Hodgkin lymphoma is a type of cancer that starts in the lymphatic system, a key part of the body’s immune defense. The lymphatic system includes lymph nodes, the spleen, thymus, and bone marrow—all helping protect the body from infections and diseases. When Hodgkin lymphoma develops, certain white blood cells called lymphocytes grow abnormally. These cells often form tumors in lymph nodes or other parts of the lymphatic system. Unlike many other cancers, this lymphoma is easy to identify under a microscope and often curable, especially when caught early and treated quickly.
What Makes Hodgkin Lymphoma Unique
What sets Hodgkin lymphoma apart from other lymphomas is the presence of Reed-Sternberg cells. These large cancer cells come from B lymphocytes and are found through a biopsy. Their presence is a key sign of the disease and helps doctors make an accurate diagnosis and stage the cancer.
Who Gets Hodgkin Lymphoma?
The disease can occur at any age but most often affects young adults between 15 and 35 years and people over 60. Males are slightly more likely to develop it than females. While the exact cause is unknown, some risk factors include family history, past infection with Epstein-Barr virus (EBV), and weak immune systems.
Types of Hodgkin Lymphoma
There are two main types of Hodgkin lymphoma:
- Classical Hodgkin Lymphoma (cHL): The most common type, making up about 95% of cases. It includes subtypes such as nodular sclerosis, mixed cellularity, lymphocyte-rich, and lymphocyte-depleted.
- Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL): A rare type that grows slowly and has unique clinical and pathological features.
How the Disease Spreads
Hodgkin lymphoma usually starts in one lymph node or a group of nearby nodes. It spreads in a clear pattern from one group of lymph nodes to another. This predictable spread makes it easier to track and manage than non-Hodgkin lymphoma, which can spread randomly.
Early Symptoms to Watch For
Early symptoms are often mild and easy to confuse with common illnesses. This is why early diagnosis is so important. Common signs include swollen lymph nodes in the neck, armpits, or groin that do not hurt, unexplained weight loss, night sweats, tiredness, and repeated fevers. Some people may also have itchy skin or feel pain in the lymph nodes after drinking alcohol—a rare but known sign linked to Hodgkin lymphoma.
How Doctors Diagnose Hodgkin Lymphoma
Doctors begin with a physical exam. Then, they use imaging tests like X-rays, CT scans, and PET scans to look inside the body. Most importantly, they perform a biopsy of the swollen lymph node. The biopsy lets doctors look at the cells under a microscope to find Reed-Sternberg cells. This confirms the diagnosis and helps rule out other cancers.
Staging the Disease
Once Hodgkin lymphoma is diagnosed, doctors determine its stage. The Ann Arbor system is common and ranges from stage I (cancer in one area) to stage IV (cancer in many organs). Patients are also classified based on symptoms: “A” means no symptoms, and “B” means symptoms like fever or weight loss are present.
Treatment Options
Treatment depends on the type and stage of the disease, as well as the patient’s age and health. Common treatments include chemotherapy and radiation therapy. Some patients may need a stem cell transplant. Immunotherapy is a newer option, especially for those whose cancer has returned or resisted other treatments. Early-stage Hodgkin lymphoma has cure rates above 90%, and even advanced cases often respond well to treatment.
Long-Term Considerations
Long-term survival is very good, but some treatments, especially radiation, can raise the risk of other cancers, heart problems, or fertility issues. Survivors need regular check-ups to watch for these effects and to keep the cancer from coming back.
Emotional Support
Emotional support is just as important as medical care. Many patients feel anxiety, depression, or stress during diagnosis and treatment. Access to counselling, support groups, and education helps improve their well-being.
Outlook for Patients
Thanks to years of research and better treatments, the outlook for Hodgkin lymphoma has greatly improved. In many wealthy countries, the five-year survival rate is over 85% for all stages. For those with relapsed disease, second treatments and clinical trials offer new hope.
In the next section, we will explore the causes of Hodgkin lymphoma, including environmental, genetic, and viral factors that may contribute to its development.
