The Symptoms of Hodgkin’s Disease and How it is Treated

What is Hodgkins Disease and What are the Symptoms?
Hodgkin’s disease is a carcinoma (another word for cancer) in a group of cancers known as lymphomas (cancer in the lymphatic system). The most common symptom of Hodgkin’s disease is a painless swelling in the lymph nodes.

The symptoms of lymphomas may also be caused by noncancerous conditions (Hodgkin’s is only one of several possible causes of swollen lymph nodes.) Oher symptoms include itchy skin, fatigue, cough, shortness of breath, chest pain, abdominal pain or feeling of fullness, night sweats, fever, and weight loss. If you experience any of these for longer than two weeks, you should make an appointment with your physician.

Lymphomas are separated into two groups: Hodgkin’s disease and Non-Hodgkin’s disease. Both are cancers of the lymphatic system, but there are differences. More cases of Non-Hodgkin’s are diagnosed than Hodgkin’s. Non-Hodgkin’s usually appears in people over the age of fifty; Hodgkin’s disease is common among that group as well, but also shows up in younger populations. The other main difference is the Reed-Sternberg cells, which are only present in patients suffering from Hodgkin’s disease.

What the Heck is a Lymphatic System?
The lymphatic system (also known as the lymph system) is a network of thin tubes that branch into the tissues throughout the body. Lymphatic vessels carry colorless lymph fluid from the tissues back to the bloodstream. The fluid contains lymphocytes (white blood cells that fight infection), and the residue of infections and cell breakdown.

Lymph nodes are small, bean-shaped organs that filter the lymph as it passes through. There are various locations of lymph nodes in the body. Among other places, clusters of them are found in the armpit, neck, groin, abdomen, inner thigh, and along the collar bone. Other important parts of the lymphatic system are the thymus, spleen, and bone marrow.

How is it Diagnosed?
If cancer is suspected, a definitive diagnosis is done by taking a biopsy (tissue sample) and searching for abnormal cells related to Hodgkin’s disease called Reed-Sternberg cells. Most times the whole lymph node is removed for testing.

Blood tests are also performed to assess the functioning level of major organs and to look for anemia (lowered red blood cell count) and elevated levels of white blood cells.

The chest, bones, liver, and spleen will all be X-rayed to see if malignant (cancerous) cells are present.

A magnetic resonance imaging (MRI) scan may be performed for a better view of the chest, pelvis, and abdomen, to see if there has been a metastasis (spreading) of cancerous cells.

After a definitive diagnosis, Hodgkin’s disease, like all other cancers is assigned a stage. Staging is a classification system that helps the doctors decide what treatment plan is best for your situation, and it also assists them in making an educated prognosis (likely outcome of the treatment).

Hodgkin’s disease is divided into four stages, one being the least serious and four being the most serious:
Stage I: The disease is found only in the nodes in one region.
Stage II: The disease is in more than one place, but remains on one side of the diaphragm (the large thin muscle that separates the abdomen from the chest)
Stage III: The cancer is in the lymph nodes on both sides of the diaphragm.
Stage IV: The disease has metastasized beyond the lymph nodes to other organs.

How is it Treated?
Treatment for Hodgkin’s disease usually consists of radiation therapy, chemotherapy, or a combination of both. The doctor makes a decision based on multiple factors, including the over all health and age of the patient, where the cancer is located, the stage of the disease, and which symptoms are being experienced.

Radiation therapy is the use of high-energy rays to destroy cancer cells and halt their growth. This is a painless procedure, but is known to cause extreme fatigue. This is normally performed in a clinic or hospital.

In addition to fatigue, redness or dryness of the skin in the area being treated happens often. Only apply creams or lotions that the doctor has recommended. Radiation to the stomach area can cause diarrhea, nausea, and/or vomiting. Some patients experience tingling or numbness in the back, legs, and/or arms. Shortness of breath and a sore throat often accompany chest radiation.

Chemotherapy is the use of anti-cancer drugs to fight the disease. The word “chemotherapy” actually refers to a large variety of cancer-fighting medications. Different medications are taken in different ways: orally (through the mouth), intrathecally (through the spine), intravenously (through the vein), and subcutaneously (a shot into the fleshy part of the skin). For certain cancers, chemo is applied in a topical manner (on the skin) as a cream.

Your treatment plan will consist of a combination of them, and will be given in cycles. What this means is you will have “rest periods” in between sets of serious chemotherapy doses. You might take chemo for three weeks and then be “off” for three weeks. This is to give your body time to heal from the previous set. Chemotherapy kills cells, but it cannot differentiate between the cancerous and healthy ones. Your body needs to time to build up a supply of healthy ones before taking the next series of medications.

Most chemotherapy patients experience side effects. Which ones depend on the medication and how your body responds to the treatment in general. Loss of hair, loss of energy, nausea, mouth sores, and a compromised immune system are all possible side effects.

Loss of appetite is very common for both radiation and chemotherapy. It is noted that people undergoing treatment who are able to eat well are better able to tolerate the side effects. It is important that your body have enough calories to fight the cancer and perpetually heal itself of the damage being done by the treatment.

Another side effect that should be discussed before you begin your treatment is the possibility of fertility problems. Younger people fighting the disease are more likely to regain their fertility, but there are no guarantees. You may want to think about sperm banking before treatment.

Patients who undergo treatment for Hodgkin’s disease have an increased risk of developing other cancers later in life, especially leukemia. It is important to schedule regular follow-up appointments with your doctor.

Clinical Trials
There are always clinical studies and research taking place to find new and better ways of fighting all cancers, Hodgkin’s disease included. In certain situations, your doctor may suggest one of these to you. Deciding to take part in a clinical trial of an up-and-coming medication is a personal choice and is based on many factors, like how far away the research is being conducted, how often you will have to be there, if you can afford to be away from home, if you have young children or other dependents, etc. No two patients have the same situation.

That being said, the good news is that with early intervention and appropriate treatment, over 85% of Hodgkin’s disease cases are curable. In the big, wide world of cancer prognosis, that’s an encouraging number.

Am I at Risk?
Hodgkin’s disease accounts for less than one percent of all cancer cases in the U.S. Risk factors include:

*Age, it is most often seen in people between fifteen and thirty-four or over fifty-five.

*Taking immunosuppressant drugs for other medical conditions.

*A family history of Hodgkin’s disease.

*Having an autoimmune disease (the body attacks its own tissues) like Acquired Immunodeficiency Syndrome (AIDS) or
Human Immunodeficiency Virus (HIV).

*Having the Epstein-Barr virus that can cause mononucleosis (a virus infection with an increase of single-nucleus white blood cells).