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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 first sign of this cancer is often an enlarged 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 cause is not known. Hodgkin's lymphoma is most common among people ages 15 - 35 and 50 - 70. Infection with the Epstein-Barr virus (EBV) is thought to contribute to most cases.
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 disease may be diagnosed after:
If tests reveal you do have Hodkin's lymphoma, additional 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.
The following procedures will usually be done:
In some cases, abdominal surgery to take a piece of the liver and remove the spleen may be needed. However, because the other tests are now so good at detecting the spread of Hodgkin's lymphoma, this surgery is usually unnecessary.
Treatment primarily depends on the following:
A staging evaluation is necessary to determine the treatment plan.
Treatment varies with the stage of the disease and age of the patient. The best treatment depends on each individual and should be discussed with a doctor who has experience treating this disease.
People with Hodgkin’s lymphoma that returns after treatment or does not respond to treatment may receive high-dose chemotherapy followed by an autologous bone marrow transplant (using stem cells from yourself).
Additional treatments depend on other symptoms. They 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 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 is more intense but the percentage of people who survive 5 years is about 90%.
Patients who survive 15 years after treatment are more likely to later die from other causes than Hodgkin’s disease.
People with Hodgkin’s lymphoma whose disease returns within a year after treatment or do not respond to the first-line therapy have a poorer prognosis.
It is important for patients to receive periodic examinations and imaging tests for years after treatment to check for signs of relapse and to check for the long-term effects of treatments.
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 minimize bleeding, apply ice and pressure to any external bleeding. Use a soft toothbrush and electric razor for personal hygiene.
Infection should always be taken seriously during cancer treatment. Contact your doctor immediately if you develop fever or other signs of infection. Planning daily activities with scheduled rest periods may help prevent fatigue associated with anemia.
Call your health care provider if:
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.