Hodgkin's disease is a relatively rare cancer of the lymphatic system. In Germany, around 160 children and adolescents and around 2,500 adults are diagnosed with the disease every year. The term Hodgkin's disease is less common today, and the disease is usually called Hodgkin's lymphoma. The prognosis is usually very good.
Here you will find further information and selected Hodgkin's disease specialists and centers.
Hodgkin's disease is a cancer that affects the B cells of the immune system. These cells, also known as B lymphocytes , are altered in such a way that they multiply uncontrollably.
Initially, only the lymph nodes are affected. However, as the disease progresses, the cancer can spread to the whole body.
Fortunately, Hodgkin's disease is usually curable nowadays. This disease is one of the cancers with the best cure rates.
The English doctor Thomas Hodgkin first described the disease in 1832. It was therefore named after him.
Hodgkin's lymphoma should not be confused with non-Hodgkin's lymphoma.
Non-Hodgkin's lymphomas are a group of different types of cancer of the lymphatic system. However, they do not have the Reed-Sternberg giant cells typical of Hodgkin's disease. The Reed-Sternberg giant cells develop through the fusion of degenerated B cells.
Hodgkin's disease is divided into two main groups based on its appearance under the microscope:
Classic Hodgkin's lymphomas account for over 90 percent of Hodgkin's lymphomas. They can in turn be divided into four types:
In most patients with Hodgkin's disease, the lymph nodes in the neck area are swollen. The swollen lymph nodes are painless and usually feel firm and rubbery. Under certain circumstances, the lymph nodes
are also affected.
Illustration of the lymph nodes in the upper part of the human body © mybox | AdobeStock
The swollen lymph nodes behind the breastbone can press on the windpipe or blood vessels if they are large enough. This leads to further symptoms such as
However, Hodgkin's disease can affect any part of the body. Therefore, completely different symptoms can also occur, such as
B symptoms
Other, rather unspecific symptoms may also occur. These are known as B symptoms. These include
All these symptoms can also have other causes, but you should always take them seriously. If your symptoms do not improve within two weeks, you should see a doctor. He or she should clarify the cause of these symptoms.
The reasons for the development of Hodgkin's disease are still largely unknown. However, studies have shown that the Epstein-Barr virus (EBV) could play a significant role. People who have been diagnosed with the Epstein-Barr virus have a 2.5 times higher risk of developing the disease.
There are also indications that the following groups of people have an increased risk:
At the beginning of the examination, the doctor will ask you about
After taking your medical history, the doctor will palpate the lymph nodes in your
armpit. He also examines the abdomen.
Hodgkin's disease could be the cause of swollen lymph nodes over a long period of time if other causes are out of the question. Lymph nodes can also swell as a result of an infection or for other reasons.
If Hodgkin's disease is suspected, a tissue sample must be examined. To do this, the doctor removes a swollen lymph node completely. Alternatively, a biopsy can be taken from another suspected organ. The tissue sample is examined histologically under a microscope.
If the typical Sternberg-Reed cells or Hodgkin cells are found, a diagnosis of Hodgkin's lymphoma can be made.
Once the diagnosis has been made, it is important to find out how far Hodgkin's disease has spread in the body. Using various imaging techniques, doctors can determine exactly how the other lymph nodes or other organs are affected.
The following procedures can be used:
Not everyone can tolerate the contrast agents used in CT examinations. Magnetic resonance imaging(MRI, magnetic resonance examination) is then possible as an alternative.
If necessary, the internal organs can be assessed even more precisely using ultrasound(sonography).
Depending on the results of the previous examinations, further examinations may follow. If the result of the PET-CT is unclear, a bone marrow biopsy may be necessary.
Further examinations
The doctor will obtain a more detailed picture in order to plan the therapy optimally with as few side effects as possible. He assesses the patient's physical condition.
Further examinations are necessary for this purpose, such as
The patient's ideas regarding family planning are also important for treatment planning.
The chances of a cure for Hodgkin's disease are very good. In the vast majority of cases, this cancer is curable.
In principle, the therapy depends on the extent of the spread in the body. Doctors use the Ann Arbor classification for this purpose. The more extensive the spread in the body, the higher the stage.
Further risk factors are taken into account when planning treatment, such as
Based on the Ann Arbor stage and the risk factors, it is possible to determine whether the disease is at an early, intermediate or advanced stage .
A decision is made depending on the stage of the disease,
In the past, the affected lymph node regions and organs were irradiated in addition to chemotherapy(radiochemotherapy). Today, radiotherapy is used more cautiously. Young patients in particular have an increased risk of late effects from radiotherapy. These include
The late effects often only become noticeable many years after the therapy.
Cancer therapy can also damage healthy cells such as eggs and sperm. If the patient still wishes to have children, they must be informed about the impact of the therapy on their fertility.
There are various ways to prevent infertility:
In the event of a relapse of the disease, also known as a recurrence, treatment is carried out in stages. Preliminary chemotherapy is followed by high-dose chemotherapy with autologous stem cell transplantation. For this purpose, the patient's own stem cells are removed before the start of therapy and then transplanted after the therapy.
If remnants of the Hodgkin's lymphoma are still detectable afterwards, these are irradiated.
If this procedure is not successful, further
can be used.
Life expectancy depends on whether
The 5-year survival rate after chemotherapy and any radiotherapy is now over 95 percent. In children, it is even better, with up to 100% of patients surviving the next 5 years. The therapy is equally successful in children and adolescents as well as adults.
Without therapy, however, Hodgkin's lymphoma leads to death.
Chemotherapy often responds so well that radiotherapy is no longer necessary. A PET-CT scan after chemotherapy is a very good way of showing whether the chemotherapy was successful. Radiotherapy may be necessary.
The disease recurs in 15 to 20 % of patients. However, such recurrences can be cured in many cases.
The 5-year survival rate is then around 50 percent.
Very rarely, the patient suffers from underlying diseases such as
These patients often tolerate chemotherapy very poorly and cannot be irradiated. The prognosis here is therefore very unfavorable.
Hodgkin's disease therapy can cause damage to organs that only becomes noticeable after many years.
Some chemotherapeutic agents can cause damage to the lungs or heart, for example. Radiation can lead to hypothyroidism and late effects on the heart.
Typical late effects on the heart are, for example
So-called secondary malignancies are also feared late effects of radiotherapy. These are newly occurring cancers in areas that were originally irradiated.
The causes of the development of Hodgkin's disease are not yet known. There are therefore no ways of specifically preventing the disease.
However, you should generally refrain from smoking and excessive alcohol consumption. This also reduces the risk of developing other cancers and cardiovascular diseases.
However, early detection of a recurrence is of the utmost importance.
The guidelines therefore recommend that patients attend regular follow-up appointments after the end of treatment:
During the follow-up examination, the doctors check
In this way, appropriate therapies can be initiated at an early stage.
