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Hodgkin's Disease
WHAT YOU SHOULD
KNOW
Hodgkin's disease is a type of cancer called a lymphoma
(lim-FO-muh). Lymphomas begin in the lymph system---a network
of tiny vessels much like the body's circulatory system.
Instead of blood, the lymph system contains a fluid that
carries infection-fighting cells to all parts of the body. The
lymph vessels converge at a series of small, bean-shaped lymph
nodes located in the groin, armpit, neck, and abdomen; behind
the knees; and below the collar bone.
Hodgkin's Disease usually starts in a set of lymph nodes
in one part of the body, then spreads to the lungs, liver,
bone, and bone marrow. To diagnose the disease, doctors examine
your lymph nodes to see if they contain any "Reed-Sternberg"
cells. These cells appear only in affected
nodes.
Causes
There is no known cause of Hodgkin's disease, although
researchers think it might be linked to infection with the
Epstein-Barr virus, a virus similar to herpes. Hodgkin's is
more likely to strike people with a family history of the
disease and those with a weak immune
system.
Signs/Symptoms
Typical signs of Hodgkin's disease
include:
-
Swollen, but not painful,
lymph nodes in the neck, arm, or groin (the most common
symptom)
-
Fevers
-
Night sweats
-
Fatigue
-
Weight loss
-
Itchy skin
-
Fleeting pain in the swollen
nodes after drinking alcohol
-
Enlarged liver or
spleen
Care
To find out what stage the cancer is in, your doctor will
order a lymph node biopsy, removing a small sample of the
tissue for testing in the lab. You may also need to have blood
tests, x-rays, CT scans, a bone marrow biopsy, an abdominal
ultrasound exam, and, perhaps, a type of surgery called a
laparotomy, in which the doctor opens the abdomen to examine
the organs and remove tissue samples for testing. Once your
doctor decides the stage and extent of the cancer, one or more
of the following treatments may be called
for:
-
Chemotherapy: Often called "chemo," this type of
therapy uses drugs to kill new tumor cells or shrink lymph
nodes that contain cancer cells. Many different chemo
medicines are available. They may be taken as a pill, as a
shot, or in an IV. You will probably need frequent blood
tests to determine how your body is doing and how much
chemo you need. The drugs can produce many side effects,
and may leave you susceptible to infection for a
while.
-
Radiation: X-rays or gamma rays can kill cancer and
help prevent it from spreading. Doctors use this type of
therapy on cancerous lymph nodes. It can also be effective
in reducing pain, controlling bleeding, and shrinking
cancerous tumors, and is sometimes used after surgery to
eliminate any remaining cancer cells. Radiation and
chemotherapy are often used together.
-
Bone Marrow Transplant: In this form of therapy,
diseased or damaged bone marrow is replaced with healthy
marrow, usually from a donor. (Your own marrow may be used
if it can be collected while your cancer is in remission.)
The transplant is given in the hospital through an IV.
Although the treatment can cure cancer, it may lead to
other very serious health problems, including severe
infections. You may have to stay in the hospital for a
month after the procedure.
-
Biologic Therapy (also called biotherapy or
immunotherapy): This type of treatment relies on special
drugs that boost the immune system to help your body fight
growing cancer cells. Certain drugs may also make cancer
cells weaker and easier to kill. The medications are
usually given through an IV. They may cause flu-like
symptoms.
-
Peripheral Stem Cell Transplant: This treatment
calls for some of your blood to be drawn and put through a
process called apheresis (A-fer-E-sis) to remove stem
cells. The stem cells are then returned to your body, where
they usually find their way into the bone marrow. There
they can grow and replenish your supply of normal white
blood cells to help fight infection.
-
Surgery: If your spleen is larger than normal, it
may have to be removed surgically. The spleen is sometimes
removed during a laparotomy.
Risks
If the cancer is not treated, it is likely to spread.
(Even with treatment, it still may spread, and could recur
later.) Many treatments---especially chemotherapy and
radiation---have unpleasant side effects, and surgery poses
risks of infection or a blood clot. Nevertheless, your chances
of survival remain better with treatment than without. Many
people treated for newly diagnosed Hodgkin's disease outlive
the illness.
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