Hodgkins Lymphoma Treatment in Mumbai, India

The lymphatic system is a connection of lymph nodes in the spleen, thymus, tonsils and all over the human body. Hodgkin’s lymphoma refers to the abnormal growth of cells in lymph nodes, which contain white blood cells (lymphocytes) that fight off infections.

There are two types of lymphocytes – B and T cell lymphocytes. Hodgkin’s lymphoma usually starts in the B cell lymphocytes. Since lymph nodes connect all the organs in the body, cancer of the lymph nodes can spread very easily to all body parts. If not treated in time, these clumps of uncontrolled cells in the lymph nodes could cause severe symptoms and may even spread (metastasize) to other organs connected to the spleen, thymus, tonsils, and all over the body.

Depending on the severity and location of the Hodgkin’s lymphoma, various multidisciplinary treatments that best suit your health condition are recommended.

Alternate Name

Cancer of the lymphatic system

Epidemiology of Hodgkin’s Lymphoma

The estimated incidence of Hodgkin’s lymphoma is high in men compared to women. Unlike other cancers, Hodgkin’s lymphoma is highly prevalent in young adults (aged 15-39) and elderly people (aged above 75).

Associated Anatomy

Lymph nodes all over the body

Pathophysiology

Hodgkin’s lymphoma is characterized by the abnormal growth of cells in the lymph nodes.

Hodgkin’s lymphoma Symptoms

Early-stage Hodgkin’s lymphoma rarely causes any symptoms. In most cases, symptoms may occur as cancer becomes invasive. Some common symptoms of Hodgkin’s lymphoma include:

• Swelling of lymph nodes in the armpit, groin or neck with no associated pain
• Excessive night sweating
• Itching
• Lump formation/ thickening of the skin
• Persistent fever and fatigue

Hodgkin’s lymphoma Causes

Although the exact mechanism is not known, in most cases, Hodgkin’s lymphoma is caused by one or a combination of the following factors:

• Genetic factors: The main reason for Hodgkin’s lymphoma is not yet known, but scientists and doctors consider genetic mutations in the DNA to be the major cause of this cancer.
• Epstein Barr Virus (EBV): People infected with EBV have a higher risk of developing Hodgkin’s lymphoma. EBV proteins have been observed in many patients with Hodgkin’s lymphoma.
• HIV (Human Immunodeficiency Virus): People infected with HIV have a higher risk of getting infected with Hodgkin’s lymphoma.
• Metastasis: Cancer can spread from other parts of the body to the lymph nodes.
• Exposure to ionizing radiation: Being exposed to ionizing radiation increases the risk of DNA mutations and developing lymph node cancer.
• Other factors: Other factors such as diet, lifestyle, age, environmental factors, smoking, alcohol consumption, or long-term use of certain medications also may contribute to the risk of developing Hodgkin’s lymphoma.

Hodgkin’s lymphoma Stages

Hodgkin’s lymphoma is classified into these five stages based on the extent to which cancer has spread:

• Stage 0: Early stage of Hodgkin’s lymphoma, where cancer is found only on the surface of the skin
• Stage 1: Cancer has penetrated deeper than the skin and has affected the neighbouring tissue but has not started to spread (metastasize). The size of the tumor is not more than 2 centimetres.
• Stage 2: The lymph node cancer cells may range in size from more than 2cm to less than 4cm
• Stage 3: Cancerous cells start spreading to the nearby organs in the body
• Stage 4: Severe stage of cancer, where the cancerous cells have spread to all the body parts

Hodgkin’s Lymphoma Treatment

The treatment for Hodgkin’s lymphoma usually depends on the patient’s overall health condition and severity of disease conditions and includes factors such as age, gender, type of cancer cell (tumor), area affected and stage of the tumor.

Classical Hodgkin’s lymphoma is of the following types and all of them are treated in the same way:

• Nodular sclerosis classical Hodgkin’s lymphoma
• Mixed cellularity classical Hodgkin’s lymphoma
• Lymphocyte-rich classical Hodgkin’s lymphoma
• Lymphocyte-depleted classical Hodgkin’s lymphoma

Some common treatment options include:

Radiation Therapy

• The early stages of Hodgkin’s lymphoma are commonly treated using radiation therapy and chemotherapy medications.
• This radiation therapy procedure aims at killing or shrinking the growth of cancerous cells in the lymph nodes.

Chemotherapy

• Chemotherapy medications such as cyclophosphamide, adriamycin, etophosphocide, bleomycin, and oncovin are generally used to slow the growth of cancerous cells or to help relieve symptoms.

Stem Cell Transplant

• Stem cell transplant is the last option and is given as a heavy dose of chemotherapy.

Hodgkin’s lymphoma Prevention

Some of the following measures may help lessen the risk of developing Hodgkin’s lymphoma:

• Regular screening will help detect early signs of cancer and reduces the risk of tumor progression
• Getting an EBV vaccine prevents Human papillomavirus infection, one of the leading causative factors for Hodgkin’s lymphoma
• Avoiding unnecessary usage of oral pills or medications
• Dietary changes and leading a healthy lifestyle

Measures to prevent a recurrence of Hodgkin’s lymphoma following treatment

• Radiation therapy at the site of recurrence can kill cancerous cells after the surgery.
• Have regular follow-up exams and screening tests to look for signs of recurrence of cancer.

Hodgkin’s lymphoma Tests

Doctors diagnose Hodgkin’s lymphoma by inquiring about the patient’s medical history, signs, symptoms, and a physical examination, followed by diagnostic imaging tests and tissue biopsy.

Prognosis

Expected Prognosis

Fortunately, recent advancements in diagnostic procedures, treatment options, and medication have drastically reduced the number of new cases of Hodgkin’s lymphoma and its associated death rate.

Natural Progression

Like other cancer types, if left untreated, Hodgkin’s lymphoma spreads to all organs of the body. This progression may cause life-threatening health conditions and can lead to death.

Hodgkin’s lymphoma Risk Factors

The factors that increase your risk of developing Hodgkin’s lymphoma include:

• Previous infection with Epstein Barr Virus (EBV)
• Immunosuppression or coexisting health conditions; individuals with weakened immune systems are more prone to developing cancer.
• An unhealthy diet, lack of physical activity, and vices such as smoking may also increase your risk of developing Hodgkin’s lymphoma.

Hodgkin's Lymphoma Complications

The possible complications of advanced Hodgkin’s lymphoma are as follows:

• Lymph node swelling in tonsils, spleen, lungs and all parts of the body
• Leukaemia (depletion of white blood cells)
• Lymphoma
• Patients treated for Hodgkin’s lymphoma have a high risk of developing other cancers like breast cancer and lung cancer.

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