Hodgkin's lymphoma (Hodgkin's disease)
General description
Hodgkin's lymphoma, formerly known as "Hodgkin's disease," is a cancer of the lymphatic system, which is part of the immune system. It may affect people of any age, but it is more common in people 20 to 40 years of age and older than 55 years old.
In Hodgkin's lymphoma, the cells of the lymphatic system grow abnormally and can spread much more.
Hodgkin's lymphoma is one of the two most common types of cancer in the lymphatic system. The other type, non-Hodgkin lymphoma, is even more frequent.
Advances in the diagnosis and treatment of Hodgkin's lymphoma have helped to give people with this disease the possibility of complete recovery. The prognosis continues to improve for people with Hodgkin's lymphoma.
Types
Chronic lymphocytic leukemia
Lymphoma
Cutaneous T-cell lymphoma
B-lymphocyte cutaneous lymphoma
Symptoms
swollen lymph nodes
swollen lymph nodes
Some of the signs and symptoms of Hodgkin's lymphoma are:
Painless swelling of the lymph nodes in the neck, armpits, or groin
Persistent fatigue
Fever and chills
Night Sweats
Rapid slimming without apparent cause
Itching
Increased sensitivity to the effects of alcohol or pain in lymph nodes after drinking alcohol
When to see your doctor
Ask for a doctor's visit if you have a sign or symptom that worries you.
Causes
The causes of Hodgkin's lymphoma are unclear.
Physicians know that most Hodgkin's lymphomas occur when a cell that fights infections called "B cell" develops a mutation in their DNA. The mutation tells the cells to rapidly dilive and continue to live when a normal cell is already dead. The mutation causes a large number of large abnormal B cells that accumulate in the lymphatic system, where they displace healthy cells and cause signs and symptoms of Hodgkin lymphoma.
There are several types of Hodgkin's lymphoma depending on the type of cells involved in the disease and its behavior. Your type determines your treatment options.
Hodgkin's lymphoma, classic
Classic Hodgkin's lymphoma is the most common type of this disease. It can also be classified into subtypes. People who receive a diagnosis of classic Hodgkin lymphoma have large abnormal cells called "Reed-Sternberg cells" in the lymph nodes.
The subtypes of classical Hodgkin lymphoma include:
Hodgkin's lymphoma with nodular sclerosis
Hodgkin's lymphoma with mixed cellularity
Hodgkin's lymphoma with lymphocyte depletion
Lymphocyte-rich Hodgkin lymphoma
Hodgkin's lymphoma, lymphocytic predominance
This most bizarre type of Hodgkin lymphoma involves large abnormal cells that are sometimes referred to as ' popcorn cells ' because of their appearance. Treatment may be different from the classic type. People with this type of Hodgkin lymphoma may have a better chance of healing when the disease is diagnosed at an early stage.
Risk Factors
Factors that increase the risk of Hodgkin's lymphoma are as follows:
Age. Hodgkin's lymphoma is usually diagnosed with people aged 15 to 30, as well as people over 55 years of age.
A family history of lymphoma. Having a close family member who has Hodgkin's lymphoma or non-Hodgkin lymphoma increases the risk of Hodgkin's lymphoma.
Sex. Men are more likely to suffer from Hodgkin lymphoma.
Anterior infection with Epstein-Barr virus. People who suffered from Epstein-Barr virus diseases, such as infectious mononucleosis, are more likely to have Hodgkin's lymphoma than people who did not have Epstein-Barr virus infections.
Diagnosis
The doctor will ask you about your personal medical history and that of your family. Then, you may be asked to submit to tests and procedures that are used to diagnose Hodgkin's lymphoma, such as:
A physical exploration. Your doctor checks for swollen lymph nodes in the neck, armpits, and groin, as well as the swollen spleen or liver.
blood test. A sample of your blood is examined in a laboratory to check if there is anything in it that indicates the possibility of cancer.
Diagnostic imaging tests. Your doctor may recommend that you do diagnostic imaging tests to look for signs of Hodgkin's lymphoma in other areas of the body. Tests may include an X-ray, a CT scan, and a positron emission tomography.
Lymph node removal for analysis. The doctor may recommend a lymph node biopsy procedure in order to remove one for analysis in the laboratory. The health care provider will diagnose classic Hodgkin's lymphoma if abnormal Reed-Sternberg cells are found within the lymph node.
Extraction of a bone marrow sample for analysis. A bone marrow biopsy and aspiration procedure involves inserting a needle into the hip bone to extract a bone marrow sample. The sample is examined to look for Hodgkin lymphoma cells.
Other tests and procedures may be used depending on your situation.
Staging Hodgkin's lymphoma
Once the doctor has determined the extent of Hodgkin's lymphoma, it is assigned a stage to cancer. The cancer stage helps to determine the prognosis and treatment options.
The stages of Hodgkin's lymphoma are:
Stadium I. Cancer is confined to a region of the lymph node or to a single organ.
Stage II. In this stage, the cancer is found in two regions of the lymph node or the cancer has invaded an organ and the nearby lymph nodes. But the cancer is still limited to a section of the body either above or below the diaphragm.
Stage III. When the cancer moves to the lymph nodes both above and below the diaphragm, it is considered a stage III. Cancer may also be in a part of the tissue or in an organ near the lymph node groups, or in the spleen.
Stage IV. This is the most advanced stage of Hodgkin lymphoma. Cancer cells are found in several parts of one or more organs and tissues. Stage IV Hodgkin lymphoma affects not only lymph nodes but also other parts of the body, such as the liver, lungs, or bones.
In addition, your doctor uses letters A and B to indicate if you are suffering from the symptoms of Hodgkin's lymphoma:
A means you don't have any significant symptoms as a result of cancer.
B indicates that you may have significant signs and symptoms, such as persistent fever, unintentional thinning, or heavy nocturnal sweating.
Treatment
The appropriate treatment options for Hodgkin's lymphoma depend on the type and stage of the disease, your overall health and your preferences. The goal of the treatment is to destroy as many cancerous cells as possible and the disease to go into remission.
Chemotherapy
Chemotherapy is a drug treatment in which chemicals are used to destroy the lymphoma cells. Chemotherapy medications move through the bloodstream and can reach almost all parts of the body.
In people with early stage classical Hodgkin lymphoma, chemotherapy is usually combined with radiotherapy. Radiotherapy is usually performed after chemotherapy. In the case of advanced Hodgkin's lymphoma, chemotherapy may be used alone or combined with radiotherapy.
Chemotherapy medications may be taken in the form of pills or injected intravenously into the arm, and sometimes both methods of administration are used. Several combinations of chemotherapy medications are used to treat Hodgkin's lymphoma.
The side effects of chemotherapy depend on the specific medications you're taking. Some of the common side effects are nausea and hair loss. Serious long-term complications, such as heart and lung damage, fertility problems, and other types of cancer, such as leukemia, may occur.
Radiation
Radiotherapy uses high-energy beams, such as X-rays or protons, to kill cancer cells. In the case of classical Hodgkin lymphoma, radiotherapy can be used alone, but is usually used after chemotherapy. People with Hodgkin's lymphoma with early stage lymphocytic predominance are usually only subjected to radiotherapy.
During radiation therapy, you are lying on a stretcher while a large machine moves around you and directs energy beams to specific points of the body. Radiation can be targeted to the affected lymph nodes and the nearby ganglion area where the disease can progress. The duration of the radiation treatment varies depending on the stage of the disease.
Radiotherapy can cause skin redness and hair loss in the place where the radiation was directed. Many people feel fatigue during radiation therapy. The most serious risks include heart disease, stroke, thyroid problems, sterility, and other forms of cancer, such as breast cancer or lung cancer.
Bone marrow transplant
Bone marrow transplantation, also known as "stem cell transplantation," is a treatment to replace the diseased bone marrow with healthy stem cells that help produce new bone marrow. Bone marrow transplantation may be an option if Hodgkin's lymphoma reappears despite treatment.
During stem cell transplantation, your own blood stem cells are extracted, frozen and stored for later use. You then receive a high dose of chemotherapy and radiation therapy to destroy the body's cancerous cells. Finally the stem cells are thawed and injected into the body through the veins. Stem cells help produce a healthy bone marrow.
Treatment with other medications
Other medications used to treat Hodgkin's lymphoma include targeted drugs, which focus on specific cancer cell vulnerabilities, and immunotherapy, whose purpose is to activate the immune system to destroy the Lymphoma cells. If other treatments did not work or if Hodgkin's lymphoma returns, the lymphoma cells may be analyzed in a laboratory to see if they have genetic mutations. Your doctor may recommend a treatment with a medication that focuses on the specific mutations present in the lymphoma cells.
Guided therapy is an area of active cancer research. Drugs for new targeted therapies are being studied in clinical trials.
Request an enquiry at Mayo Clinic
Clinical studies
Explore the Mayo Clinic's assessment of new treatments, interventions, and analyses as a means of preventing, detecting, treating, or controlling this disease.
Alternative medicine
No alternative medicines have been found to treat Hodgkin's lymphoma. However, alternative medicine can help you cope with the stress of a cancer diagnosis and the side effects of oncological treatment. Talk to your doctor about your options, like the following:
Art Therapy
Exercise
Meditation
Music therapy
Relaxation Exercises
Spirituality
Coping and Support strategies
Coping with a diagnosis of Hodgkin's lymphoma can be extremely difficult. The following strategies and resources can help you cope with cancer:
Look for information on Hodgkin lymphoma. Get enough information about the type of cancer you have to make you feel comfortable in making health care decisions. In addition to talking to your doctor, look for information at the local library and on the Internet. Start your search for information by the National Cancer Institute and the Leukemia & Lymphoma Society (Leukemia and Lymphoma Association).
Keep a strong support system. Having a support system and a positive attitude can help you cope with the problems, pains and concerns you may have. Although friends and family can be the best allies, they can sometimes have a hard time coping with your illness. If that happens, the interest and understanding of a formal support group or other people facing cancer may be helpful.
Set reasonable goals. Having goals gives you a sense of control and can provide you with a purpose. However, it avoids getting goals that are practically impossible to fulfil. You may not be able to work 40 hours per week, for example, but you can work at least half a day. In fact, it is useful for many people to continue working.
Take time for yourself. Eating well, relaxing and resting enough can help fight the stress and fatigue of cancer. In addition, you plan for periods of inactivity where you may need to rest more or limit the tasks you do.
Stay active. Getting a cancer diagnosis does not mean you should stop doing the things you enjoy or do normally. In general, if you feel well enough to do something, go and do it. It is important that you stay active and engaged as much as you can.
Preparing for the Consultation
Ask for a consultation with your primary care physician or a general practitioner if you have any signs or symptoms that concern you. Once you receive the diagnosis, your doctor may refer you to a specialist who treats Hodgkin's lymphoma, such as a hematologist, an oncologist, or an radiotherapy oncologist.
As the queries can be brief and there is usually a lot to talk about, it is advisable to go well prepared. Below you will find information that will help you prepare for the consultation and know what you should expect from the doctor.
What you can do
Be aware of any pre-consultation restrictions. When you program the query, be sure to ask if there is anything you should do in advance, such as restricting your diet before the analysis.
Write down any symptoms you have, even those that appear to be unrelated to the reason you programmed the query.
Write down your most important personal information, even the most stressful or any recent change in your life.
Make a list of all the medications, vitamins, or supplements you take.
Consider asking a family member or a trusted friend to accompany you. Sometimes it can be difficult to assimilate all the information that is provided during a consultation. The person who accompanies you can remember some detail that you have overlooked or forgotten.
Write questions to ask the doctor.
Your time with the Doctor is limited; So preparing a list of questions can help you make the most of the time together. Order the questions from the most important to the least important, in case the time is up. Some basic questions to ask your doctor about Hodgkin's lymphoma are:
What could be causing my symptoms or my illness?
In addition to the most probable cause, what are other possible causes of my symptoms or my illness?
What kind of tests do I need to do?
Can this condition be temporary or chronic?
What would be the best measures to take?
What are the alternatives to the main approach you suggest?
I have other health problems. What is the best way to control them together?
Do I have to respect any restrictions?
Should I consult a specialist? How much will it cost? Will my insurance cover it?
Will I need a biopsy?
Is there a generic alternative to the medicine you prescribe?
Is there a pamphlet or other printed material that can take me? What websites do you recommend?
In addition to the questions you have prepared for the doctor, do not hesitate to do others.
What to expect from the doctor
The doctor will probably ask you a series of questions. Being prepared to answer them can leave time to go over the points you want to spend more time with. The doctor may ask you:
When did you start having the symptoms?
Have the symptoms been continuous or occasional?
How intense are the symptoms?
Is there anything that seems to be improving the symptoms?
Is there anything that is apparently worsening symptoms?
Do you have a family member who has had cancer, including Hodgkin's lymphoma?
Have you or anyone in your family suffered from a disorder that affects the immune system?
Have you ever had infections in the past?
Have you or your family been exposed to toxins?
Hodgkin lymphoma Care at Mayo Clinic
The Mayo Clinic Care Team
In Mayo Clinic, hematologists, oncologists oncologists, radiologists, pathologists, and bone marrow transplant specialists work as an interdisciplinary team to provide comprehensive medical care for people with Hodgkin's lymphoma. Other professionals are involved as needed.
Advanced Diagnosis and Treatment
Mayo Clinic Hematopatólogos have training and experience in accurate diagnosis of all Hodgkin lymphoma subtypes, including very rare types. Mayo Clinic Labs are equipped with the advanced technology that physicians need to thoroughly analyze genetic mutations in cancer cells, in order to help you choose the right treatment for you.
Mayo Clinic physicians work with you to review all treatment options and choose the treatment that best suits your needs and goals. The range of treatments offered to people suffering from Hodgkin's lymphoma includes chemotherapy, laradioterapia, and bone marrow transplantation.
Mayo Clinic is a leader in lymphoma research and has been recognized by the National Cancer Institute with a subsidy from the specialized Program of Research Excellence (Research Excellence Program) on Lymphoma to accelerate progress in lymphoma research.
Survival clinics for follow-up health care
Mayo Clinic offers services for people who have completed treatment for Hodgkin's lymphoma through cancer survival clinics. Follow-up medical care is important for all people who received treatment for Hodgkin's lymphoma. The Survival Clinic offers physical and psychological side-effect assessments, and also provides follow-up health care plans and to lead a healthy life after oncological treatment. Occasionally, follow-up medical care includes blood tests or bone marrow studies.
Expertise and qualifications
Mayo Clinic Physicians have extensive recognition for their expertise in diagnosing and treating people with all types of Hodgkin's lymphoma, including the rare and aggressive. Each year, Mayo Clinic physicians serve more than 800 people with Hodgkin's lymphoma.
Recognized expertise at the national level
The national organizations recognize Mayo Clinic for the high quality of their lymphoma care and research.
Mayo Clinic's Cancer center complies with stringent standards of the National Cancer Institute as a comprehensive Oncology center, in recognition of scientific excellence and a multidisciplinary approach focused on prevention, diagnosis and Cancer treatment.
Mayo Clinic is part of the Alliance for Clinical Trials in Oncology (Alliance for Clinical Trials in oncology), and NRG Oncology (NRG Oncology), which are international groups of scientists working together to conduct clinical trials and reduce Cancer impact.
Mayo Clinic is part of a select group of medical centers in the United States recognized for having a specialized program of excellence in Lymphoma Research, funded by the National Cancer Institute. To obtain a highly competitive SPORE subsidy, institutions must demonstrate a high degree of collaboration between world-class scientists and clinical health professionals, as well as excellence in translational research projects.
According to the best hospitals ranking conducted by U.S. News & World report, Mayo Clinic in Rochester, Minnesota, Mayo Clinic in Jacksonville, Florida, and Mayo Clinic in Scottsdale, Arizona, they are among the best hospitals for the care of Cancer.
The Mayo Clinic Pediatric Center has once again held the first place in the performance of pediatric hospitals in Minnesota, the Dakotas and Iowa, according to the best pediatric hospitals classification in U.S. News & World Report 2017 and 2018.
Locations, travel and accommodation
Mayo Clinic's most important campuses are located in Phoenix and Scottsdale, Arizona; Jacksonville, Fla.; and Rochester, Minnesota. Mayo Clinic Health System has dozens of locations in several states
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