Learn how this cancer differs from other lymphomas. Find out about risk factors and treatments, such as chemotherapy, radiation and bone marrow transplant.
Hodgkin's lymphoma is a type of cancer that affects the lymphatic system, which is part of the body's germ-fighting immune system. In Hodgkin's lymphoma, white blood cells called lymphocytes grow out of control, causing swollen lymph nodes and growths throughout the body.
Hodgkin's lymphoma, which used to be called Hodgkin's disease, is one of two general categories of lymphoma. The other is non-Hodgkin's lymphoma.
Advances in diagnosis and treatment of Hodgkin's lymphoma have helped give people with this disease the chance for a full recovery. The prognosis continues to improve for people with Hodgkin's lymphoma.
The lymphatic system is part of the body's immune system, which protects against infection and disease. The lymphatic system includes the spleen, thymus, lymph nodes and lymph channels, as well as the tonsils and adenoids.
Signs and symptoms of Hodgkin's lymphoma may include:
Make an appointment with your health care provider if you have any persistent signs or symptoms that worry you.
One of the most common places to find swollen lymph nodes is in the neck. The inset shows three swollen lymph nodes below the lower jaw.
Doctors aren't sure what causes Hodgkin's lymphoma. They know that it begins when infection-fighting white blood cells called lymphocytes develop changes in their DNA. A cell's DNA contains the instructions that tell a cell what to do.
The DNA changes tell the cells to multiply rapidly and to continue living when other cells would naturally die. The lymphoma cells attract many healthy immune system cells to protect them and help them grow. The extra cells crowd into the lymph nodes and cause swelling and other Hodgkin's lymphoma signs and symptoms.
There are multiple types of Hodgkin's lymphoma. Your type is based on the characteristics of the cells involved in your disease and their behavior. The type of lymphoma you have helps determines your treatment options.
Classical Hodgkin's lymphoma is the more common type of this disease. People diagnosed with this type have large lymphoma cells called Reed-Sternberg cells in their lymph nodes.
Subtypes of classical Hodgkin's lymphoma include:
This much rarer type of Hodgkin's lymphoma involves lymphoma cells that are sometimes called popcorn cells because of their appearance. Nodular lymphocyte-predominant Hodgkin's lymphoma is usually diagnosed at an early stage and may require less intensive treatments compared to the classical type of the disease.
Factors that can increase the risk of Hodgkin's lymphoma include:
Tests and procedures used to diagnose Hodgkin's lymphoma include:
A procedure to remove a lymph node. Your provider may recommend a lymph node biopsy procedure to remove a lymph node for laboratory testing that looks for signs of cancer.
Other lab tests will analyze the lymphoma cells for markers on the surface of the cells that can tell your health care team exactly what type of Hodgkin's lymphoma you have and which treatments are best for your particular cancer.
Other tests and procedures may be used depending on your situation.
Your health care team uses the results of your tests to assign your Hodgkin's lymphoma a stage. Your stage is helpful for understanding the seriousness of your condition and determining which treatments are most likely to help you.
Hodgkin's lymphoma staging uses the numbers 1 to 4 to indicate the stage. A lower number indicates an earlier stage cancer that's more likely to be cured. A higher number means the cancer is more advanced.
Sometimes Hodgkin's lymphoma stages also include the letters A and B. The letter A means that you don't have worrying symptoms of cancer. The letter B means that you have some signs and symptoms, such as a persistent fever, unexplained weight loss and night sweats.
In a bone marrow aspiration, a health care provider uses a thin needle to remove a small amount of liquid bone marrow, usually from a spot in the back of your hipbone (pelvis). A bone marrow biopsy is often done at the same time. This second procedure removes a small piece of bone tissue and the enclosed marrow.
The goal of Hodgkin's lymphoma treatment is to destroy as many of the lymphoma cells as possible and bring the disease into remission. Which treatments are right for you depends on the type and stage of your cancer, your overall health, and your preferences.
Chemotherapy is a drug treatment that uses chemicals to kill lymphoma cells. Chemotherapy drugs travel through your bloodstream and can reach nearly all areas of your body. Chemotherapy drugs can be taken in pill form or through a vein in your arm, or sometimes both methods of administration are used.
Classical Hodgkin's lymphoma treatment usually begins with chemotherapy. It may be the only treatment needed or it may be combined with radiation therapy.
For nodular lymphocyte-predominant Hodgkin's lymphoma, chemotherapy is often combined with drugs that target the cancer cells (targeted therapy) and radiation therapy.
Side effects of chemotherapy depend on the drugs you're given. Common side effects are nausea and hair loss. Serious long-term complications can occur, such as heart disease, lung damage, fertility problems and other cancers.
Radiation therapy uses high-energy beams, such as X-rays and protons, to kill cancer cells. During radiation therapy, you lie on a table and a large machine moves around you, directing the energy beams to specific points on your body.
For Hodgkin's lymphoma treatment, radiation can be aimed at affected lymph nodes and the nearby areas where the disease might spread. It's usually used with chemotherapy. For people with early-stage nodular lymphocyte-predominant Hodgkin's lymphoma, radiation therapy may be the only treatment needed.
Radiation therapy side effects include fatigue and skin redness at the site where the radiation is aimed. Other side effects depend on where the radiation is aimed. For instance, radiation to the neck can cause dry mouth and thyroid problems, such as an underactive thyroid (hypothyroidism). Radiation to the chest can cause heart and lung problems.
Bone marrow transplant, also known as stem cell transplant, is a treatment to replace your diseased bone marrow with healthy stem cells that help you grow new bone marrow. A bone marrow transplant may be an option if Hodgkin's lymphoma returns or doesn't respond to other treatments.
During a bone marrow transplant, your own blood stem cells are removed, frozen and stored for later use. Next you receive high-dose chemotherapy and radiation therapy to destroy cancerous cells in your body. Finally your stem cells are thawed and put back in your body where they help build healthy bone marrow.
Side effects of a bone marrow transplant include the side effects that might be caused by the chemotherapy or radiation you undergo before your transplant. In addition, you may have an increased risk of infection after your transplant.
Other drugs that are sometimes used to treat Hodgkin's lymphoma include:
No alternative medicines have been found to treat Hodgkin's lymphoma. But alternative medicine may help you cope with the stress of a cancer diagnosis and the side effects of cancer treatment. Talk with your health care provider about your options, such as:
A Hodgkin's lymphoma diagnosis can be challenging. The following strategies and resources may help you cope with your diagnosis:
Make an appointment with your health care provider if you have any signs or symptoms that worry you. If your provider suspects that you have a type of lymphoma, he or she may refer you to a doctor who specializes in diseases that affect the blood cells (hematologist).
Because appointments can be brief, and because there's often a lot of information to discuss, it's a good idea to be well prepared. Here's some information to help you get ready.
Your time with your health care provider is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important, in case time runs out. For Hodgkin's lymphoma, some basic questions to ask include:
In addition to the questions that you've prepared, don't hesitate to ask additional questions.
Your health care provider is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to spend more time on. Your provider may ask: