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I O N |
Hodgkin's disease is a type of lymphoma. Lymphomas are cancers that develop in the lymphatic system, part of the body's circulatory system. The job of the lymphatic system is to help fight diseases and infection.
The lymphatic system is made up of a network of thin tubes that branch, like blood vessels, into all the tissues of the body. Lymphatic vessels carry lymph, a colorless, watery fluid that contains infection-fighting cells called lymphocytes. Along this network of vessels are groups of small, bean-shaped organs called lymph nodes that filter the lymph fluid as it passes through the nodes. Clusters of lymph nodes are found in the underarm, groin, neck and abdomen. Other parts of the lymphatic system are the spleen, thymus gland, tonsils and bone marrow.
In Hodgkin's disease, abnormal cells in the lymphatic system called Reed-Sternberg cells begin growing, and if left untreated, they spread in the lymph system and eventually to other organs. As the disease progresses, the number of normal lymphocytes is reduced, leaving the body with fewer cells to fight infection.
Hodgkin's disease is one of the shining successes in modern oncology. Even in advanced cases, the chances of a cure are great: More than 75 percent of those diagnosed will be cured by a combination of chemotherapy and radiation therapy.
R I S K
Hodgkin's disease is rare. It makes up only 1 percent of all cases of cancer in the United States. It is most often seen in young people ages 15 to 34 and in people over the age of 50.
S Y M P T O M S
The most common symptom of Hodgkin's disease is a painless swelling in the lymph nodes in the neck, underarm or groin. Other symptoms may include fever, night sweats, fatigue, weight loss or itchy skin. However, these symptoms are not sure signs of cancer. They may also be caused by many common illnesses, such as the flu or other infections. But it is important to see a doctor if any of these symptoms lasts longer than two weeks. Any illness should be diagnosed and treated as early as possible, and this is certainly true of Hodgkin's disease.
D I A G N O S I
If doctors suspect Hodgkin's disease, they ask about the patient's medical history and conduct a thorough physical exam. Blood tests and X-rays of the chest, bones, liver and spleen are also performed. Tissue from an enlarged lymph node is removed. This is known as a biopsy, and it is the only sure way to tell if cancer is present. A pathologist looks at the tissue under the microscope for Reed-Sternberg cells.
When Hodgkin's disease is diagnosed, doctors need to know what stage the disease is in so they can plan treatment. Determining the stage is usually done through an abdominal surgery known as an exploratory laparotomy. The stage indicates where the disease has spread and how much tissue has been affected. In staging, the doctor checks the number and location of affected lymph nodes; whether the affected lymph nodes are above, below or on both sides of the diaphragm (the thin muscle under the lungs and heart that separates the chest from the abdomen); and whether the disease has spread to the bone marrow or to places outside the lymphatic system, such as the liver.
Also during staging, the doctor usually orders several tests, including biopsies of the lymph nodes, liver and bone marrow. Many patients get lymphangiograms, X-rays of the lymphatic system using a special dye to outline the lymph nodes and vessels. Another test is computed tomography (also called CT scan), a series of X-rays of various cross-sections of the body.
T R E A T M E N
Treatment for Hodgkin's disease usually includes radiation therapy or chemotherapy; sometimes both are administered. Treatment decisions are made by looking at the stage of disease, its location in the body, which symptoms are present, and the general health and age of the patient.
For early stages of Hodgkin's disease, radiation therapy is often used. Radiation therapy (also called X-ray therapy, radiotherapy or irradiation) uses high-energy rays to damage cancer cells and stop their growth. Chemotherapy is used in more advanced cases of Hodgkin's disease. The drugs may be given orally or injected into an artery, vein or muscle.
P R E V E N T I O
Research suggests that lifestyle modication with regard to patterns of diet, exercise, and tobacco use, among other factors, is the best way to prevent any form of cancer, including Hodgkin's disease. It's also good to be aware of the possible symptoms, as described above, and to alert your doctor if you notice them.