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Hodgkin Lymphoma

            Introduction

            Hodgkin lymphoma is “a malignant cancerous growth of cells in the lymph system. Hodgkin disease is the better known form of lymphoma” (Lymphoma Info Network). Hodgkin lymphoma was first described by Thomas Hodgkin in 1832, in his well-known work On Some Morbid Appearances of the Absorbent Glands and Spleen (National Cancer Institute). All other forms of lymphoma are usually categorized as “non Hodgkin’s diseases”. Hodgkin lymphoma is listed among the most dangerous and the most difficult health conditions. Given the growing number of patients with diagnosed Hodgkin lymphoma, it will be useful to review the signs, the symptoms, incidence / prevalence, and cures which medical professionals use to treat and relieve the symptoms of Hodgkin disease.

            Hodgkin’s Lymphoma: statistics

            Hodgkin lymphoma is listed the third among the most common forms of cancer in children. Since the 1970s, the number of patients with diagnosed lymphoma has been steadily decreasing; nevertheless, more than 10,730 children under the age of 15 were diagnosed with Hodgkin lymphoma in 2008 (National Cancer Institute). “Adolescents and older teenagers are more commonly diagnosed with Hodgkin lymphoma than young children” (Lymphoma Info Network). White and Hispanic children appear the most vulnerable to Hodgkin disease, with the latter being extremely rare among children with American Indian or Alaskan background. Hispanic children between 1 and 9 are more susceptible to lymphoma risks than white children of the same age; simultaneously, white children from 10 to 19 are more likely to be diagnosed with lymphoma than their Hispanic peers (National Cancer Institute). Now, the average adjusted rates of Hodgkin disease among all population groups are approximately 2.8 per 100,000 annually (National Cancer Institute). The median death age for Hodgkin disease is 61 years, and only 2 percent of patients with diagnosed lymphoma die before they are 20 (National Cancer Institute). On January, 2005, there were approximately 156 thousand of men and women alive with history of Hodgkin lymphoma in the United States. Relative survival rates for Hodgkin disease is 84.8% across all groups of patients (National Cancer Institute).

            Signs and symptoms

            Hodgkin lymphoma is characterized by a number of symptoms and signs, most of which are not specific for lymphoma and can easily be confused with other diagnoses and health complications. The most common signs of this type of lymphoma include swollen lymph nodes, general fatigue, weight loss, fevers, night sweats, and itching. Painless node swelling is the distinctive feature of Hodgkin lymphoma. Sometimes (but not always) patients may have lower back pain complaints (Lymphoma Info Network).

            Possible causes

            Medical science lacks objective and unbiased knowledge with regard to the possible causes of Hodgkin lymphoma. The major portion of Hodgkin disease cases are diagnosed among people without any identifiable risk factors; “the Epstein-Barr virus has been associated with a proportion of cases, but its precise role in the predisposition or onset of the disease is still under study” (National Cancer Institute). Recent research findings confirm the link between Hodgkin lymphoma and weakened immune system. Hodgkin lymphoma is more frequent among people with diagnosed HIV; however, HIV cannot be readily considered the direct cause of Hodgkin disease (the majority of people with diagnosed lymphoma do not have HIV or AIDS – Lymphoma Info Network).

            From the viewpoint of genetics and hereditary factors, Hodgkin lymphoma survivors are more likely to have further cancer complications (or other forms of solid cancer) in their lives. Among those who are cured from Hodgkin lymphoma, the prevailing majority will have absolute risks for female breast cancer, colorectum cancer, and lung cancer. Women with medical history for Hodgkin lymphoma are much more vulnerable to other types of solid cancer than men. “For the current survivors, there is a need to investigate interventions to reduce the morbidity and mortality caused by second cancers” (National Cancer Institute).

            Diagnosis: adolescents vs. adults

            Biopsy is the main analytical tool used by medical professionals to diagnose Hodgkin disease. Children usually go through the whole set of other diagnostic procedures, which include general physical examination, complete blood work-up, tomography and MRI, a gallium scan and a bone marrow aspiration (Lymphoma Info Network). In adults, biopsy is supplemented with Reed-Sternberg cells test – a test specific for Hodgkin lymphoma. A chest x-ray is used to see, whether Hodgkin lymphoma has impacted other organs. In case of adults, “A Positron Emission Tomography is used as a newer method to pinpoint hotspots of cellular activity” (Lymphoma Info Network). In complex cases, laparotomy is used to evaluate the extent of disease, but both laparotomy and lymphangiogram are gradually becoming the two outdated approaches to diagnosing Hodgkin lymphoma in adults (Lymphoma Info Network).

            Hodgkin disease: treatment

            Hodgkin lymphoma treatment plans include chemotherapy, field radiation therapy, and pharmacological treatment. Bleomycin, Lomustine, Prednisone, and Vincristine are most frequently used to treat Hodgkin lymphoma (Lymphoma Info Network). If Hodgkin lymphoma is widely spread and the patient has fever and weight loss, chemotherapy may be the only kind of treatment prescribed (The Leukemia and Lymphoma Society). Chemotherapy is usually divided into several cycles. The length of chemotherapy may vary from 6 to 10 months. In case of infection, patients may require hospitalization and antibiotics, to guarantee that the infection does not impact the course of treatment. Depending on the complexity of the diagnosis and treatment, patients may need an autologous stem cell transplant, to ensure that their immune systems can fight the disease. “High-dose chemotherapy plus autologous stem cell transplant is not a cure. However, it may give a patient a longer disease-free period than standard-dose chemotherapy without a stem cell transplant” (The Leukemia and Lymphoma Society).

            Hodgkin lymphoma treatment may cause a number of side effects, which are particularly visible in young patients. These include nausea, diarrhea, bladder irritation, hair loss, cough, tingling sensation, and even nerve problems. Chemotherapy may also cause long-term health complications in terms of fertility in women and men, cancer-related fatigue, etc. Even when Hodgkin lymphoma seems to be cured and defeated, patients should be constantly alert in connection with possible long-term complications and related symptoms. The majority of young patients with diagnosed cancer require psychological assistance. Many of them will need some time to adjust to their health condition and to return to normal life. Despite the difficulties and possible complications, Hodgkin lymphoma is totally curable, if diagnosed at its initial stage. Regular examinations and follow-up care are expected to protect patients with history for Hodgkin lymphoma from related health dangers, giving them another chance for a happy and full life.

Conclusion

            Despite the life-threatening character of Hodgkin lymphoma, it remains one of the most curable forms of infant and adult cancer. If diagnosed at the initial stages, children and adolescents have a chance to defeat lymphoma. Patients with history for Hodgkin lymphoma require regular medical examinations and follow-up care, to avoid regression and long-term health complications.

Works Cited

Lymphoma Info Network. “What is lymphoma?” 2008. Lymphoma Info Network. 5 February

2009.  http://www.lymphomainfo.net/lymphoma/whatis.html

National Cancer Institute. “Hodgkin lymphoma.” 2008. National Cancer Institute. 5 February

2009.  http://www.cancer.gov/hodgkinsdisease

The Leukemia & Lymphoma Society. “Hodgkin lymphoma.” 2009. The Leukemia &

Lymphoma Society. 5 February, 2009. http://www.leukemia-lymphoma.org/all_page.adp?item_id=7085#_MoreInfo

 

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