Young people are being made aware of a form of cancer known as Hodgkin lymphoma that mostly affects adults in their 20s and 30s. Hodgkin lymphoma is a cancer of the lymphatic system, which is one of the body’s natural defences against infection.
It is one of the most common cancers in young people. However, treatment has a very good success rate and most teenagers and young people with Hodgkin lymphoma are cured.
Symptoms could be mistaken for other health conditions, such as persistent tiredness or fatigue, night sweats and a persistent cough. There are two main types of lymphoma - Hodgkin lymphoma and non-Hodgkin lymphoma (NHL).
What is Hodgkin lymphoma?
Hodgkin lymphoma's most common symptom is the enlargement of lymph nodes in the neck, armpit, or groin. Typically, the swelling is not accompanied by any pain - although a few individuals may experience mild discomfort.
The accumulation white blood cells in a lymph node (also known as lymph glands) is what causes the swelling. These lymph nodes, which are small, pea-sized masses of tissue distributed throughout the body, contain white blood cells that play a crucial role in fighting infections.
It is important to note that it's unlikely you have Hodgkin lymphoma if you have swollen lymph nodes. The common cold, ear infection, tonsillitis, scalp infection mouth ulcers are some causes of a swollen lymph node.
Symptoms of Hodgkin lymphoma
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A painless lump is usually the main symptom of Hodgkin lymphoma. But some people may experience other more general symptoms, like:
- night sweats
- unintentional weight loss
- a high temperature (fever)
- a persistent cough or feeling of breathlessness
- persistent itching of the skin all over the body
The symptoms experienced will vary depending on the location of the enlarged lymph glands in the body. For instance, if the abdomen (tummy) is affected, you might experience abdominal pain or indigestion.
Some people with lymphoma may have abnormal cells in their bone marrow when they're diagnosed, which can cause:
- persistent tiredness or fatigue
- an increased risk of infections
- excessive bleeding – such as nosebleeds, heavy periods and spots of blood under the skin
Occasionally, individuals with Hodgkin lymphoma may experience discomfort in their lymph nodes when drinking alcohol. It's best to visit a doctor if you're experiencing symptoms, especially if you have swollen glands that don't seem to be related to an infection.
Who's most at risk?
Although the initial mutation that triggers Hodgkin lymphoma is unknown, there are a number of factors that can increase your risk, according to the NHS, such as:
- age and gender – anyone can get Hodgkin lymphoma but it's more common in people aged 20 to 40 or over 75; it also affects slightly more men than women
- having a medical condition that weakens your immune system, such as HIV
- having medical treatment that weakens your immune system – for example, taking medicine to suppress your immune system after an organ transplant
- being previously exposed to the Epstein-Barr virus (EBV) – a common virus that causes glandular fever
- having previously had non-Hodgkin lymphoma, possibly because of treatment with chemotherapy or radiotherapy
- being very overweight (obese) – this may be more of a risk factor in women than men
- smoking
Hodgkin lymphoma isn't infectious and isn't thought to run in families.
How is Hodgkin lymphoma diagnosed?
If you're worried about symptoms of Hodgkin lymphoma and decide to see a GP, they will inquire about your health and conduct a basic physical examination. If required, the GP may then refer you to a hospital for additional tests.
You may need a lymph node biopsy, which involves removing some or all of an affected lymph node, which is then studied in a laboratory. Further tests may include blood tests, bone marrow sample, chest x-ray, CT scan, MRI scan or a PET scan.
The main stages of Hodgkin lymphoma are:
- Stage 1 – the cancer is limited to 1 group of lymph nodes, such as your neck or groin nodes either above or below your diaphragm (the sheet of muscle underneath the lungs).
- Stage 2 – 2 or more lymph node groups are affected, either above or below the diaphragm.
- Stage 3 – the cancer has spread to lymph node groups above and below the diaphragm.
- Stage 4 – the cancer has spread through the lymphatic system and is now present in organs or bone marrow.
Treatment
There are a few options for treating Hodgkin lymphoma. One option is to undergo chemotherapy on its own, while another is to have chemotherapy followed by radiotherapy.
In some cases, chemotherapy may be paired with steroid medicine. Additionally, some individuals may also receive biological medicines as part of their treatment plan.
Surgery is not typically used as a treatment, except for when the biopsy is performed to diagnose Hodgkin lymphoma. In general, treatment for Hodgkin lymphoma is extremely effective. The majority of individuals with this condition are ultimately cured.