Hodgkin’s Disease - Causes, Symptoms and Treatment

What is Hodgkin’s Disease

Hodgkin’s disease is a very rare type of lymphoma (cancer of lymph tissues) which is found in lymph nodes, liver, spleen and bone marrow (lymphatic system). Reed-Sternberg cells (RS) are found with abnormality in lymphatic system, if a person is suffering from Hodgkin’s disease. This disease can occur in people of any age, but it is prevalent in two age groups viz.15-37 years and over-50 years.

Hodgkin’s disease was named after a scientist Thomas Hodgkin who first described it. This disease (cancer) attacks the lymphatic system in our body and spreads from one lymphatic node group to another. The lymphatic system works as a guard and fights with infections in our body. The lymphatic system in our body consists of tonsils, bone marrow, lymph nodes and spleen. Hodgkin’s system compromises our body’s ability to fight with infections and makes it vulnerable to any kind of infectious diseases.

There is no specific cause known which leads to Hodgkin’s disease. Just like in the case of any other type of cancer, possibilities are that this disease is caused due to microbial infection or existence of virus in the host’s body. According to some researchers, people with history of Epstein-Barr virus are at higher risk of developing Hodgkin’s disease. Also a person is prone to this disease, if any of his/her family members have ever had Hodgkin’s disease.

Classification of Hodgkin’s Lymphoma

Hodgkin’s lymphoma can be classified into five subtypes based on the composition of reactive cell infiltrate and Reed-Sternberg cell morphology developed in lymphatic node groups. These subtypes are: Nodular Sclerosis (this is the most common type of Hodgkin’s lymphoma, in which large tumor nodules are developed with lacunar RS cells. This is further classified as nodular sclerosis type I and nodular sclerosis type II.), Mixed-Cellularity, Lymphocyte-rich & Lymphocyte Depleted.

This disease is also classified in four stages based on the extent of its development and spread within the host’s body.

Stage I: In this stage, the lymphoma has started with only one lymphatic node and is the primary stage of the disease. More than 90% cases diagnosed in this stage get cured and the patient can live a long life.

Stage II: In this stage of disease, more than one lymph node regions get infected on the same side of diaphragm and a contiguous extralymphatic site.

Stage III: In this stage, lymph node regions on both the sides of the diaphragm get infected. This may include the spleen and/or limited contiguous extralymphatic organ.

Stage IV: This stage is considered the most advanced stage of lymphoma. In this stage, the lymph node regions get infected and the lymphoma spreads to other organs of the body (for example: liver, bone marrow and tonsils etc).

Symptoms of Hodgkin’s Disease

• Sudden and unexplained weight loss
• Painless swelling of lymph nodes in neck, groin and armpits.
• Fatigue
• Itching
• Fever, chills and sweating at night
• Loss of appetite
• Hepatomegaly may be experienced in some cases (swelling of liver)
• In some cases, back pain is noticed by patients
• Enlargement of spleen is observed some cases

Diagnosis and Treatments

Your doctor will need you to undergo some tests in order to confirm if you are suffering from Hodgkin’s disease and not from any other non-cancerous lymph node related problems. Your doctor may ask you to undergo one or more than one tests such as:

Biopsy: In this test, tissues from lymph nodes are collected and examined for the trace of Hodgkin’s disease.

Blood Test: Blood is tested in order to confirm normal functioning of all the body organs.

Positron Emission Tomography and Gallium Scan: These are used to detect smaller deposits in the body which generally don't show in CT scan.

X-Ray, CT Scan: Picture of lymph nodes can help in confirming any abnormal changes in the lymph nodes.

Once doctor confirms Hodgkin’s disease based on the diagnostic tests the patient underwent, he/she may decide to use one or a combination of available treatment options in order to treat the disease based on the stage of the disease, patient’s condition etc. The treatment options available are:

Radiation Therapy: Radiation therapy is used to eliminate the cancerous cells and tumors developing in lymph node regions with the help of strong X-rays. This therapy has side effects such as destruction of some non-cancerous cells, problems related to stomach and fatigue etc.

Chemotherapy: In this therapy, strong medications are used to kill the infected cells and fight the disease. These medicines are very powerful, but they also have many side effects including hair loss, vomiting, nausea, loss of blood cells etc. One of the most dangerous side effects of this therapy is that it weakens the patient’s (generally children) infection fighting ability.