Hodgkin Lymphoma
Hodgkin Lymphoma (HL)
Hodgkin Lymphoma (HL) is a highly treatable cancer of the lymphatic system, distinguished by the presence of a specific giant cell called the Reed-Sternberg cell. It typically spreads in a predictable, orderly fashion from one group of lymph nodes to the next.
When You Should Consider Hodgkin Lymphoma Evaluation
Painless, firm swelling of lymph nodes in the neck, armpits, or groin.
Drenching night sweats that require a change of clothes.
Unexplained fevers that may come and go.
Significant weight loss of more than 10% of body weight in 6 months.
Rare but specific pain in the lymph nodes after consuming alcohol.
Methods of Hodgkin Lymphoma Classification
Classical Hodgkin Lymphoma (cHL): Accounts for about 95% of cases; includes subtypes like Nodular Sclerosis which often affects the chest and neck.
Nodular Lymphocyte-Predominant (NLPHL): A rarer, slower-growing version that often requires less intensive treatment.
Staging (Stages I–IV): Categorized based on whether the cancer is on one or both sides of the diaphragm.
How Hodgkin Lymphoma Is Managed
ABVD Chemotherapy: The "gold standard" regimen using a combination of four specific drugs (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine).
Radiation Therapy: Utilized as "involved-site" radiation to target specific areas of bulky disease after chemotherapy.
Immunotherapy: Use of checkpoint inhibitors like Nivolumab or Pembrolizumab to help the immune system identify and kill cancer cells.
Targeted Therapy: Drugs like Brentuximab Vedotin that specifically seek out the CD30 protein found on Hodgkin cells.
Pre-Procedure Preparation
Identifying the specific subtype through an excisional biopsy for the most accurate diagnosis.
Baseline testing of heart and lung function to minimize long-term "late effects" from chemotherapy drugs.
Detailed consultation for younger patients (teens to 30s) regarding fertility preservation and future health risks.
Nutritional assessment to manage significant weight loss associated with "B symptoms."
Tests Before Hodgkin Lymphoma Treatment
Excisional Biopsy: Preferred over needle biopsies to accurately identify Reed-Sternberg cells.
PET/CT Scan: Advanced imaging used to map active cancer sites and determine the stage of the disease.
Blood Work: To evaluate overall health and check for inflammatory markers.
Diaphragm Assessment: Imaging to determine if the cancer has crossed the muscle separating the chest and abdomen.
Life After Hodgkin Lymphoma Treatment
The 5-year survival rate is excellent, currently at approximately 89%.
For early-stage disease, cure rates often exceed 90%.
Long-term monitoring is essential to watch for second cancers or cardiovascular issues later in life.
Regular follow-up appointments focus on ensuring the patient remains in remission and managing treatment side effects.
Benefits of Hodgkin Lymphoma Treatment
High cure rates even in advanced stages of the disease.
Standardized "gold standard" regimens provide predictable and successful outcomes.
Modern targeted therapies and immunotherapies reduce the need for more toxic treatments if the cancer returns.
Successfully alleviates systemic symptoms such as drenching night sweats and chronic fevers.