Hodgkin's lymphoma is a cancer of lymph tissue found in the lymph nodes, spleen, liver, bone marrow, and other sites.
Lymphoma - Hodgkin's; Hodgkin's disease; Cancer - Hodgkin's lymphoma
The cause is not known. Hodgkin's lymphoma is most common among people ages 15 - 35 and 50 - 70. Past infection with the Epstein-Barr virus (EBV) is thought to contribute to some cases. Patients with HIV infection are more at risk than the general population.
Other symptoms that may occur with this disease:
Note: Symptoms caused by Hodgkin's lymphoma may also occur also with other conditions. Talk to your doctor about the meaning of your specific symptoms.
The first sign of Hodgkin's lymphoma is often a swollen lymph node, which appears without a known cause. The disease can spread to nearby lymph nodes. Later it may spread to the spleen, liver, bone marrow, or other organs.
The disease may be diagnosed after:
If tests reveal that you do have Hodgkin's lymphoma, more tests will be done to see if the cancer has spread. This is called staging. Staging helps guide treatment and follow-up, and gives you some idea of what to expect in the future.
The following procedures will usually be done:
Some people may need abdominal surgery to take out a piece of the liver and remove the spleen. However, because the other tests are now so good at detecting the spread of Hodgkin's lymphoma, this surgery is usually not needed.
Treatment depends on the following:
Tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future. Staging is needed to determine your treatment plan. Stages of Hodgkin's lymphoma range from I to IV. The higher the staging number, the more advanced the cancer.
Treatment depends on your age and stage of the cancer.
People with Hodgkin's lymphoma that returns after treatment or does not respond to the first treatment may receive high-dose chemotherapy. That is followed by an autologous stem cell transplant (using stem cells from yourself).
What other treatments you have depend on your symptoms, but may include:
You can often ease the stress of illness by joining a support group of people who share common experiences and problems. See: Cancer - support group
Hodgkin's disease is considered one of the most curable forms of cancer, especially if it is diagnosed and treated early. Unlike other cancers, Hodgkin's disease is often very curable, even in its late stages.
With the right treatment, more than 90% of people with stage I or II Hodgkin's lymphoma survive for at least 10 years. If the disease has spread, the treatment may be more intense. However, 90% of people with advanced disease survive for at least 5 years.
Patients who survive 15 years after treatment are more likely to later die from other causes, including complications of the treatment, rather than from Hodgkin's disease.
People with Hodgkin's lymphoma whose disease returns within a year after treatment or who do not respond to the first treatment have a poorer outlook.
You will need to have regular exams and imaging tests for years after your treatment. This helps your doctor check for signs of the cancer returning, and for any long-term treatment effects.
Treatments for Hodgkin's lymphoma can have complications. Long-term complications of chemotherapy or radiation therapy include:
Chemotherapy can cause low blood cell counts, which can lead to an increased risk of bleeding, infection, and anemia. To reduce bleeding, apply ice and pressure. Use a soft toothbrush and electric razor for personal hygiene.
Always take an infection seriously during cancer treatments. Contact your doctor right away if you develop fever or other signs of infection, especially if your white blood cell counts are low due to treatment. Planning rest periods during your daily activities may help prevent fatigue due to anemia.
Call your health care provider if:
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Horning SJ. Hodgkin's lymphoma. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 111.
Armitage JO. Early-stage Hodgkin's lymphoma. N Engl J Med. 2010 Aug 12;363(7):653-62.