Hodgkin lymphoma is a type of lymph node cancer. Lymph or lymphatic system consists of glands and vessels scattered throughout the body. This lymphatic system has a role in controlling the immune system.
Hodgkin's lymphoma occurs when a type of white blood cell, namely type B lymphocytes, develops abnormally and spreads to various parts of the body through the vessels of the lymphatic system. Excessive levels of B lymphocytes will interfere with the immune system so that people with Hodgkin's lymphoma are more susceptible to infection.
The most easily recognized symptom of Hodgkin's lymphoma is painless enlargement of the lymph nodes in the neck, armpits or groin area. Although it can attack any age, this disease is more common in people aged 20–40 years, as well as seniors over 55 years.
Apart from Hodgkin's lymphoma, there is another type of lymphoma cancer that is more common, namely non-Hodgkin's lymphoma . Although the symptoms of the two are similar, there are Reed-Sternberg cells in the Hodgkin's lymphoma biopsy examination. In addition, the difference also lies in the incidence rate, treatment method, and cure rate.
Causes of Hodgkin Lymphoma
Hodgkin lymphoma is caused by changes (mutations) in B lymphocyte cells that function to fight infection. These mutations cause B lymphocyte cells to develop abnormally and uncontrollably so that they become cancer cells . These cells can grow rapidly and kill healthy cells. As a result, the body becomes more susceptible to infection.
It is not yet known what causes the mutations in these cells, but it is suspected that they are related to the following factors:
- Age 20 and over
- Male gender
- Family history of cancer
- Epstein-Barr virus infection
- Weak immune system, for example due to HIV
Hodgkin Lymphoma Symptoms
Hodgkin lymphoma can be characterized by the appearance of lumps in the neck, armpits and groin. Other symptoms that may result from Hodgkin's lymphoma include:
- Fever
- Itching on the skin
- Fatigue
- Night sweats
- Weight loss for no apparent reason
- Cough, chest pain and shortness of breath
- Abdominal pain or swelling
- Loss of appetite
When to see a doctor
Check with your doctor if you experience swollen lymph nodes, or other symptoms of Hodgkin's lymphoma as mentioned above.
It's important to know that having one or more of the symptoms of Hodgkin's lymphoma doesn't necessarily mean you have the disease. Even so, a doctor's examination still needs to be done as an early detection.
Diagnosis of Hodgkin Lymphoma
The doctor will ask about the patient's and family's symptoms and medical history, followed by a thorough physical examination. After that, the doctor will carry out supporting examinations to confirm the diagnosis, in the form of:
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Blood
tests Blood tests were carried out in the form of a complete blood count, blood sedimentation rate test , lactate dehydrogenase (LDH) examination, and an HIV test. -
Scanning
This examination is done to help doctors detect enlarged lymph nodes and to determine the stage of cancer. Scans performed can be in the form of X-rays, CT scans , MRIs, or PET scans. -
Biopsy
Biopsy is done by taking a sample of the enlarged lymph node using a needle, to be examined in the laboratory. If the sample is difficult to take with a needle, the doctor will perform an operation to remove the enlarged lymph node and then examine it under a microscope.
Apart from the lymph nodes, a biopsy can also be done by taking and examining a fluid sample from the bone marrow.
After the diagnosis is confirmed, the doctor will determine the stage of Hodgkin's lymphoma. Here's the description:
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Stage 1
Cancer is only in one lymph node or one part of the body, for example in the neck or other areas above or below the diaphragm. -
Stage 2
Cancer is in two lymph nodes or has spread to nearby lymph nodes, but is still in the same part of the body, above or below the diaphragm. -
Stage 3
Cancer has invaded other nearby tissues or organs, such as the spleen. In this condition, the cancer has also spread from its location to the collection of glands above or below the diaphragm. -
Stage 4 (end stage)
Cancer has spread to other tissues or organs, such as the lungs, bones, liver, spleen, skin, or bone marrow.
Treatment of Hodgkin's Lymphoma
Hodgkin's lymphoma has a high chance of cure if detected and treated early. Hodgkin's lymphoma treatment is determined based on the stage and health condition of the patient. The goal is to kill as many cancer cells in the patient's body as possible.
Some of the treatment steps taken to treat Hodgkin's lymphoma are:
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Chemotherapy
Chemotherapy is the administration of drugs to kill cancer cells. Chemotherapy drugs are available in the form of pills or liquids that are injected into a vein. -
Immunotherapy
Immunotherapy is the administration of drugs to stimulate the body's immune system to recognize and destroy cancer cells. Some of the drugs used are brentuximab vedotin and rituximab . -
Radiotherapy
Radiotherapy or radiation therapy uses X-rays to destroy cancer cells in certain areas of the body. The duration of radiation therapy depends on the stage of the cancer. -
Bone marrow or stem cell transplant ( stem cell ) The
bone marrow transplant procedure aims to replace damaged bone marrow with healthy bone marrow. This procedure is done when the cancer cells are not completely gone after chemotherapy and radiation, or when Hodgkin's lymphoma reappears.
It is important to remember, cancer treatment needs to be accompanied by periodic health checks. The aim is to monitor the patient's condition and detect when the cancer recurs. Examination is also useful to overcome the side effects of drugs.
Health checks can be done every few weeks or every few months. Over time, the doctor can reduce the frequency of examinations.
Hodgkin Lymphoma Complications
Hodgkin's lymphoma sufferers are at risk of complications from treatment, even if the patient has recovered. Some of these complications are:
-
Weakened immune system
Decreased immune system can make sufferers susceptible to disease or infection. In some cases, sufferers need to take antibiotics regularly to prevent infection. -
Fertility disorders
Treatment with chemotherapy and radiation can cause temporary or permanent fertility problems. The patient will be offered to save the egg or sperm cells before starting treatment, so they can be used when planning a pregnancy. -
Health
problems Hodgkin lymphoma can also cause health complications, such as heart disease , lung disease, and hypothyroidism . -
Development of other types of cancer.
These complications usually occur several years to 10 years after the patient has received chemotherapy or radiotherapy. Types of cancer that can occur include blood cancer ( leukaemia ), lung cancer, or breast cancer.
Prevention of Hodgkin Lymphoma
Although the exact cause is not known, Hodgkin's lymphoma can be prevented by avoiding the risk factors. For example, Hodgkin's lymphoma due to HIV infection can be prevented by avoiding the spread of the HIV virus, namely by:
- Do not change sexual partners
- Using condoms during sexual intercourse
- Avoid drug abuse, especially injecting types