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Hodgkin's disease (lymph node cancer)

Reviewed by Dr Rachel Green, consultant haematologist

What is Hodgkin's disease?

Hodgkin's disease is one of a group of diseases called lymphomas. They are all produced by cancers forming in the cells of the lymphatic system.

The lymphatic system is a series of microscopic vessels that drain fluid away from the tissues and return it to the blood system. Throughout this system there are small organs called lymph nodes and there are clusters of these nodes around the body especially in the neck, groin and armpits. The spleen is also part of this system.

The lymphomas are divided into two main categories:

Hodgkin's disease
non-Hodgkin's lymphoma.

There are about 1500 new cases of Hodgkin's disease every year in the UK and it is most likely to be diagnosed between the ages of 20 and 40.

The cause of the disease is unknown but there is some evidence that it may be caused by the same virus that causes glandular fever.

What are the signs and symptoms of Hodgkin's disease?

The first sign is usually firm but painless swelling of the lymph glands. Swelling of the lymph glands is a natural response to infection but in this case the glands are also tender to touch.

Other symptoms include tiredness, weight loss, severe night sweats, fever and generalised itchy skin.

How is Hodgkin's disease diagnosed?

Hodgkin's disease affects the lymph glands and may be hidden in the deeper parts of the body. Your doctor will want to know whether these lymph glands or nodes are involved as this will influence the kind of treatment required. Common tests include:

removal of an affected gland for investigation.
a bone marrow sample - taken from the back of the hip bone.
X-rays.
CT Scan - a special whole body scan.

How is Hodgkin's disease treated?

The treatment of Hodgkin's disease normally involves radiotherapy, chemotherapy or both. The type of treatment depends on the number of clusters of lymph glands and the types of cells involved.

Radiotherapy

For some patients this may be all the treatment they require to be cured. The patient will attend a specialist centre as an outpatient for six to eight weeks.

Chemotherapy

Chemotherapy is usually given as injections into veins and tablets may also be prescribed. It is usually given on an outpatient patient basis at three to four weekly intervals over a period of four to six months. Chemotherapy may make patients lose their hair but it will grow back over the next few months. Chemotherapy may cause sickness but doctors will give additional medicines to prevent this.

Prognosis

Even though this is a serious disease there is a good chance that patients will be cured especially if the disease is detected early.

Based on a text by Dr Erik Fangel Poulsen, specialist and Dr Per Grinsted, GP

Last updated 01.05.2005

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