Hodgkin lymphoma is a rare type of cancer that develops in the body’s immune system, or lymph system. Recent breakthroughs in treatment for Hodgkin lymphoma mean a cure is possible for most people.
What is Hodgkin lymphoma?
Hodgkin lymphoma (previously called Hodgkin’s disease or Hodgkin's lymphoma) is a type of lymphoma found in white blood cells (lymphocytes). These cells make up the majority of the lymph system, the body’s germ-fighting network.
White blood cells protect you from infection and disease. Hodgkin lymphoma causes those white blood cells to grow abnormally, making it harder to fight off infections.
Along with white blood cells, your lymph system includes tissue, lymph vessels, and lymph nodes (glands that help your body fight infection) throughout the body. Hodgkin lymphoma can occur almost anywhere. It often affects lymph nodes in the:
- Abdomen, groin, or pelvis
Hodgkin lymphoma often moves from one lymph node to the next, but it rarely spreads beyond the lymph system. If it does spread outside the lymph system, it may affect the liver, lungs, or bone marrow.
Causes and risk factors
We don’t know what causes Hodgkin lymphoma. Scientists suspect genetic changes in white blood cells may be responsible.
These risk factors may increase your chance of developing Hodgkin lymphoma, including:
- Age: It is most common in those 15 - 30 years old and people over 55.
- Family history: The risk increases if a relative has had Hodgkin lymphoma or non-Hodgkin lymphoma.
- Gender: It is more common in males.
- Viruses: Certain infections—including Epstein-Barr, mononucleosis, and HIV—increase risk.
The first sign of Hodgkin lymphoma is often an enlarged lymph node. This may feel like a lump in your neck, underarm, or groin. Infections and other cancers can cause swollen lymph nodes, so it’s important to get them checked by a doctor.
Other symptoms may include:
- Severe night sweats
- Weight loss
Classic Hodgkin lymphoma
This type makes up 95% of all Hodgkin cases. It includes:
- Nodular sclerosis Hodgkin lymphoma: Often starts in lymph nodes in the chest and neck
- Mixed cellularity Hodgkin lymphoma: Most common in people with HIV, the virus that causes AIDS
- Lymphocyte-rich Hodgkin lymphoma: Similar to the mixed cellularity type, but more rare
- Lymphocyte depleted Hodgkin lymphoma: Most aggressive type and more common in older people or people with HIV
Nodular lymphocyte-predominant Hodgkin lymphoma
This slow-growing type forms in the lymph nodes and has cancer cells shaped like popcorn kernels. It’s rare and grows more slowly.
To diagnose Hodgkin lymphoma, your doctor performs a medical exam and asks about your health and family health history. You may also have tests to look for signs of cancer and determine the stage (or extent) of it:
- Blood tests: These tests show how advanced the cancer is and if you have any signs of infection.Blood tests can measure levels of white and red blood cells, the amount of inflammation in the body, and liver and kidney function.
- Biopsy: Your doctor may remove part or all of a lymph node to examine it for signs of cancer. This is the only way to accurately confirm a Hodgkin lymphoma diagnosis.
- Imaging: These tests produce detailed images of the body to help determine the cancer type and its severity. They also show the location of affected lymph nodes and tumors. Imaging tests may include X-ray, CT scan, and MRI.
- Heart and lung function tests: Treatments can weaken the heart and lungs, so it’s important to understand the condition of those organs. An echocardiogram uses sound waves to produce detailed images of the heart. A lung function test shows how well your lungs work by measuring air flow and how much air they can hold.
Hodgkin lymphoma is very curable with treatment, especially when it’s detected early. You and your doctor will discuss the best treatment options.
Your treatment depends on the stage of the cancer, as well as your overall health. Doctors use stages to describe the extent to which cancer has spread. They are:
- Stage I: Cancer in one lymph node area
- Stage II: Cancer in two or more lymph node regions on one side of the diaphragm
- Stage IIE: Cancer involves one organ and nearby lymph nodes
- Stage II bulky: Same as Stage II or Stage IIE, along with a mass in the chest
- Stage III: Cancer in lymph nodes on both sides of the diaphragm
- Stage IV: Cancer spread to one or more organs
- Recurrent: Cancer that has returned after treatment
Treatment is also based on the type of Hodgkin lymphoma and may include:
- Chemotherapy: These drugs destroy cancer cells. You receive chemotherapy drugs through an injection in the vein or in pill form.
- Radiation therapy: Radiation uses focused beams of energy to target and kill cancer. Doctors carefully plan treatments to pinpoint the location of the cancer and reduce harm to nearby healthy tissue.
- Immunotherapy: These drugs help your immune system fight off cancer. Immunotherapy treatments include antibodies, drugs that help your body develop antibodies, and targeted therapies that block cancer cells from multiplying.
- Stem cell transplant: A stem cell transplant (also called a bone marrow transplant) may be an option if other treatments haven’t worked. The doctor extracts damaged stem cells (blood-forming cells in the bone marrow) and replaces them with healthy cells from either the patient or a donor.
- Clinical trials: Clinical trials available at some medical centers may give eligible patients access to promising treatments not widely available.
- Combination treatments: Doctors often recommend a combination of several different therapies to treat Hodgkin lymphoma. Options include a combination of chemotherapy drugs or chemotherapy and radiation.
Other helpful organizations
The below organizations offer additional information and resources for Hodgkin lymphoma patients and their loved ones.