What is Hodgkin lymphoma?
Hodgkin lymphoma, also known as Hodgkin disease, is cancer of the lymphatic (immune) system which eventually makes the body less able to fight infection.
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Symptoms of Hodgkin lymphoma include:
- Painless enlargement of lymph nodes, spleen or other immune tissue
- Weight loss
- Night sweats
Be aware that these symptoms could be due to conditions other than Hodgkin lymphoma, so it’s best to see a doctor right away.
Experts don't yet know what causes Hodgkin's lymphoma. However, some factors are known to increase your risk of getting it.
This cancer is most common in people ages 15 to 35 and people age 55 and older. Other risk factors for Hodgkin lymphoma include:
- Infection with a virus, such as Epstein-Barr or HIV
- Having a weak immune system
- A family history of the disease
The first step to making a Hodgkin lymphoma diagnosis is usually a physical exam, during which a doctor will look for swollen lymph glands and other signs. A doctor will also consider personal and family medical history. If Hodgkin lymphoma is suspected, you will be referred to a specialist for diagnosis.
Specialists use a variety of procedures and tests to deliver an accurate Hodgkin lymphoma diagnosis, as well as to determine the stage of the cancer (how far the cancer has spread).
- Blood and urine tests – Measures the levels of certain antibodies, known as immunoglobulins, to determine presence of the cancer.
- Flow cytometry – A lab test that measures the number of cells in a sample, the percentage of live cells, their size and shape, and the presence of tumor markers on the cell surface.
- Bone marrow aspiration and biopsy – A needle is inserted into the hipbone of sternum to get a small piece of bone and bone marrow to determine if the cancer has spread there.
- Lumbar puncture – A needle is inserted into the spinal column to collect cerebrospinal fluid and look for signs of the cancer.
- Lymph node biopsy – A lymph node is removed and examined under a microscope to look for cancer.
- Chest X-rays – Images are taken to look for tumors in the chest and lungs.
- CT or CAT scan (computerized axial tomography) – More detailed than an X-ray, this procedure uses a combination of X-rays and computer technology to produce detailed images.
- MRI (magnetic resonance imaging) – A powerful magnet, radio waves and computer imaging combine to create highly detailed pictures of areas inside the body.
- PET scan (positron emission tomography) – Small amounts of radioactive sugar are injected to highlight cancers and areas of infection and inflammation.
Additionally, ultrasound, Gallium and bone scans may also be used for Hodgkin lymphoma diagnosis.
Which treatment is right for you will depend on a variety of factors, including the type and stage of your lymphoma, possible side effects, results of scans during treatment, and your preferences and overall health. Treatment options include:
Chemotherapy – Most individuals with newly-diagnosed Hodgkin lymphoma receive chemotherapy, followed by radiation therapy. A combination of chemotherapy drugs is usually given one at a time. If the disease does not go into complete remission following the first treatment, or if it relapses, second-line chemotherapy treatments are available.
Stem cell transplantation – Stem cell transplantation may be recommended if chemotherapy and radiation are not effective in treating the lymphoma or if it recurs. The goal of transplantation is to destroy the cancer cells in the bone marrow, blood and other parts of the body with high doses of chemotherapy and/or radiation therapy and then enable blood stem cells to create healthy bone marrow.
Immunotherapy – Recent advancements in immunotherapies are offering new treatment options for patients with Hodgkin lymphoma that has recurred or progressed after other treatments.
Radiation therapy – Radiation therapy is directed at the affected lymph node areas to reduce the risk of damaging healthy tissues. At Northwell Health Cancer Institute, advanced radiation therapies are available, including intensity modulated radiotherapy (IMRT), respiratory gated radiation and proton therapy.