Hodgkin Lymphoma

What is Hodgkin lymphoma?

Hodgkin lymphoma (also called Hodgkin disease) is a growth of abnormal white blood cells that forms tumors in the lymph system. The lymph system is part of your body's system for fighting infection. The lymph system consists of lymph nodes that store blood cells (lymphocytes) to fight infection and vessels that carry fluid, nutrients, and wastes between your body and your bloodstream. The disease can occur in one lymph node, in a group of nodes, or in an organ. It can then spread to almost any part of your body.

Hodgkin lymphoma is one of the many types of lymphoma. Other types of lymphomas are called non-Hodgkin lymphomas. The type of lymphoma is determined by how the cancer cells look under a microscope.

There are different types and stages of Hodgkin disease based on where the cancer cells are found, what the cells look like, and how they grow. Knowing the type and stage of cancer you have can help your healthcare provider decide on the best treatment plan for you. Although Hodgkin disease is one of the most curable cancers, it is important to diagnose and treat it as soon as possible. The main goals of treatment are to kill the cancer cells and prevent the cancer from spreading.

Hodgkin disease is most often diagnosed in people between the ages of 15 and 35 years, or age 55 years or older. The cause of Hodgkin disease is not well known. However, there are things that increase your risk. These include:

• Being infected with Epstein-Barr virus (EBV) or the human immunodeficiency virus (HIV)
• Having a weakened immune system
• Family history of lymphoma

What can I expect in the hospital?

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

• You will be checked often by the hospital staff.
• Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
• Your fluid output may be monitored by keeping track of the amount of urine you produce.

Testing

Testing may include:

• Physical exam: An exam of the body to check for swollen lymph nodes or swelling in the spleen or liver
• Blood tests to check for certain hormones, proteins, or chemicals that may be abnormal if you have cancer
• Lymph node biopsy: A biopsy is the removal of a part or all of a lymph node for testing. This can be done in several ways:
  • Needle biopsy: The surgeon puts a long needle through the skin and into the lymph node to take a sample of tissue. The surgeon may use ultrasound or a CT scan to help guide the needle into the lymph node.
  • Surgical biopsy: The surgeon will make a cut in the skin over the abnormal tissue to remove all or part of the lymph node for testing
• Chest X-ray: Pictures of the inside of your chest to check for cancer
• Bone marrow biopsy: A biopsy is the removal of a small amount of bone marrow for testing.
• Tests to check if the cancer has spread to other parts of your body, including:
  • Blood tests to check for certain hormones, proteins, or chemicals that may be abnormal if you have cancer
  • Bone X-rays: Pictures of your bones to check for cancer
  • Bone scan: A series of detailed pictures is taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows any areas of bone where the radioactive material is being absorbed.
  • Computed tomography (CT) scan: A series of X-rays is taken from different angles and arranged by a computer to show thin cross sections of the chest, abdomen, and pelvis.
  • Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the chest, abdomen, and pelvis.
  • Positron emission tomography (PET) scan: A series of detailed pictures is taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows areas where the radioactive material is being absorbed.

Treatment

The treatment for Hodgkin disease depends on the type and stage of the disease, how well you respond to treatment, your overall health, and any complications you may have. Your chance of cure depends on how far the cancer has advanced. You may need to make lifestyle changes to stay as healthy as possible or manage.

• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
• Treatments may include:
  • Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
  • Radiation therapy, which uses high-energy X-rays to kill cancer cells
  • Biological therapy, which uses medicine designed to help your immune system fight the cancer or block the growth of cancer cells
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Treat or prevent low blood counts caused by the cancer or its treatment
  • Treat or prevent side effects, such as nausea or constipation, from other treatments
  • Help your immune system fight cancer
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.
• You may need a bone marrow or stem cell (cells that can restore bone marrow) transplant after your treatment. Stem cells may be taken from your bone marrow or blood before treatment and kept frozen. Stem cells may also be donated from another person’s bone marrow or blood, or a newborn’s umbilical cord blood. If chemotherapy severely damages your bone marrow and its ability to make blood cells, the blood-forming stem cells can be given to you so that new, healthy cells can begin to replace the cells that were killed by the chemotherapy. If the stem cells were taken from bone marrow, the procedure is called a bone marrow transplant.
• You may become temporarily or permanently sterilized by the treatment. Before treatment begins, women can freeze their eggs and men can freeze their sperm if they may want to have children in the future.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Swelling of lymph nodes in the neck, armpits, or groin
  • Signs of infection, including chills or muscle aches
  • Night sweats
  • Shortness of breath
  • Loss of appetite
  • Deep bone pain
• Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many things, such as your general health, why you are in the hospital, and the treatment you need. The average amount of time to stay in the hospital with Hodgkin disease is 7 to 11 days. Talk with your provider about how long your stay may be.