|Note . Hodgkin’s disease is one of two types of cancer of the lymphatic system. The other category, non-Hodgkin’s lymphoma , is much more common. It is the subject of another sheet.|
The Hodgkin’s disease accounts for 1% of all of all cancers and affects the lymphatic system , one of the components of the immune system. It is characterized by the abnormal development and transformation of immune cells called B-cells.These cells grow, proliferate and accumulate in the lymph nodes.
Hodgkin’s disease most often begins in the lymph nodes in the upper part of the body (the neck or armpits) but can also appear in the groin. These abnormal cells prevent the immune system from effectively fighting infections . Hodgkin’s disease can also spread to other components of the lymphatic system: the spleen, thymus and bone marrow.
This type of cancer affects about 5 in 100,000 people. It occurs most often around the age of 30, or around age 60, when there are two peaks in the frequency of this disease. Most of these are young adults, with a median age of 35 years.
Current treatments can completely cure this disease on average in more than 80% of cases.
Causes of Hodgkin’s disease
The cause of Hodgkin’s disease is unknown . However, some research has shown that people who have already contracted the Epstein-Barr virus (responsible for infectious mononucleosis) seem to have a higher risk of developing this type of cancer. There could also be genetic factors.
When to consult?
Consult your doctor if you discover a painless mass , especially in the area of your neck that does not go away after a few weeks.
The symptoms of Hodgkin’s disease
The initial symptoms often resemble those of the flu: fever, fatigue and night sweats. Subsequently, lumps, corresponding to swollen lymph nodes often appear in the neck.
Some of the most common symptoms include the following:
- Non-painful swelling of the neck, armpit or groin glands . Note that in case of ordinary infection, the ganglia are most often painful;
- Persistent tiredness ;
- Fever ;
- Abundant night sweats ;
- Unexplained weight loss
- Diffuse or generalized itching .
Risk factors for Hodgkin’s disease
- Family history . Having a brother or sister who has suffered from the disease increases the risk. It is not known at this time whether genetic factors are involved or if growing up in a similar environment is at issue;
- Sex . Men are slightly more likely than women to suffer from Hodgkin’s disease;
- Infection with Epstein-Barr virus (infectious mononucleosis). People who have contracted the virus in the past would have a higher risk of developing the disease;
- Immune insufficiency . Patients with HIV or who have had a transplant and are taking anti-rejection medications seem to be at higher risk than average.
To date, there is no known measure to prevent Hodgkin’s disease.
Medical treatments for Hodgkin’s disease
Treatment depends on the stage of cancer . Indeed, there are 4 stages in Hodgkin’s disease. Stage I is the milder form and stage IV is the most advanced form of the disease. Each stage is divided into (A) or (B), (A) meaning that there are no general symptoms and (B) that there are general symptoms.
Stage me. The cancer is still confined within a single group of lymph nodes on one side of the thoracic diaphragm.
Stage II. The cancer has spread to the lymphatic system, while remaining on one side of the diaphragm.
Stage III. The cancer has spread to the lymphatic system, above and below the diaphragm.
Stage IV. The cancer has spread beyond the lymphatic system, in some organs.
The treatment is essentially based on chemotherapy even for the early stages. It is a matter of rapidly decreasing the tumor mass, then to complete with radiotherapy on residual tumor masses. Chemotherapy is therefore essential at all stages.
For the early stages the cycles of chemotherapy are reduced (around 2) for the more advanced stages they are more numerous (up to 8).
In the same way the doses of radiotherapy vary according to the stage. It is sometimes no longer performed at the early stage by some teams.
|Note . Radiation treatments for Hodgkin’s disease increase the risk of other types of cancer , particularly breast cancer and lung cancer. As the risk of breast cancer is higher for girls and women under 30, radiotherapy is less recommended as a standard treatment for this specific group.
The different chemotherapy treatment protocols are often referred to by the initials of the products used. Here are the two most common ones:
If a relapse occurs after chemotherapy treatment, there are other so-called “second-line” protocols with an accurate and repeated evaluation of efficacy during treatment. These treatments may eventually damage the bone marrow . Sometimes an autologous transplant is required : bone marrow is often removed from the person with Hodgkin’s disease before chemotherapy and then reintroduced into the body if necessary.
Up to 95% of people diagnosed in stage I or II are still alive 5 years after diagnosis. In more advanced cases, the survival rate after 5 years is still around 70%.