Hodgkin’s disease, which is also referred to as Hodgkin lymphoma, Hodgkin disease, or Hodgkin’s lymphoma, is a type of blood cancer called lymphoma. The cancer originates in the lymphatic system, particularly in white blood cells – lymphocytes, which help the body to fight infection. Hodgkin’s disease mostly starts in the lymph nodes of the neck, chest, and underarms. When Hodgkin’s disease progresses, it prevents the body’s ability to fight infection. Hodgkin lymphoma exists in two types: classical and nodular lymphocyte-predominant. Most Hodgkin lymphomas are the classical type and is divided into the following four subtypes:
- Lymphocyte depletion Hodgkin lymphoma
- Lymphocyte-rich classical Hodgkin lymphoma
- Mixed cellularity Hodgkin lymphoma
- Nodular sclerosing Hodgkin lymphoma
- ABVD chemotherapy: Adriamycin (doxorubicin), vinblastine, bleomycin and dacarbazine
- BEACOPP – etoposide, bleomycin, doxorubicin, vincristine, procarbazine, cyclophosphamide and prednisolone
- ChlvPP – vinblastine, procarbazine, chlorambucil and prednisolone
- ESHAP – etoposide, cytarabine, prednisolone and cisplatin
- GemP – gemcitabine, prednisolone and cisplatin
- Stanford V – doxorubicin, mustine, vinblastine, bleomycin, vincristine, etoposide and steroids
Hodgkin’s disease has a common symptom – painless swelling in the lymph nodes of:
About 70% of patients diagnosed with Hodgkin’s disease have a swollen lymph node in their neck. Lymph glands may also swell if you have an infection but after recovery lymph nodes usually go back to normal. In case of Hodgkin’s lymphoma, the lymph nodes usually grow slowly and may stay unnoticed for months or years. Other symptoms, which may indicate Hodgkin’s disease, are the following:
The main cause of Hodgkin’s disease is still unknown. It is believed that in most cases Hodgkin’s occurs when an infection-fighting cell, which is called a B cell, develops a mutation in its DNA. A healthy cell may die and the mutated cells divide rapidly and continue living. The mutation results in a large number of abnormal B cells, which accumulate in the lymphatic system and cause the symptoms and signs of Hodgkin’s lymphoma. There are certain factors that may increase the risk of Hodgkin’s, including:
- Age – Hodgkin’s lymphoma may occur at any age; however, it mostly occurs between the ages of 15 – 40 or after the age of 55.
- Family history of lymphoma – having a family member with lymphoma increases the risk of Hodgkin’s disease.
- Past Epstein-Barr infection. Those who have had infectious mononucleosis are more likely to have Hodgkin’s lymphoma.
- Sex – males have Hodgkin’s lymphoma more often.
- Weakened immune system, e.g. during having HIV/AIDS, after medication treatment to suppress the immune response before having an organ transplant.
Hodgkin’s disease is diagnosed by a healthcare professional by performing a physical examination and asking about the patient’s medical history. To get a final diagnosis, various tests should be ordered, including:
- Blood tests, e.g. complete blood count, measure levels of white and red blood cells, platelets, blood protein and uric acid
- Bone marrow biopsy to see whether the cancer has spread
- Echocardiogram to determine the work of heart
- Imaging tests, such as CT scans or x-rays
- Immunophenotyping to determine the kind of lymphoma cells
- Lung function tests to determine the functioning of lungs
- Lymph node biopsy
After a diagnosis of Hodgkin’s disease is established, it is important to determine the stage of cancer, which shows the location and spread of disease.
Hair loss, or alopecia, cannot be treated with medication although medication exists to slow the rate of hair loss. Patients may be prescribed the over-the-counter preparation of minoxidil though this only slows the rate of hair loss in the crown area. Prescription preparations of finasteride – which works by inhibiting the effects of testosterone – have been shown to significantly reduce the degree of hair loss. However, its effects subside with time, and the drug does not work to the same extent in every user. Surgical options exist to replace hair from one part of the head to the bald area, which may be performed on both men and women. Hair loss due to chemotherapy returns once the medication is stopped. Many females experience temporary alopecia – for example, during times of stress of hormonal imbalance – and the hair, as with chemotherapy, usually returns when the immediate cause has been eliminated.