Hodgkin’s Lymphoma can develop anywhere, it mostly starts in the lymph nodes in the upper part of the body, like in the chest, neck or underarms. This cancer starts like any other cancer i.e. when our cells begin to grow out of control. Lymphomas are cancers that start in the white blood cells. There are two types of lymphoma:
- HODGKIN LYMPHOMA ( HL )
- NON- HODGKIN LYMPHOMA ( NHL ).
To know about Hodgkin-Lymphoma, we should know about the Lymphatic System, which fights infections and some other diseases. The lymph system is made up of cells called lymphocytes, a type of white blood cell. These lymphocytes are also of two types:
- B lymphocytes ( B cells ): B cells make proteins called antibodies to protect the body from germs ( bacteria and viruses ).
- T lymphocytes ( T cells ): The T cells destroy germs or abnormal cells in the body.
HODGKIN LYMPHOMA generally starts in the B lymphocytes. It can also develop in any part of the body. The main areas are :
1) Lymph nodes – inside the chest, abdomen and pelvis.
2) Lymph vessels– tiny blood vessels that connect the lymph nodes.
3) Spleen– This is a part of the immune system. It stores healthy blood cells and filters out damaged blood cells, bacteria and waste from the cells.
4) Bone– Marrow, Thymus, Adenoids and tonsils and in the Digestive Tract.
TYPES OF HODGKIN LYMPHOMA:
Each type of HL grows, spreads and is treated differently. There are two types of Hodgkin Lymphoma. 95% of the cases are classical Hodgkin Lymphoma, which is further divided into four subtypes:
- NODULAR SCLEROSIS: This is the most common one and is often seen in young women, children and young adults. This causes fibrous scars in the neck and chest. 70% OF HL are of this type. But this type is treatable and can also be cured.
- MIXED CELLULARITY: 25% of the people are affected by this disease. It is most common among older adults and is found in the stomach.
- LYMPHOCYTE-RICH: 5% of the men are affected by this disease. It is generally diagnosed at an early stage. Nearly one-fourth of HL is this disease.
- LYMPHOCYTE-DEPLETED: Only 1% of the people are affected by it. It’s a rare disease affecting older adults and people who are in their 30s. People with HIV are also more affected.
- Middle-aged adults between 30 and 50 years of age are affected by a very rare type of Hodgkin Lymphoma, which is NODULAR LYMPHOCYTE-PREDOMINANT HODGKIN LYMPHOMA (NLPHL). This is common in men and it rarely transforms into a type of aggressive NHL.
HODGKIN’S Lymphoma starts in the B cells or in the immune system known as Reed-Sternberg(RS). The main cause of HL is not known, but there are certain risk factors that can increase the disease, they are:
Age: It is found in the age groups between 20 and 30 and in above 55 years.
Sex: Men most are prone to this disease than women.
Family history: If one person in the family gets it and others may get it too.
Infectious mononucleosis: Infection can cause what is known as mononucleosis and this, in turn, causes lymphoma.
Affluence: People, who belong to a rich family or whose socioeconomic status is higher this cancer develops in them.
Immunodeficiency: Individuals with HIV are also more prone to this disease.
STAGES OF LYMPHOMA:
Both NHL and HL are classified into four stages:
Stage 1 is when the cancer is in one lymph node.
Stage 2 is when cancer is in two lymph nodes, near one another and on one side of the body.
Stage 3 the cancer is in one organ and spreads to nearby lymph nodes.
Stage 4 is an advanced lymphoma and is curable. About 60% of the patients are treated. It responds well to treatment whether radiation or chemotherapy.
HODGKIN LYMPHOMA TREATMENT:
A plan is drawn by the doctor, according to the health, age of the patient; there are a number of treatments the patient has to undergo that can strain their body. The best treatment also depends on how far cancer has spread. The treatment plan is done by a multidisciplinary team of doctors and professionals. Once the plan is ready, the patient can speak to his family and friends and give his consent to start the treatment at the earliest.
- CHEMOTHERAPY: Generally Hodgkin Lymphoma, is treated with Chemotherapy itself. In this, medicine is given to kill cancer. A drip is given in the vein or chemo tablets, whichever is more feasible. There may be a few side effects which go away after the treatment.
- RADIOTHERAPY: This treatment in the early stage of HL, where the cancer is only in one part of the body. Treatment is given for several weeks, but one need not stay in the hospital. Radiotherapy is painless but there may be a few side effects- tiredness, loss of appetite, but they are temporary.
- STEROID MEDICATION: This treatment is sometimes combined with chemotherapy if the initial treatment has not worked. The steroid medication is given intravenously, along with chemo. The side effects that occur improve after the treatment.
- RITUXIMAB MEDICATION: If HL is of a rare type called LYMPHOCYTE-PREDOMINANT HODGKIN LYMPHOMA, this treatment is given along with chemotherapy. It is a biological therapy that attacks and kills the cancerous cells.
- BRENTUXIMAB VEDOTIN: This is a new drug, given to those who already had a stem cell transplant using their own cells or who cannot have a stem cell transplant and have already had two other treatments.
Follow up sessions are a must, to check the recovery of the patient or if there are signs of cancer returning. It can be for a few weeks, or months, but will reduce as time passes.
Hodgkin Lymphoma can be treated, more than 90% of the patients survive and live long and healthy lives after successful treatment.
Awareness about Hodgkin Lymphoma is not common among the general public. So we need to highlight through campaigns, in public places, universities, hospitals and workplaces and increase the knowledge and awareness about HODGKIN LYMPHOMA.