Approximately 173,000 people in the United States are living with Hodgkin lymphoma, or are in remission. Less common than non-Hodgkin lymphoma, Hodgkin lymphoma (sometimes referred to as Hodgkin’s lymphoma) is a malignancy of B lymphocytes, an important cell in the immune system. This malignant B cell is known as the Reed-Sternberg cell.
Arnold Freedman, MD, clinical director of the Dana-Farber/Brigham and Women’s Cancer Center Adult Lymphoma Program, answers some questions about the disease:
1. What are the different types of Hodgkin lymphoma? There are two main types:
- Classical – This is the most common form, which can be broken down into four subtypes, including nodular sclerosing, mixed cellularity, lymphocyte depletion, and lymphocyte-rich.
- Nodular lymphocyte-predominant (NLPHL) – A rare form of Hodgkin lymphoma that is a slow-growing disease.
2. What are the risk factors for Hodgkin lymphoma? Age and gender can increase the chance of developing Hodgkin lymphoma. Other risk factors include:
- Being in young or late adulthood
- Being male
- Being exposed to the Epstein-Barr virus
- Having a first-degree relative (parent or sibling) with Hodgkin lymphoma
3. What are the symptoms of Hodgkin lymphoma? The most common signs of Hodgkin lymphoma are swollen (painless) lymph nodes in the neck, underarm, or groin, as well as fever, night sweats and weight loss. Other symptoms can include itchy skin, fatigue, cough or shortness of breath.
4. How do doctors diagnose Hodgkin lymphoma? Typically, the doctor will first conduct a physical exam to check for signs of health and any unusual lumps. The doctor will also check routine blood tests and perform scans, such as a CT scan or MRI.
A biopsy of involved tissue or lymph nodes is essential to make a diagnosis. A pathologist then examines the lymph node tissue to look for the malignant B cells.
A doctor may decide to run additional blood tests, including a blood chemistry study and a check for erythrocyte sedimentation rate.
5. What are the treatment options for Hodgkin lymphoma? There are two main tools used in standard treatment for Hodgkin lymphoma: Chemotherapy and radiation therapy.
Combination chemotherapy is used in both early and advanced stages of the disease, and depending on the stage or extent of disease, radiation therapy is added to parts of the body where there are sites of the disease.
Patients with a recurrence of the disease may be considered for a stem cell transplant. These transplants typically use the patient’s own stem cells.
Clinical trials of new chemotherapy combinations are also an option for patients in all stages of Hodgkin lymphoma, as well as patients with a recurrent form of the disease. Dana-Farber currently has several clinical trials open for Hodgkin lymphoma patients and the National Cancer Institute maintains a list of clinical trials at clinicaltrials.gov.
My daughter was 19 when she was diagnosed with Hodgkin’s Lymphoma. It was detected in her thymus gland. She had the classic symptoms that you listed. Weight loss, constant coughing, night sweats, always tired. She did have chemo for about 10 months and I am very happy to say that she hit her 5 year mark in remission. All her PET and CAT scans are clear! She had left college due to her illness and I’m very proud to say she went back and made the Dean’s list and she is graduating in May with a degree in Elementary Special Education. She is a fighter and very strong willed!! She went thru a lot at her age but it made her a better person! It’s wonderful to see the way she is now. God bless all of you out there who have fought this cancer!!
My daughter was diagnosed when she was 22 – she felt a lump below her clavical. Biopsy, then 6 months of chemotherapy (she had to move home for her treatment, but she continued to work via the computer.) She has had 2 clear PET scans. Next one in January. She now has a new job, moved to NC, and is training for a half marathon. She is the bravest, strongest person I know. She stayed positive throughout it all. We consulted with Dana Farber, and then had an oncologist who works in Boston, but comes to our hospital one day a week. He consulted with Dr. LaCase throughout the process. She is getting her follow-up PET scans at Duke.
Maybe this isn’t the right place to ask, but it seems like information is lacking on this subject: Are all lymph nodes affected by hodgkin lymphoma? or is it just one the lymph node that has cancer? Also, is it possible for swollen lymph nodes affected by cancer to shrink down after being larger than normal?
The reason I ask is because I am concerned that I have lymphoma. My brother was diagnosed at the age of 16, and I am showing symptoms of this disease as a young adult. I had a lymph node that was 6cm long surgically removed from my armpit and biopsied, but there wasn’t any sign cancer found. I still have swollen lymph nodes in other areas around my body and have recently developed shortness of breath and a dull chest pain. I am 23 years old and am in very good shape, but feel tired all the time. I hope someone can answer, thanks.
Hi Miller,
Our apologies for the delay. We would suggest going to a physician to address these concerns. If you would like to schedule an appointment with a lymphoma specialist here at Dana-Farber, you can call 617-632-6246.
Wishing you the best.
DFCI