HODGKIN DISEASE aka HODGKIN'S DISEASE

Scientists at hospitals and medical centers all across the country are studying Hodgkin's disease. They are trying to learn more about what causes the disease and more effective methods of treatment.

What is Hodgkin's Disease?

Hodgkin's disease, sometimes called Hodgkin's lymphoma, is a cancer that starts in lymphatic tissue. Lymphatic tissue includes the lymph nodes and related organs that are part of the body's immune and blood-forming systems.

What are the Risk Factors of Hodgkin's Disease?

The following are some of the risk factors associated with this disease:

• Age/Sex -- Hodgkin's disease occurs most often in people between 15 and 34 and in people over the age of 55. It is more common in men than in women.
• Family History -- Brothers and sisters of those with Hodgkin's disease have a higher-than-average chance of developing this disease.
• Viruses including the Epstein-Barr virus

What are the Symptoms of Hodgkin"s Disease?

• A painless swelling in the lymph nodes in the neck, underarm, or groin
• Unexplained recurrent fevers
• Night sweats
• Unexplained weight loss
• Itchy skin

When symptoms like these occur, they are not sure signs of Hodgkin's disease. In most cases, they are actually caused by other, less serious conditions, such as the flu. When symptoms like these persist, however, it is important to see a doctor so that any illness can be diagnosed and treated. Only a doctor can make a diagnosis of Hodgkin's disease. Do not wait to feel pain; early Hodgkin's disease may not cause pain.

Types of Hodgkin Disease

Classical Hodgkin disease: Classical HD has 4 subtypes, all of which have classical appearing Reed-Sternberg cells.

• Nodular sclerosis Hodgkin disease: This is the most common type of Hodgkin disease in developed countries. It occurs mainly in younger people, most of whom are female. It tends to start in lymph nodes in the chest (mediastinum). Under the microscope, the lymph nodes are seen to contain fibrous bands that criss-cross the node and encircle nodules of lymph tissue.
  
• Mixed cellularity Hodgkin disease: This is the second most common type and is seen mostly in adults. It can occur in any lymph node but most often in the upper half of the body. Microscopically there is a sheet of many different kinds of cells including white blood cells dotted with Reed-Sternberg cells.
  
• Lymphocyte-rich Hodgkin disease: This is very much like mixed cellularity except that microscopically most of the cells are small lymphocytes. It also usually occurs in the upper half of the body and is rarely found in more than a few lymph nodes.
  
• Lymphocyte-depleted Hodgkin disease: This is the least common form of Hodgkin disease. It is seen in older people. The disease is more likely to involve abdominal lymph nodes as well as the spleen, liver, and bone marrow. Microscopically, it resembles mixed cellularity but with more Reed-Sternberg cells.

Nodular lymphocyte predominant Hodgkin disease: This type doesn’t often contain Reed-Sternberg cells but instead has large cells, often called “popcorn” cells because of their resemblance to popcorn. They are kind of a cross between the Reed-Sternberg cell and normal lymphocytes. Under the microscope, this type appears as sheets of lymphocytes arranged in nodules. This type mostly involves lymph nodes in the neck and under the arm. It can occur at any age.

What causes Hodgkin's Disease?

At this time, the cause or causes of Hodgkin's disease are not known, and doctors can seldom explain why one person gets this disease and another does not. It is clear, however, that Hodgkin's disease is not caused by an injury, and it is not contagious; no one can "catch" this disease from another person. By studying patterns of cancer in the population, researchers have found certain risk factors that are more common in people who get Hodgkin's disease than in those who do not. However, most people with these risk factors do not get Hodgkin's disease, and many who do get this disease have none of the known risk factors.

How is Hodgkin Disease Diagnosed?

If Hodgkin disease is suspected, the doctor asks about the person's medical history and performs a physical exam to check general signs of health. The exam includes feeling to see if the lymph nodes in the neck, underarm, or groin are enlarged. The doctor may order blood tests.

The doctor may also order tests that produce pictures of the inside of the body including X-rays, CAT scan, MRI, and or biopsy.

What is the Treatment for Hodgkin Disease?

Hodgkin disease is often treated by a team of specialists that may include a medical oncologist, oncology nurse, and/or radiation oncologist. Hodgkin disease is usually treated with radiation therapy or chemotherapy. The doctors may decide to use one treatment method or a combination of methods.

Taking part in a clinical trial (research study) to evaluate promising new ways to treat Hodgkin disease is an important option for many people with this disease.

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