What causes hodgkin's lymphoma?

The cause of HL is still pretty much unknown, but scientists have discovered a few key trends:

• It can occur at any age, but it’s more common in people in their 20s.

• People who are taking medicines after an organ transplant or people who have HIV are slightly more likely to develop HL than other people. This is because their overall immunity may be weakened.

• Infection with the Epstein Barr virus (commonly known as glandular fever or the ‘kissing disease’) may slightly increase the risk of developing HL later in life.

What are some of the symptoms?

• Swollen lymph nodes in the neck, armpit or groin (these are usually painless).

• Unexplained high temperatures or sweating (usually at night).

• Weight loss

• Tiredness

• A cough or breathlessness

• A pesky itch all over the body

• Back pain

• Enlargement of the liver or spleen

TIP: It’s important to remember that a lot of these symptoms are common to conditions other than HL, so don’t think that you have it just because you can relate to a few of them! If you’re worried though, it’s probably a good idea to organise a check up with your doctor.

How is it diagnosed?

Usually, it will start by seeing a GP. They’ll give a full examine and organise any tests that might be needed.
These could include:

• Blood tests

• X-rays

• CT Scan

If any of the tests look a bit suspicious, they’ll make a referral to a specialist.

For a definite diagnosis, the doctor will arrange a biopsy. This is a small operation, usually done under general anaesthetic, where an enlarged lymph node (or just part of it) is removed and examined under a microscope.

Staging

Once someone is diagnosed with HL, their doctors will work out what ‘stage’ of cancer they are in. This helps them identify the best treatment.

The staging system for HL looks like this:

• Stage 1: Only one group of lymph nodes is affected.

• Stage 2: Two or more groups of lymph nodes are affected on the same side of the diaphragm (the sheet of muscle underneath your lungs).

• Stage 3: Lymph nodes above and below the diaphragm are affected.

• Stage 4: The lymphoma has spread outside the lymph glands to organs like the liver, bones or lungs.

Doctors also use a letter code – either A or B – to show whether or not the patient has certain symptoms. The doc will ask whether the patient has lost a significant amount of weight or have had fevers or night sweats. If they don’t have any of these symptoms the lymphoma will be classified as ‘A’. If the patient has one or more of them it is classified as ‘B’.

How is it treated?

Many people with HL can be cured - even when the lymphoma has spread across many different areas of the body.

Treatment usually includes chemotherapy, radiotherapy or a combination of both.
The specific treatment plan will be based on what stage the patient is at, and their:

• Age
• General health
• Specific type of HL they have
• What parts of their body are affected

TIP: Don’t be afraid to ask the doctor as many questions as you need to. Sometimes it helps to write down a list of questions before your appointment so you don’t forget them once you’re in their office.

What about clinical trials?

After HL is diagnosed, a doctor might ask if the patient would be interested in participating in a research trial. There can be benefits to doing this, as it’s the only way of finding out whether new treatments are better than what’s already available.

It’s also important to remember though, that some treatments look good at first but are later found to be less effective than existing ones, or to have bad side effects. It's a good idea to do a bit of research and ask a lot of questions before committing to anything.