Hodgkin lymphoma (HL) is a type of blood cancer that begins in the lymphatic system, which consists of lymph nodes–small, bean-shaped structures that store and help circulate white blood cells. These lymph nodes trap harmful substances that enter the body and help defend against infection. When affected by cancer, the lymphoma cells may spread from the original lymph node to nearby lymph nodes or other parts of the lymphatic system, such as the spleen and bone marrow. HL is most likely to occur in young people and is considered highly treatable, so the earlier the detection, the better the survival outcomes.
Causes and Risk Factors
The origin of HL lies in the abnormal growth of certain immune cells, particularly white blood cells known as B lymphocytes, which help fight infections; These abnormal B cells are called Reed-Sternberg cells, which are large, abnormal cells playing a fundamental role in the diagnosis of HL. The exact cause of HL is not known, but a number of factors may heighten the possibility of developing the disease, which includes genetics, viral infections, and an immune system that is suppressed. The list below is ordered by the highest risk to the lowest risks.
1. Epstein-Barr virus
Studies indicate that a person who has had infectious mononucleosis (mono) at adolescence has a three times higher risk of developing HL. Mono is caused by the Epstein-Barr virus (EBV), a member of the herpes family; Mono is transmitted through bodily fluids, especially saliva, and touch.
2. Weakened immune system
Conditions that weaken the body's immune system, such as HIV/AIDS or the use of immunosuppressant medications that impair the body's general ability to fight off infection, can increase the risk for developing HL; a weak immune system may not be able to detect and destroy abnormal cells, which can grow out of control.
3. Family history
Although Hodgkin lymphoma is not strictly a hereditary disease, one is at an increased risk if a family member had the disease because of inherited genetic variations. Siblings are at high risk, especially identical twins.
Diagnosis of Hodgkin Lymphoma
The symptoms of HL include painless swelling of lymph nodes in areas such as the neck, underarms, or groin, unexplained fever, persistent fatigue, intense night sweats, weight loss without increased physical activity over a period of more than six months, a lack of appetite, shortness of breath and constant shivering, especially in colder weather, may occur as well. In addition, in stage 3 or 4 of HL, pain in the abdomen may be present.
As a result, If symptoms are present, a biopsy is conducted to confirm a diagnosis of HL. However, prior to doing a biopsy, a complete blood cell count (CBC) test is done to find the presence of this cancerous disease in the patient by checking for anomalies on the level of red cells, white cells, and platelets. In addition, An Erythrocyte Sedimentation Rate (ESR) may also be performed to look for inflammation, which is typically elevated in HL.
In a biopsy, a portion of the affected lymph node or tissue is taken out and checked under a microscope in a laboratory for the presence of the Reed-Sternberg cells mentioned earlier. After a confirmed diagnosis, imaging studies such as CT scans, PET scans, or MRI are then conducted to determine the extent and stage of the disease.
Stages of Hodgkin Lymphoma
After diagnosis, staging is the next important step to ensure a comprehensive understanding of a patient’s HL condition. Staging provides information about whether the lymphoma is constricted to one lymph node area or if it has spread into other areas, like the bone marrow, the spleen, or other organs. Corect staging is critical for developing an effective and appropriate treatment plan, as the stage influences decisions about chemotherapy, radiation, or other options.
HL is divided into four stages according to distribution…
Stage I: HL is present in one lymph node or a single nearby organ.
Stage II: HL is present in two or more groups of lymph nodes that are either above the diaphragm or below the diaphragm.
Stage III: HL is present in lymph nodes on both sides of the diaphragm and may involve nearby organs.
Stage IV: HL has spread to multiple organs, like the liver, lungs, or bone marrow.
Treatment Options
Chemotherapy: Chemotherapy is the main treatment for HL, usually with a combination of drugs that target and kill cancer cells. Chemotherapy is used in all stages, both early and advanced disease.
Radiation Therapy: In certain cases of HL, radiation therapy may be used after chemotherapy, especially in early-stage disease or in localized areas where the cancer is active.
Stem Cell Transplant: A Stem-cell transplant is another, last choice option for patients when HL has relapsed or become unmanageable. The transplantation is mainly indicated to replace the bone marrow after aggressive treatments.
Immunotherapy: Newer approaches, such as immunotherapy, are being investigated in patients with recurrent HL. These therapies enhance the body's immune system to better recognize and destroy cancer cells.
VIII. Prognosis & Survival Rates
The prognosis for HL, considering the advances in its treatment, such as chemotherapy, radiation, and immunotherapy, is generally excellent. The outlook for early-stage HL is usually very positive; most patients can achieve long-term remission or cure. In more advanced stages, the prognosis remains positive, though treatment might be more intensive. It is important to have follow-ups and monitoring regularly to ensure the cancer is under control or does not recur.
Since HL is considered highly curable and treatable, the 5-year relative survival rate is about 89%, though this depends on the stage. Generally, for those patients who have an early stage of HL, Stage I or II, the survival rate is usually over 90%, whereas in advanced stages, it goes down but at around 80%. It might also depend on age, health in general, and the overall response to the given treatment.
IX. Battling Hodgkin Lymphoma
A diagnosis of Hodgkin lymphoma is a heavy burden; The disease, like many other cancers, is overpowering because a patient is confronted with anxiety, depression, stress, and other emotional impacts related to the treatment and recovery.
HL also causes physical and psychological changes in a patient's body, which lower their self-esteem due to treatment that may make one bald, weak, disrupt their lifestyle, and cause social withdrawal. It's helpful when loved ones rally around a HL patient, as connecting with other people can sometimes ease that emotional weight.
Treatment for HL can harbor long-term effects, relapses including fertility issues, second cancers, and heart problems. Fatigue and emotional challenges can also linger long after treatment ends. Important ways to manage these long-term effects is to attend regular follow-ups and form an establishment of healthy habits
As mentioned earlier, support is always helpful. Support networks like cancer support groups, counseling, and family involvement can go a long way in supporting the patient through the disease and treatment process psychologically.
X. Conclusion
HL is a type of cancer that is highly treatable yet still threatening. Treatment often comes with living long-term negative effects, such fatigue or infertility, or even secondary cancers. Certainly not helpless, family and friends can help, mental health resources, and an inroad into others with these same experiences may help to rebuild that strength and confidence in the patient. With continuing medical advancements, attention to wellness, and a steadfast spirit, those with Hodgkin lymphoma may just advance into a bright and hopeful future in healing and growth.
Sources
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“Hodgkin Lymphoma.” Medlineplus.gov, medlineplus.gov/hodgkinlymphoma.html.
Kaseb, Hatem, and Hani M. Babiker. “Hodgkin Lymphoma.” PubMed, StatPearls Publishing, 2024, www.ncbi.nlm.nih.gov/books/NBK499969/.
Cleveland Clinic. “Hodgkin Lymphoma: Symptoms, Diagnosis, Causes & Treatment.” Cleveland Clinic, 5 Aug. 2022, my.clevelandclinic.org/health/diseases/6206-hodgkin-lymphoma.
Leukemia & Lymphoma Society. “Hodgkin Lymphoma Staging.” 26 Feb. 2015, www.lls.org/lymphoma/hodgkin-lymphoma/diagnosis/hodgkin-lymphoma-staging.
American Cancer Society. “What Is Hodgkin Lymphoma? | Define Hodgkin Lymphoma.” Www.cancer.org, 1 May 2018, www.cancer.org/cancer/types/hodgkin-lymphoma/about/what-is-hodgkin-disease.html.