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What is hodgkin lymphoma?

Hodgkin lymphoma, sometimes called Hodgkin disease, is a type of lymphoma - a general term for cancer of the lymphatic system (the various lymph glands around the body). 

There are two types of Hodgkin lymphoma: 

  • classical Hodgkin lymphoma which makes up about 95% of cases 
  • nodular lymphocyte-predominant Hodgkin lymphoma 

Hodgkin lymphoma is a rare cancer accounting for approximately 0.5% of all cancers diagnosed in Australia. It is most commonly diagnosed in people aged between 15 and 29 or over 65. 

In 2016, 685 people in Australia were diagnosed with Hodgkin lymphoma. 

In 2018 there were 1653 deaths caused by Hodgkin lymphoma in Australia.   



Hodgkin lymphoma symptoms

  • painless swelling in the neck, armpit or groin

  • excessive sweating, especially at night

  • unexplained fatigue

  • itching

  • shortness of breath

  • unexplained cough

  • fever

  • unexplained weight loss



Causes of Hodgkin lymphoma

Some factors that can increase your risk of Hodgkin lymphoma include:

  • exposure to viruses such as the Epstein-Barr virus or HIV

  • family history

  • a weakened immune system

  • smoking



Diagnosis of Hodgkin lymphoma

Initially your GP may give you a physical examination and feel the lymph nodes in your neck, underarm and groin for any swelling. If there is some enlargement you may have some additional tests.

Biopsy

This is the most common test to diagnose Hodgkin lymphoma. Some tissue from the enlarged lymph node will be removed for examination under a microscope. There are two types of biopsy:

  • excision biopsy removes part or the whole lymph node under general anaesthetic
  • core needle biopsy uses a needle to remove some cells and tissue from the lymph node.

Further tests

If the results of your biopsy indicate you have Hodgkin lymphoma you may have additional tests to determine how far the cancer has spread. These may include:

  • chest x-ray
  • imaging tests such as CT, PET and MRI scans or an ultrasound
  • bone marrow biopsy
  • blood tests. 


Treatment for Hodgkin lymphoma

Treatment for Hodgkin lymphoma will depend on how advanced the disease is as well as your age, symptoms and overall health.

Staging

Further tests after a biopsy will tell your doctor how far Hodgkin lymphoma has spread. This is called staging. Staging helps your doctors decide on the best treatment.

Radiation therapy (radiotherapy)

Radiation therapy (also known as radiotherapy) uses x-rays or gamma rays to destroy or damage cancer cells. A combination of radiation therapy and chemotherapy (chemoradiation) is often used to treat early stage Hodgkin lymphoma.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells or slow their growth. In advanced Hodgkin lymphoma, chemotherapy is the principal treatment.

Stem cell transplant

You may have a stem cell transplant if the Hodgkin lymphoma has, or is likely to, return. It may also be offered when the lymphoma has not responded well to other treatments.

Palliative care

In some cases of Hodgkin lymphoma, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer, without aiming to cure it.

As well as slowing the spread of Hodgkin lymphoma, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.

Treatment Team

Depending on your treatment, your treatment team may consist of a number of different health professionals, such as:
  • GP (General Practitioner)- looks after your general health and works with your specialiststo coordinate treatment.
  • Haematologist- specialises in diagnosing and treating diseases of the blood and lymphatic system.
  • Surgeon- surgically removes tumours and performs some biopsies.
  • Medical oncologist- prescribes and coordinates the course of chemotherapy.
  • Radiation oncologist- prescribes and coordinates radiation therapy treatment.
  • Cancer nurses- assist with treatment and provide information and support throughout your treatment.
  • Other allied health professionals- such as social workers, pharmacists and counsellors.


Screening for Hodgkin lymphoma

There is currently no screening for Hodgkin lymphoma available in Australia. 



Preventing Hodgkin lymphoma

There are no proven measures to prevent lymphoma, however, people with an HIV infection or Epstein-Barr virus have an increased risk of contracting lymphoma.



Prognosis for Hodgkin lymphoma

Prognosis refers to the expected outcome of a disease. While is it not possible for your doctor to predict the exact course of the disease, you may want to discuss your treatment options and how well you are responding to treatment. 

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