Hodgkin Lymphoma

 What is Hodgkin lymphoma?

Hodgkin lymphoma, also known as Hodgkin disease, is a type of cancer that starts in a part of your lymphatic system, which is a network that helps your body fight infections. In Hodgkin lymphoma, abnormal cells that are called Reed-Sternberg cells grow in the lymph nodes and make them get larger. While it mainly affects the lymph nodes, it can spread to other parts of the body, including the liver, spleen and bone marrow. 

Hodgkin lymphoma is rare and highly curable, especially when it's found early. It is different from non-Hodgkin lymphoma, which is a more common group of lymphatic cancers.

Symptoms of Hodgkin lymphoma

Hodgkin lymphoma symptoms can vary depending on the cancer stage and the area of the lymphatic system that’s affected. Common signs of Hodgkin disease include:

• Swollen lymph nodes in the neck, armpits or groin (most common symptom)
• A low-grade fever that doesn't go away
• Night sweats
• Unexplained weight loss
• Fatigue and feeling tired even after you rest
• Itching, especially after bathing or drinking alcohol
• Pain in your lymph nodes after drinking alcohol
• Belly or chest pain

These symptoms can also be caused by other conditions. If you notice them, contact your health care provider.

Causes and risk factors for Hodgkin lymphoma

It’s not clear exactly what causes Hodgkin disease. It starts with changes to the DNA in your lymphocytes, which are a type of white blood cell. There is currently no way to prevent it.

Risk factors include:

• Being between age 15 and 35, although people over 55 are also at higher risk
• A family history of Hodgkin lymphoma
• Conditions like HIV/AIDS or autoimmune diseases
• Organ transplant
• Having a past Epstein-Barr virus (EBV) infection
• Being male

Even though these factors may increase your risk, many people with Hodgkin lymphoma do not have any known risk factors.

Diagnosis of Hodgkin lymphoma

To figure out if Hodgkin lymphoma is causing your symptoms, your health care provider may:

• Ask you about your medical history and symptoms and perform a physical exam to check for swollen lymph nodes.
• Test your blood to evaluate your overall health and find any issues in your red blood cell counts or other markers.
• Order imaging tests such as ultrasound, CT scans, PET scans or X-rays to check for enlarged lymph nodes and signs of the disease.
• Perform a biopsy and remove a small sample of tissue from an enlarged lymph node to check it for Reed-Sternberg cells. This Hodgkin lymphoma test determines whether you have the disease.
• In some cases, perform a bone marrow biopsy to see if the cancer has spread.

There are two main types of Hodgkin lymphoma:

• Classic Hodgkin lymphoma: About 95% of cases fall into this category, which contains four subcategories: nodular sclerosing Hodgkin lymphoma, mixed cellularity Hodgkin lymphoma, lymphocyte-rich classic Hodgkin lymphoma and lymphocyte depleted Hodgkin lymphoma.
• Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL): This type is rare and grows slowly.

Stages of Hodgkin lymphoma

If you’re diagnosed with Hodgkin lymphoma, your health care provider will use the Ann Arbor staging to guide treatment recommendations:

• Stage 1: The lymphoma is in one lymph node area or one organ.
• Stage 2: The lymphoma is in two or more lymph node areas on the same side of your diaphragm (a large muscle below your lungs that helps you breathe).
• Stage 3: The lymphoma is in lymph nodes above and below your diaphragm.
• Stage 4: The lymphoma has spread to other parts of the body, such as the liver, bone marrow or lungs.

Staging may also include the letters A and B:

• A means that you do not have symptoms of Hodgkin lymphoma
• B means that you have symptoms

Hodgkin lymphoma treatment options

Treating Hodgkin disease depends on the stage of the disease, your overall health and other factors. Hodgkin lymphoma is highly treatable and can be cured. Common treatment options include:

• Chemotherapy: Chemotherapy uses powerful drugs to kill cancer cells throughout your body. It is often the main treatment for Hodgkin lymphoma. 
• Radiation therapy: High-energy radiation can target and destroy cancer cells. Treatment may include a combination of radiation therapy and chemotherapy.
• Stem cell or bone marrow transplant: When chemotherapy or radiation aren't effective, these treatments may restore bone marrow.
• Immunotherapy: This treatment uses medication to boost your immune system and help it fight cancer.
• Targeted therapies: These newer treatments target specific cancer cells and kill them.
• Clinical trials: You may be able to test new treatment options.

Your health care provider can talk to you about the side effects of different types of treatment.

Hodgkin lymphoma prognosis and survival rates

Hodgkin lymphoma has one of the highest cure rates of all cancers. The prognosis depends on factors such as the stage at diagnosis, age and response to treatment. If you are diagnosed at an early stage, the survival rate is very high.

Survival rates for Hodgkin disease:

• Stage 1: These cancers have a high survival rate with the right treatment.
• Stage 2 to 3: These cancers have a good prognosis, especially with a combination of chemotherapy and radiation.
• Stage 4: These cancers are more challenging to treat but aggressive treatment, including stem cell transplants and clinical trials, can lead to successful outcomes.

Coping with Hodgkin lymphoma

Being diagnosed with cancer can be overwhelming. Here are some of the ways people with Hodgkin disease can cope with the emotional and physical challenges:

• Emotional support: Getting professional counseling and joining in-person or online support groups can help you cope with fear, stress, anxiety and other emotions.
• Physical rehabilitation: Rehab can help you rebuild your strength and regain energy after treatment.
• Lifestyle adjustments: Eating a balanced diet, staying active and managing stress can help you recover and improve your overall well-being.

Getting care

Early detection and timely care are key to treating Hodgkin lymphoma. If you or a loved one have any symptoms, don’t wait. Contact a health care provider right away.

At Banner MD Anderson Cancer Center, we provide expert care for people with Hodgkin lymphoma. Our team of oncologists, radiologists and support staff work together to develop personalized treatment plans. We offer the latest in diagnostic technology, cutting-edge treatment options and compassionate care centered around your needs and preferences. 

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