Hodgkin's disease - symptoms and treatment
The British doctor Thomas Hodgkin (1798 - 1866) was the first to describe tumors in the lymphatic system, which he called Hodgkin's disease. The symptoms are often referred to as lymph node cancer.
The lymphatic system
Lymph nodes, spleen, tonsils and the lymphatic tissue in the intestine form the lymphatic system. The organism needs this system to fight pathogens. The lymphatic system forms its own cells, the so-called lymphocytes.
The lymphatic vessels run through the body and transport fluid into the blood. The lymph nodes act as a filter to keep bacteria, viruses and tumor cells away from vital organs. Usually they are the first to be affected by Hodgkin's disease. The cancer later spreads to the spleen and ultimately from organs that do not belong to the lymphatic system.
Causes of Hodgkin's Disease
Hodgkin recognized the disease, but only recently has science discovered that the tumors arise from degenerate B lymphocytes. The Epstein-Barr-Viurs, which triggers Pfeiffer's glandular fever, also seems to play a role. Three out of 100,000 people develop “lymph node cancer”, roughly as many men as women.
The exact causes are still in the dark. 60% of the tumors are located in the neck area, 30% in the chest, 20% in the armpit, 15% in the groin and 15% in the abdominal cavity. Tumors often appear in different parts of the body at the same time.
Tumors on the lymph nodes in the chest lead to extreme coughing. If the cancer is located on lymph nodes in the abdomen, this is shown by non-specific symptoms such as pain, pressure or diarrhea. A unique selling point of Hodgkin's disease is alcohol pain: the lymph nodes affected by tumors hurt when those affected drink alcohol.
Not always, but about every third patient experiences the following symptoms:
- Recurring fever that persists for a long time and is highest in the late afternoon
- Severe weight loss with no apparent cause
- General feeling of weakness
- Night sweats
Except for alcohol pain, none of these symptoms occur exclusively with Hodgkin's disease. On the contrary: These non-specific symptoms can not only indicate a variety of cancers, but can also have other serious and harmless causes - from allergies (itching) to depression (weakness) to intestinal inflammation (weight loss). So you should definitely go to the doctor to clarify the symptoms. It can only be determined with a laboratory analysis of the lymph nodes whether it is a lymph carcinoma.
Do not take these symptoms lightly because it is cancer and this form of cancer is almost always fatal if left untreated. Conversely, however, the following applies: Hodgkin's disease is one of the tumor diseases that is best curable - as long as it is recognized early. If the tumors have only formed on individual lymph nodes, there is a good chance that no further cancer will develop if the affected areas are operated on.
Recognize Hodgkin's disease early
With any cancer, the sooner doctors recognize it, the greater the chance of curing it. Like other malignant tumors, Hodgkin's disease is difficult to diagnose at an early stage because the affected lymph nodes swell, but usually do not cause pain.
In addition, the lymph nodes swell in other diseases, especially viral infections. An indication is the duration of the symptoms. If they last longer than two weeks, this is unusual for a virus. So go to the doctor and ask if it could be tumors on the lymphs.
The organization of Hodgkin's disease presents several reports from those affected. A 20-year-old patient describes his early symptoms: “During a vacation in Spain, in 1987, I got a severe stomach and intestinal infection, during which I lost some weight. In addition to this infection, when I returned home, night sweats and chest pain occurred. The weight loss was now 15 kg. ”
In retrospect, there was a lot of evidence of lymph cancer, but the disease was still in the dark. The symptoms worsened: “In early 1988, after my health had not improved, I went to a doctor who used X-rays to find several lumps between my lungs. Fever attacks (39 °) and anorexia added to my already bad feeling. "
The patient now suspected that it was cancer. Then he got certainty: “A hospital stay that lasted four weeks should bring a final diagnosis, which was then: Hodgkin's disease IVb. It was not a surprise for me, because I expected lung cancer inside. The death of my friend who had died of leukemia was an incentive for me to defeat the disease. ”
The patient already suffered in the advanced stage of the disease, so he underwent tougher chemotherapy with subsequent radiation, which lasted a total of one year. The disease seemed to be defeated at first. However, in November 1990, the patient felt severe pain in the legs and hip, and two months later the diagnosis came again: Hodgkin's disease. Despite five months of chemotherapy, he soon had malignant nodules in his throat again.
Now the doctors underwent a bone marrow transplant and took 1.5 liters of bone marrow from him. Chemotherapy killed all malignant cells in the body, it also destroyed the bone marrow. The doctors replaced this with the removed cells shortly afterwards. The patient does not report on the further course.
A 32-year-old woman complained of chest pain. An x-ray showed a tumor and analysis revealed Hodgkin's disease. Despite cancer, chemotherapy and radiation therapy, she decided to have children. She had a healthy son 2.5 years after starting therapy and a daughter 20 months later. Then two girls followed - twins. At the time of the report, the patient was a single mother, working full time and had no tumors in the body.
There are no specific ways to prevent lymph node cancer like lung cancer, where the first rule is: stop smoking.
In general, you can pay attention to the symptoms and have a doctor check you regularly.
If your lymph nodes are enlarged and the doctor recognizes no infection, X-rays of the lungs, chest, sinuses and examinations of the throat, spleen and tonsils follow. In any case, go to the doctor early: Because if lymph node cancer is detected early, the complete cure rate is 70% to 90%.
If you experience symptoms, see a doctor, your family doctor or, better, an oncologist. For example, he judges her weight loss. If you lost more than ten percent of your body weight in six months, that's a clue, as is lymph nodes on your neck, armpits, or groin. If the swollen areas also hurt after drinking alcohol, lymph node cancer is likely.
A blood test gives first certainty. Cancer cells displace healthy cells and change the blood picture. Imaging procedures show how far cancer has progressed. An analysis of the affected lymph nodes provides final clarity. In any case, the doctor removes the swollen lymph nodes. This is the only way to make a reliable diagnosis.
Once the stage of the cancer has been identified, chemotherapy begins. Radiation therapy is also an option. (Dr. Utz Anhalt)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch
- German Cancer Society: Hodgkin's Disease (accessed: August 12, 2019), krebsgesellschaft.de
- Charité - Universitätsmedizin Berlin: Hodgkin lymphoma (accessed: August 12, 2019), kinderkrebsinfo.de
- German Cancer Research Center: Lymphoma (accessed: August 12, 2019), krebsinformationsdienst.de
- Herold, Gerd: Internal Medicine 2019, self-published, 2018
- German Society for Hematology and Medical Oncology (DGHO): S3 guideline for diagnosis, therapy and aftercare of Hodgkin lymphoma in adult patients, status: June 2016, awmf.org
- American Cancer Society: Lymph Nodes and Cancer (accessed: August 12, 2019), cancer.org
- Mayo Clinic: Lymphoma (accessed: August 12, 2019), mayoclinic.org
- U.S. National Library of Medicine: Cancer and lymph nodes (accessed: August 12, 2019), medlineplus.gov
ICD codes for this disease: C81-C85ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.