Are you experiencing lumps on your body? Could it be Hodgkin Lymphoma? Let's talk!

Have you ever noticed a small lump on your neck, armpit, or groin? Or have you been feeling extremely tired for days, or have a sudden fever? Sometimes these can be normal. However, if you have these symptoms, it is good to be a little concerned. Because these may be symptoms of a disease called Hodgkin Lymphoma. Although the name may sound scary, this is a disease that can often be treated and cured. So, today we will talk in detail about Hodgkin Lymphoma.

What is Hodgkin Lymphoma?

Simply put, Hodgkin Lymphoma is a type of cancer that develops in our lymphatic system , the system that fights germs in our body. It was also called Hodgkin's disease in the past. There are two main types of lymphoma. One is Hodgkin lymphoma, and the other is Non-Hodgkin Lymphoma. Both of these cancers affect lymphocytes, a type of white blood cell that is essential to our immune system.

Hodgkin lymphoma is caused by a mutation in the genes of our B lymphocytes (B cells). These changes occur throughout life. Most often, this lymphoma starts in the lymph nodes in the neck or chest cavity. Sometimes, it can also develop in lymph nodes in the armpits, groin, abdomen, or pelvis.

The good news is that the number of people who are treated for Hodgkin lymphoma and living longer is increasing every year. In many cases, treatment can completely cure Hodgkin lymphoma. However, sometimes the disease can recur. If that happens, medical researchers are constantly looking for new treatments.

What are the main types of Hodgkin Lymphoma?

There are four main types of Hodgkin lymphoma. Let's take a look at what they are:

• Nodular sclerosis Hodgkin lymphoma: This is the most common type of Hodgkin lymphoma. It occurs more often in young people, especially women. It most often affects the lymph nodes in the middle of the chest.
• Mixed cellularity Hodgkin lymphoma: This type usually occurs in people in their 60s. It can sometimes develop in the abdomen (belly).
• Lymphocyte-rich classic Hodgkin lymphoma: This type occurs in about 6% of people with Hodgkin lymphoma. It is more common in men.
• Lymphocyte-depleted Hodgkin lymphoma: This is very rare. It occurs in about 1% of people with Hodgkin lymphoma. It is more common in people over 60 years of age and in people with HIV/AIDS .

How common is Hodgkin Lymphoma?

Hodgkin lymphoma is a rare disease . It affects only about three in 100,000 people each year. But surprisingly, it is the most common type of cancer in children and young adults between the ages of 15 and 19.

However, Hodgkin lymphoma is much less common than non-Hodgkin lymphoma.

What are the symptoms of Hodgkin Lymphoma?

The most common first sign of Hodgkin lymphoma is painless swollen lymph nodes in the neck, armpit, or groin . In addition, there may be several other symptoms:

• Persistent fatigue: Feeling more tired than usual for several days. As if your body has no energy.
• Unexplained fever: A high fever that doesn't subside after two hours of home treatment, or that lasts for more than two days, could be a sign of something serious.
• Excessive night sweats: Sweating so much at night that the sheets and clothes get wet.
• Unexplained weight loss: Weight loss without effort. If you lose 10% or more of your total weight within six months, it's something to be concerned about.
• Itching (Pruritus): Some people experience excessive itching of the skin after drinking alcohol or taking a bath.
• Stomach pain or bloating: Not all stomach aches are a sign of a serious illness. But if you have persistent, severe stomach pain that doesn't go away, see a doctor.
• Chest pain: This symptom can occur if Hodgkin lymphoma is present in the lung tissue or lymph nodes within the chest.
• Difficulty breathing: This could be a sign of Hodgkin lymphoma in the lungs or a large lump in the chest.

Doctors also call these three symptoms—fever, weight loss, and night sweats—"B symptoms." The presence of these symptoms helps doctors plan your prognosis and treatment.

What causes Hodgkin Lymphoma?

As we mentioned earlier, Hodgkin lymphoma develops when genetic changes occur in your B cells . These changes are not something you are born with, but something that is acquired during life.

When B cells change in this way, they produce a type of cancer cell that is larger than normal cells. These are called Reed-Sternberg cells . These Reed-Sternberg cells produce substances called cytokines . These cytokines attract normal cells to the lymph nodes that contain abnormal cells. Then, the substances released by these normal cells cause the Reed-Sternberg cells to grow even more. This results in the lymph nodes swelling.

This cancer can spread through your lymphatic system to other lymph nodes, such as the thymus and spleen . It can also spread to lymph nodes throughout the body. Rarely, it can affect other organs, such as the lungs, liver, and bone marrow .

What are the risk factors?

Doctors have identified several factors that increase the risk of developing Hodgkin Lymphoma:

• Your age: If you are between 20 and 39 years old, or over 65, you are more likely to develop this disease.
• Your gender: Men are more likely to develop Hodgkin lymphoma. However, the type we discussed earlier, nodular sclerosis, is more common in women.
• Your family medical history: If your siblings or parents have had Hodgkin lymphoma, you have a slightly higher chance of developing it too.
• If you have had an organ transplant: If you have had an organ transplant, you will need to take antirejection medications, which increases your risk of developing lymphoma.
• Certain viral infections: Having viral infections such as HIV , human T-lymphotropic virus type 1, or Epstein-Barr virus may increase your risk of developing Hodgkin lymphoma.

How is Hodgkin Lymphoma diagnosed?

A doctor will first examine you physically to check for signs of Hodgkin lymphoma, such as swollen lymph nodes. They will also ask about any changes you have been feeling, such as a persistent fever or unexplained weight loss. Several tests may be done to diagnose Hodgkin lymphoma. These may include blood tests, imaging tests, and biopsies .

Blood tests

Blood tests can give your doctor an idea of ​​your overall health. They can also detect signs of cancer. Some of the tests you may have include:

• Complete blood count (CBC): This checks for low blood cell counts if there is lymphoma in the blood or bone marrow.
• Blood chemistry study: This measures your electrolyte levels, liver and kidney function, and looks for substances that accumulate in the blood when organs and tissues are damaged.
• Erythrocyte sedimentation rate (ESR): This measures inflammation in the body. This value may be elevated in Hodgkin lymphoma.
• Lactate dehydrogenase (LDH) test: This measures a protein released when cells are damaged. LDH levels are sometimes elevated with lymphoma.
• Viral tests: These tests can detect current or past viral infections that may be associated with Hodgkin lymphoma, such as HIV , hepatitis B , and hepatitis C. The results can help your doctor plan your treatment.

Imaging tests

Scans can look for signs of cancer inside your body. The type of scan you need will depend on where the cancer is and whether you are pregnant. (Scans that use X-rays can be harmful to the fetus.) These tests include:

• Chest X-ray
• CT scan (CT scan - Computed tomography scan)
• PET scan (Positron emission tomography scan)
• MRI scan (Magnetic resonance imaging scan) (safe during pregnancy)
• Ultrasound scan (safe during pregnancy)

Biopsy

Doctors usually diagnose Hodgkin lymphoma with a lymph node biopsy . In this procedure, a doctor removes all or part of a lymph node. A pathologist then examines the tissue under a microscope to see if there are Reed-Sternberg cells, which we talked about earlier. (The presence of these Reed-Sternberg cells means you have Hodgkin lymphoma, not non-Hodgkin lymphoma.)

Sometimes, Hodgkin lymphoma can also be diagnosed based on the results of a biopsy of tissue taken from another location, such as the lungs, liver, spleen, or bone marrow.

What are the stages of Hodgkin Lymphoma?

After your doctor diagnoses you with Hodgkin lymphoma, the results of your tests will determine the stage of the disease. Knowing the stage of your cancer helps doctors determine how far the cancer has spread, how quickly it is likely to spread, and what treatment is best for you. Here are the stages of Hodgkin lymphoma:

• Stage I: Cancer cells are in one lymph node region or an organ in the lymphatic system (e.g., thymus, spleen, bone marrow). Or the lymphoma is in one area of ​​a single organ outside the lymphatic system.
• Stage II: There are cancer cells in two or more lymph node groups on the same side of your diaphragm (other lymph nodes near the diaphragm may also be affected).
• Stage III: There are lymphoma cells in the lymph nodes on both sides of the diaphragm, or there are cancer cells in the lymph nodes above the diaphragm and in the spleen.
• Stage IV: Lymphoma is present in at least one organ outside the lymphatic system (e.g., liver, lungs, bone marrow).

Doctors also use the terms "favorable" and "unfavorable" to classify Hodgkin lymphoma, based on whether it responds well to treatment and whether it remains symptom-free (remission).

How is Hodgkin Lymphoma treated?

Doctors use different treatments for Hodgkin lymphoma, depending on the stage of the cancer. These treatments either kill cancer cells or stop them from dividing. Treatment options include:

• Chemotherapy: This is the most common treatment for Hodgkin lymphoma. It uses one or more drugs to kill cancer cells or stop them from multiplying. Doctors may use one type of chemotherapy or a combination of several types of chemotherapy.
• Radiation therapy: This treatment uses high-energy beams of energy to kill cancer cells in affected lymph nodes or areas where the cancer has spread. It is also used with chemotherapy in the treatment of early-stage Hodgkin lymphoma.
• Immunotherapy: This treatment works by stimulating your body's immune system to help it recognize and destroy cancer cells. Checkpoint inhibitors are an important immunotherapy treatment for Hodgkin lymphoma.
• Targeted therapy: Targeted therapy uses drugs or other substances to attack only cancer cells. For example, a treatment called antibody-drug conjugates . In this, lab-made antibodies are attached to a chemotherapy drug, which then seeks out and destroys cancer cells.
• Chemotherapy with stem cell transplantation: This treatment is often used if Hodgkin lymphoma has relapsed after going into remission or is not responding to treatment. In this case, you will be given a different type of chemotherapy than the one you were given initially. If the cancer responds to it, your doctor will perform a stem cell transplant.

Side effects of treatments

Each treatment can have different side effects. For example, chemotherapy can cause hair loss and nausea. Radiation therapy can cause sunburn in the treated area. Side effects of immunotherapy can include skin rashes, diarrhea, and inflammation of the lungs, which can cause difficulty breathing and coughing.

Ask your doctor about possible side effects before starting treatment. He or she will help you weigh the potential side effects against the benefits of treatment.

What is the outlook for Hodgkin Lymphoma?

Doctors consider Hodgkin lymphoma a treatable and largely curable cancer. Your outlook depends on the stage of the disease and other factors. Your doctor can talk to you about this. However, sometimes treatment is not successful and the cancer may come back. Ask your doctor how these classifications affect your prognosis.

What is the survival rate for Hodgkin Lymphoma?

Survival rates for Hodgkin lymphoma continue to improve as doctors develop new and improved treatments. According to the US National Cancer Institute, 88% of people diagnosed with Hodgkin lymphoma between 2014 and 2020 were still alive five years after treatment.

Survival rates vary depending on the stage of the cancer. According to the same statistics, between 92% and 95% of people diagnosed with early-stage disease were still alive five years after diagnosis. Between 81% and 87% of people diagnosed with later-stage disease were still alive five years after diagnosis. This shows how important it is to detect the disease early, doesn't it?

How can I take care of myself?

You may feel relieved to know that your Hodgkin lymphoma symptoms are going away with treatment. However, you may also be worried or afraid that the condition will return. These suggestions can help make living with Hodgkin lymphoma a little easier:

• Rest: Both cancer and cancer treatments can cause extreme fatigue. Give your mind and body the rest they need.
• Eat a balanced, nutritious diet: There is no clear link between what you eat and Hodgkin lymphoma. However, eating well can help protect your immune system and reduce your risk of getting viruses. If you want to learn more about eating well, talk to a dietitian.
• Manage stress: Hodgkin lymphoma can come back after treatment. Worrying about getting sick again can be stressful. If you constantly worry that your condition will come back, talk to your doctor. He or she is the best person to know about your condition. Knowing what to expect can help reduce your stress.
• Exercise: Regular exercise not only helps your immune system, but it also helps manage stress. It's also a good way to combat fatigue, a common side effect of cancer treatment.

The important thing is that being diagnosed with Hodgkin lymphoma doesn't mean you can't live your life to the fullest. You'll have to make some changes to deal with the side effects. You'll have to see your doctor more often than someone without a cancer diagnosis. But, little by little, you'll find a routine and pace that works for you.

When should I see my doctor?

If you are being treated for Hodgkin lymphoma, see your doctor if you notice any signs that your condition is getting worse despite treatment (e.g., new lumps, fever). Once you have completed treatment, you will have follow -up appointments to monitor your overall health and to check for any recurrence of the disease.

When should I go to the emergency room?

If you have treatment side effects that don't go away after taking your prescribed medication, are more severe than you expected, or last longer, go to the emergency room. Your doctor and medical team will talk to you about this.

What questions should I ask my doctor?

You may have many questions during the diagnosis and treatment of Hodgkin lymphoma. Here are some questions to ask your doctor:

• What type of Hodgkin lymphoma do I have?
• What is the stage of my disease?
• What treatment do you recommend?
• What side effects should be expected from the treatment?
• Can you cure my condition?
• What is the chance of the cancer coming back?

What is the difference between Hodgkin Lymphoma and Non-Hodgkin Lymphoma?

Hodgkin lymphoma and non-Hodgkin lymphoma are both cancers that affect your lymphocyte cells, but there are a few differences between the two.

Doctors consider Hodgkin lymphoma to be one of the most curable types of cancer. New treatments can eliminate the symptoms of Hodgkin lymphoma and almost completely cure the disease.

However, your outlook depends on the type of Hodgkin lymphoma and the stage of the cancer. Studies show that more than 90% of people who are treated for early-stage Hodgkin lymphoma are still alive five years after diagnosis. In other words, the sooner it is detected, the better.

Be aware of changes in your body, such as swollen lymph nodes, persistent fever, and fatigue. Having these symptoms doesn't mean you have Hodgkin lymphoma, but it's a good idea to get tested. When it comes to this disease, early diagnosis can increase your chances of living cancer-free.

Finally, take-home message:

It's normal to feel scared when you hear the name Hodgkin Lymphoma. But remember, this is a cancer that is largely curable. The most important thing is to seek medical advice as soon as you notice symptoms. Especially if you have symptoms such as painless lumps in the neck, armpits, or groin, persistent fatigue, unexplained fever, excessive night sweats, and weight loss, you should definitely see a doctor.

With early diagnosis and proper treatment, many people have been able to fully recover from Hodgkin lymphoma and live normal lives. So, never give up hope. The most important message I have for you is to seek medical advice as soon as possible if you or someone you know has these symptoms.

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