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Lymphomas and Hodgkin's Disease
The lymphatic system is a complex arrangement of vessels responsible for transporting cells (lymphocytes) that fight infection. The lymph vessels are interrupted in some areas by swellings known as lymph nodes. The nodes act like filters to fight infection in the body. The lymph nodes can enlarge in response to a viral or bacterial infection in the body. Cancer of the lymphatic system and lymph nodes is known as lymphoma.
Lymphomas can affect people of any age. There are about 45,000 cases of lymphoma per year in the United States. Hodgkin's disease is a common type of lymphoma which accounts for approximately 7,000 cases per year in the United States. The rest (and the majority) of the cases of lymphoma are referred to as non-Hodgkin lymphomas. The majority of patients with Hodgkin's disease are children and young adults, whereas older adults make up the majority of non-Hodgkin lymphomas.
Symptoms of Lymphomas
Presenting symptoms of lymphomas depend in part upon the type of lymphoma. Symptoms of all types of lymphomas include: weakness, fatigue, weight loss, recurrent upper respiratory infections, fevers, anemia, and lymph node swelling (swollen glands). The doctor may notice enlargement of the spleen or liver on physical examination of the abdomen. Hodgkin's disease often appears as a lymph node swelling in the neck (the area just above the collar bone).
Evaluation and Treatment of Lymphomas and Hodgkin's Disease
Evaluation will include history and physical examination. Blood tests such as the complete blood count (CBC) will be performed. Lymph node biopsy is used for definitive diagnosis. CT-scanning of the chest and abdominal CT can give the physician additional clues for diagnosis. In some cases, bone marrow aspiration and biopsy is used for the staging (judging the extent) of the disease. In some cases, the spleen may need to be surgically removed for staging purposes.
Treatment is dependent upon the type and extent of the lymphoma. Surgery is rarely curative. Radiation therapy has been used successfully to destroy the cancer cells in the lymph nodes that are more localized in one area of the body. It is also useful in combination with chemotherapy in more extensive lymphomas. Chemotherapy is indicated in all but a few cases when the disease is very limited (Hodgkin and non-Hodgkin lymphomas).
Remarkable improvements have been made in the treatment of this form of cancer. If detected and treated early, most patients with Hodgkin's disease will live 5 years or more (5 year survival is considered a "cure", because in most cases it does not recur). Patients with non-Hodgkin lymphomas have a greater than 50% chance of cure.
Some of the less aggressive types of non-Hodgkin lymphomas may not result in a complete cure, but long term periods of successful controlled illness can be expected, especially in older patients. The Hematologist is the expert in the diagnosis and treatment of this disorder.
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