Hodgkin's disease is one of a group of cancers called lymphomas (cancers that develop in the lymphatic system). Hodgkin's disease – an uncommon lymphoma – accounts for less than 1% of all cases of cancer in the US. Other cancers of the lymphatic system are called non-Hodgkin's lymphomas.
In Hodgkin's disease, cells in the lymphatic system become abnormal. They divide too rapidly and grow without any order or control. Because lymphatic tissue is present in many parts of the body, Hodgkin's disease can start almost anywhere. Hodgkin's disease may occur in a single lymph node, a group of lymph nodes, or, sometimes, in other parts of the lymphatic system such as the bone marrow and spleen. This type of cancer tends to spread in a fairly orderly way from one group of lymph nodes to the next group. For example, Hodgkin's disease that arises in the lymph nodes in the neck spreads first to the nodes above the collarbones, and then to the lymph nodes under the arms and within the chest. Eventually, it can spread to almost any other part of the body.
At the time of writing, the cause or causes of Hodgkin's disease are not known, and doctors can seldom explain why one person gets this disease and another does not. It is clear, however, that Hodgkin's disease is not caused by an injury, and it is not contagious; no one can "catch" this disease from another person.
By studying patterns of cancer in the population, researchers have found certain risk factors that are more common in people who get Hodgkin's disease than in those who do not. However, most people with these risk factors do not get Hodgkin's disease, and many who do get this disease have none of the known risk factors.
Symptoms of Hodgkin's disease may include the following:
When symptoms like these occur, they are not sure signs of Hodgkin's disease. In most cases, they are actually caused by other, less serious conditions, such as the flu. When symptoms like these persist, however, it is important to see a doctor: only a doctor can make a diagnosis of Hodgkin's disease. Do not wait to feel pain; early Hodgkin's disease may not cause pain.
If Hodgkin's disease is suspected, the doctor performs a physical exam, including feeling to see if the lymph nodes in the neck, underarm, or groin are enlarged. The doctor may order blood tests and other tests such as X-rays, CAT scan or MRI.
The final diagnosis depends on a biopsy, in which a surgeon removes a sample of lymphatic tissue (part or all of a lymph node) so that a pathologist can examine it under a microscope to check for cancer cells. Other tissues may be sampled as well. The pathologist studies the tissue and checks for Reed-Sternberg cells, large abnormal cells that are usually found with Hodgkin's disease.
If the biopsy reveals Hodgkin's disease, the doctor needs to learn the stage – or extent – of the disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. Treatment decisions depend on these findings. The doctor considers the following to determine the stage of Hodgkin's disease:
During staging, the doctor may use some of the same tests used for the diagnosis. Other staging procedures may include additional biopsies of lymph nodes, the liver, bone marrow, or other tissue. A bone marrow biopsy involves removing a sample of bone marrow through a needle inserted into the hip or another large bone. Rarely, an operation called a laparotomy may be performed. During this operation, a surgeon makes an incision through the wall of the abdomen and removes samples of tissue. A pathologist examines tissue samples under a microscope to check for cancer cells.
Eating well during cancer treatment means getting enough calories and protein to help prevent weight loss and regain strength. Good nutrition often helps people feel better and have more energy.
Some people with cancer find it hard to eat a balanced diet because they may lose their appetite. In addition, common side-effects of conventional treatment, such as nausea, vomiting, or mouth sores, can make eating difficult. Often, foods taste different. Also, people being treated for cancer may not feel like eating when they are uncomfortable or tired.
The prognosis for Hodgkin's disease can be affected by many factors, particularly the stage of the cancer, the patient's response to treatment, and the patient's age and general health.
Conventionally, Hodgkin's disease is treated by a team of specialists that may include a medical oncologist, oncology nurse, and/or radiation oncologist. Treatment usually involves radiation therapy or chemotherapy. The doctors may decide to use one treatment method or a combination of methods. Conventional treatments for Hodgkin's disease are very powerful. It is hard to limit the effects of therapy so that only cancer cells are destroyed. Because such treatment also damages healthy cells and tissues, it often causes side-effects.
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