A lymphoma is a cancer of cells in the lymphatic system. The lymphatic system is a system of lymph channels and lymph glands that occurs throughout the body. Lymphomas are divided into two types - Hodgkin's lymphoma and non-Hodgkin's lymphomas. Hodgkin's lymphoma is sometimes called Hodgkin's disease.
What causes it?
The exact cause of Hodgkin's lymphoma is not known. The lymphoma develops from an abnormal cell in the lymphatic system. It is not known why the cell becomes abnormal. It is thought that something damages or alters certain genes in the cell. The abnormal cell then multiplies to make many abnormal cells, which continue to multiply to form a cancer.
Read more about the causes of Hodgkin's lymphoma.
How common is it?
Hodgkin's lymphoma affects about 2 people in every 100,000 each year. People aged 20-40 years are most often affected but there is a smaller increase in people aged 55 years and older. Slightly more men than women are diagnosed with Hodgkin's lymphoma.
About 1 in 5 people with lymphoma have a Hodgkin's lymphoma. Most lymphomas are non-Hodgkin's lymphoma.
What are the symptoms?
The most common early symptom is to develop one or more swollen lymph glands, most often on one side of the neck, in the armpit or in the groin. The swollen lymph glands tend to be painless and gradually get bigger. Various other general symptoms may also develop, including high temperature (fever), sweats, weight loss, poor appetite and feeling itchy all over your body.
If the lymphoma becomes large and presses on nearby parts of the body, various other symptoms can develop. For example, you may develop a cough or breathing problems if the tumour enlarges in the lymph glands inside your chest.
Find out more about the symptoms of Hodgkin's lymphoma.
How is it diagnosed?
If your doctor suspects that you may have a Hodgkin's lymphoma you will be referred to a specialist. A specialist will normally arrange a biopsy of one of the swollen glands.
If the biopsy confirms that you have a Hodgkin's lymphoma then further tests are usually advised. This is called staging and is very important for planning the best treatment for the lymphoma. These further tests may include a CT scan, an MRI scan, a PET scan, blood tests, a bone marrow biopsy or other tests.
Read more about the tests for Hodgkin's lymphoma.
What are the treatments?
The treatment options for Hodgkin's lymphoma include:
- Treatment for Hodgkin's lymphoma is usually with medicines that destroy the cancer cells (chemotherapy).
- Radiotherapy is also sometimes used for treatment. Radiotherapy may be used as the only treatment or together with chemotherapy.
- A stem cell transplant (sometimes called a bone marrow transplant) is not a usual treatment for Hodgkin's lymphoma because chemotherapy and radiotherapy usually cure the disease. A stem cell transplant tends to be used if the disease returns (relapses) after the initial treatment.
Find out more about the treatments for Hodgkin's lymphoma.
What is the outlook?
The outlook (prognosis) is generally very good for most people with Hodgkin's lymphoma. It often responds very well to treatment and is one of the most curable forms of cancer. About 8 or 9 people out of 10 with the disease will have permanent remission.
The cure rate tends to be highest in younger people. Virtually all young adults who are diagnosed in the early stages of the lymphoma can expect to be completely cured. It is also often possible to cure Hodgkin's lymphoma even if the initial treatments are not successful.
New treatments continue to be developed. There are some newer medicines that have been introduced in the last few years that show promise to improve the outlook.
Further reading and references
Hodgkin's lymphoma: ESMO Clinical Practice Guidelines for diagnosis treatment and follow-up; European Society for Medical Oncology (2014)
Guideline on the Management of Primary Resistant and Relapsed Classical Hodgkin Lymphoma; British Committee for Standards in Haematology and the British Society of Blood and Marrow Transplantation (2013)
Classical Hodgkin Lymphoma - First Line Management; British Committee for Standards in Haematology (2014)
Ansell SM; Hodgkin lymphoma: 2016 update on diagnosis, risk-stratification, and management. Am J Hematol. 2016 Jun91(4):434-42. doi: 10.1002/ajh.24272.
Gobbi PG, Ferreri AJ, Ponzoni M, et al; Hodgkin lymphoma. Crit Rev Oncol Hematol. 2013 Feb85(2):216-37. doi: 10.1016/j.critrevonc.2012.07.002. Epub 2012 Aug 4.
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