weight loss
• The above symptoms are also common in other disorders. Thus, it is more common for them not to be related to Hodgkin's Disease but rather to be a sign of something else

Etiology / Carcinogens / Risks

• Cause as yet unknown
• Suspect a possible defect in body's immunologic (infection-fighting) system plus response to external stimulant, e.g. virus
• More common in countries where people have not been exposed to common childhood infections to some extent
• Less common in developing countries, where people reaching adulthood have survived numerous exposures to disease
• Can occur at any age but is more commonly seen in adults where the risk is not affected by age
• Males and females are equally susceptible

Prevention

• No effective prevention is available

Diagnosis / Screening / Staging / Grading / Types

• Medical and physical examination with attention to lymph nodes, spleen, liver and pain in bones
• Laboratory tests of blood and urine
• Chest X-ray
• CT scan of the chest, abdomen and pelvis
• Biopsy of affected node or other tissue

Staging

• Careful diagnostic and staging procedures will identify the exact cell type and the pattern of spread
• Staging is based on the Ann Arbor classification:

Stage I	Involves a single lymph node region
Stage II	Involvement of two or more lymph node regions on the same side of the diaphragm
Stage III	Involvement of lymph node regions on both sides of the diaphragm
Stage IV	Spread of the disease outside the lymph system

• Each stage is divided into A and B categories:
  • "A" patients have no generalized symptoms
  • "B" patients have had unexplained weight loss of more than 10% in the six months before diagnosis, or unexplained fevers above 38 C (100.4 F), or persistent heavy night sweats

Types

• Hodgkin's Disease has been classified by several systems
• Current system, the World Health Organization Classification, divides it into:
  • Classical Hodgkin's lymphoma
  • Nodular sclerosis - (about 75% of cases); more common in women than men; less common in people over the age of 50
  • Lymphocyte-rich - rare
  • Mixed cellularity - (about 20% of cases) - widespread disease at the time of diagnosis
  • Lymphocyte depletion – rare
  • Nodular lymphocyte predominance - rare (do not tab, should be open circle)

Treatment

• Depending on the type and specific location of the disease and condition of the patient, radiation, chemotherapy or a combination of both may be used for the purpose of cure
• Radiation and chemotherapy are technically difficult to administer correctly; the details and duration of treatment need to be carefully planned and executed. Patients are advised to seek out physicians who are experienced in treating Hodgkin's disease.
• Hodgkin's disease responds extremely well to treatment
• Patients are usually treated in outpatient clinics

Radiotherapy

• Directs super voltage X-rays to the affected area in doses that damage or destroy the cancer cells but leave surrounding normal tissues largely unharmed
• May have unpleasant side effects:
• Skin reactions
• Nausea and vomiting
• Feeling of fatigue
• Counteracted by rest and good nutrition
• Disappear after completion of treatment

Chemotherapy

• Used to kill cancer cells throughout the body
• Doctor must find a balance in the dose of drugs to kill the cells while affecting as few healthy ones as possible
• Chemotherapy interferes with cell division and growth and so retards the development of the disease, and eradicates it
• Side effects may include:
  • Nausea and vomiting
  • Diarrhea
  • Anemia
  • Hair loss
  • Reduced blood clotting ability
  • Susceptibility to infections
  • Mouth sores
  • Numbness and tingling in hands or feet

Bone Marrow Transplantation

• Used with extremely high dose chemotherapy +/- radiation for disease which relapses after previous chemotherapy

Revised April 2000

March 2007  We are currently reviewing and updating these pages.  If you have any questions about your cancer and its treatment, please discuss with your oncologist or physician.  Thank you.