Hodgkin's lymphoma is a type of cancer of the lymph nodes (lymphoma). The lymph or lymphatic system consists of glands and vessels that are scattered throughout the body. The lymphatic system has a role in controlling the immune system.
In Hodgkin's lymphoma, one type of white blood cell (lymphocyte), namely type B lymphocyte, will begin to multiply abnormally and cause the lymphocyte to lose its function of fighting infection, making the sufferer susceptible to infection.
The most easily recognizable symptom of Hodgkin's lymphoma is enlarged lymph nodes, which is the appearance of a painless lump in the neck, armpit, or groin area. This disease can affect all ages, but most often affects people aged 20-40 years, and the elderly over 55 years.
Symptoms of Hodgkin's Lymphoma
In addition to the appearance of lumps in the neck, armpits, and groin, other symptoms of Hodgkin's lymphoma include:
- Fever
- Weak
- Itch
- Sweating at night
- Weight loss
- Enlargement of the spleen
- Cough, chest pain, and shortness of breath.
Causes of Hodgkin's Lymphoma
Hodgkin's lymphoma is caused by cancer cells that develop in the lymphatic system. Cancer cells originate from mutations in cells, so that cells develop abnormally and uncontrollably. The cause of cancer cell mutations is not yet known.
In Hodgkin's lymphoma, type B lymphocytes that fight infection mutate into cancer cells and multiply rapidly. These cells continue to multiply until they kill healthy cells. This is when the body begins to be susceptible to infection, and various symptoms begin to appear.
Although it is not known what causes these cells to mutate into cancer cells, the following factors can increase the risk of developing Hodgkin's lymphoma:
- History of cancer in the family
- 20 years and over
- Male gender
- Suffering from Epstein-Barr virus infection, with symptoms of swelling of the lymph glands and liver, fever, weakness, rash on the skin, and sore throat
- Weak immune system, for example due to HIV.
Hodgkin's Lymphoma Diagnosis
Doctors can suspect a patient has Hodgkin's lymphoma if there are symptoms, which are confirmed by a physical examination and a history of the patient and family. However, to be more certain, further examination is needed. Among others are:
- blood test
- Body imaging tests, such as X-rays, CT scans, MRIs, and PET scans
- Biopsy, which is an examination by taking a sample of enlarged lymph nodes through a needle, then examined in a laboratory. This procedure is performed with the help of a local anesthetic beforehand. Another type of biopsy is to take fluid from the bone marrow to detect signs of cancer.
Once the diagnosis is confirmed, the doctor will determine the stage of Hodgkin's lymphoma. Here's the description:
- Stage 1 - the cancer is in only one lymph node or in one part of the body, for example in the neck or other areas above/below the diaphragm.
- Stage 2 - the cancer has invaded two lymph nodes or has spread to nearby lymph nodes, but is still in the same body part, above or below the diaphragm.
- Stage 3 - the cancer has invaded surrounding tissue or other organs, such as the spleen. In this condition, the cancer has also spread from the site of its first appearance, to the collection of glands above and below the diaphragm.
- Stage 4, also known as the final stage, is when the cancer has spread to other tissues or organs. Cancer can spread to the lungs, bones, liver, spleen, skin, and bone marrow.
Hodgkin's Lymphoma Treatment
Hodgkin lymphoma has a high chance of cure if detected and treated early. Hodgkin's lymphoma treatment is determined based on the stage of the cancer as well as the patient's health condition, and aims to destroy as many cancer cells in the patient's body as possible.
Some of the treatment steps taken to treat Hodgkin's lymphoma are:
- Chemotherapy.Drugs will be used to kill lymphocyte cells that have turned into cancer cells. Chemotherapy drugs are available in the form of pills and liquids that are injected into a vein. In advanced stages, chemotherapy drugs can be used without being combined with other treatment methods. Common side effects of chemotherapy drugs are nausea and hair loss.
In some cases of Hodgkin's lymphoma, chemotherapy can be combined with radiation therapy, both to treat cancer in its early stages and advanced stages.
- Corticosteroids.These drugs will be used in conjunction with chemotherapy treatment. Side effects that will appear in the form of sleep disturbances, anxiety, increased appetite which can trigger weight gain, and digestive disorders.
- Rituximab.Rituximab is a drug that helps antibodies to attack cancer cells. This drug will stick to the surface of cancer cells, thereby triggering the immune system to kill the cancer cells. Some of the side effects of rituximab that can appear are nausea, diarrhea, fatigue, and flu-like symptoms, such as dizziness and muscle aches.
- Radiotherapy.Therapy uses X-rays to kill cancer cells. X-rays will be exposed to areas of cancer, such as lymph nodes or areas where cancer cells have spread. The duration of therapy will depend on the stage of the cancer. Some of the side effects of this therapy are hair loss, redness of the skin exposed to radiation, and fatigue.
- Bone marrow or stem cell transplantation (stem cells). This procedure is performed to replace bone marrow cells that produce lymphocytes with healthy ones. A bone marrow transplant procedure is chosen if Hodgkin's lymphoma recurs. The procedure is done with the help of chemotherapy drugs and radiation to destroy cancer cells before healthy bone marrow is inserted into the body.
Cancer treatment will require regular medical check-ups to monitor the patient's condition and detect signs of cancer recurrence. Screening is also useful for treating side effects or complications of treatment, which in the worst case risk developing other types of cancer. Periodic health checks can be carried out starting from once a few weeks to several months. Over time, the frequency of examinations may decrease.
Complications of Hodgkin's Lymphoma
People with Hodgkin's lymphoma are at risk for complications due to treatment. Complications can still occur even though the patient has recovered. Some of these complications include:
- Weakened immune system, making it susceptible to infection and disease. In some cases, patients must take antibiotics regularly to prevent
- Fertility disorders. Treatment with chemotherapy and radiation can cause temporary or permanent infertility. Patients will be offered to store eggs or sperm before starting treatment, so they can be used when they are planning a pregnancy.
- Health problems, such as heart and lung disease.
- The development of other types of cancer, such as blood cancer (leukemia), lung cancer, or cancer The risks caused by chemotherapy and radiotherapy usually appear several years to more than ten years after the patient undergoes the treatment procedure.