CanCer-666: hodgkin's disease

Childhood Hodgkin Lymphoma

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Childhood Hodgkin lymphoma is a type of cancer that develops in the lymph system, which is part of the body's immune system. The lymph system is made up of the following:<br />
<ul>
<li><b>Bone marrow</b>: The soft, spongy tissue in the center of large bones. Bone marrow makes white blood cells, red blood cells, and platelets.</li>
<li><b>Lymph nodes</b>: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the underarm, pelvis, neck, abdomen, and groin.</li>
<li><b>Lymph vessels</b>: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream.</li>
<li><b>Lymph</b>: Colorless, watery fluid that travels through the lymph system and carries white blood cells called lymphocytes. Lymphocytes protect the body against infections and the growth of tumors.</li>
<li><b>Spleen</b>: An organ that makes lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. The spleen is on the left side of the abdomen near the stomach.</li>
<li><b>Thymus</b>: An organ in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone.</li>
<li><b>Tonsils</b>: Two small masses of lymph tissue at the back of the throat. The tonsils make lymphocytes.</li>
</ul>
<br />
The two types of childhood Hodgkin lymphoma are:<br />
<ul>
<li>Classical Hodgkin lymphoma.</li>
<li>Nodular lymphocyte-predominant Hodgkin lymphoma.</li>
</ul>
<br />
Classical Hodgkin lymphoma is divided into four subtypes, based on how the cancer cells look under a microscope:<br />
<ul>
<li>Lymphocyte-depleted Hodgkin lymphoma.</li>
<li>Lymphocyte-rich classical Hodgkin lymphoma.</li>
<li>Mixed cellularity Hodgkin lymphoma.</li>
<li>Nodular sclerosis Hodgkin lymphoma.</li>
</ul>
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<span style="font-family: Verdana, sans-serif;"><b>Signs of Childhood Hodgkin Lymphoma</b></span><br />
<br />
Signs of childhood hodgkin lymphoma include swollen lymph nodes, fever, night sweats, and weight loss. These and other signs and symptoms may be caused by childhood Hodgkin lymphoma or by other conditions. Check with a doctor if your child has any of the following:<br />
<ul>
<li>Anorexia.</li>
<li>Fatigue.</li>
<li>Fever for no known reason.</li>
<li>Itchy skin.</li>
<li>Night sweats.</li>
<li>Pain in the lymph nodes after drinking alcohol.</li>
<li>Painless, swollen lymph nodes in the neck, chest, underarm, or groin.</li>
<li>Weight loss for no known reason.</li>
</ul>
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<span style="font-family: Verdana, sans-serif;"><b>Risk Factor of Childhood Hodgkin Lymphoma</b></span><br />
<br />
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your child’s doctor if you think your child may be at risk. Risk factors for childhood Hodgkin lymphoma include the following:<br />
<ul>
<li>Being infected with the Epstein-Barr virus.</li>
<li>Being infected with the human immunodeficiency virus (HIV).</li>
<li>Having a personal history of mononucleosis ("mono").</li>
<li>Having certain inherited diseases of the immune system.</li>
</ul>
<br />
Being exposed to common infections in early childhood may decrease the risk of Hodgkin lymphoma in children because of the effect it has on the immune system.<br />
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<b><span style="font-family: Verdana, sans-serif;">Treatment</span></b><br />
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Treatment of Hodgkin disease in children is slightly different from the treatment used for adults. Children’s bodies tend to tolerate chemotherapy better in the short term than adults do. But some side effects are more likely to occur in children. And because some of these side effects could be long-term, children who survive their cancer need careful attention for the rest of their lives.<br />
<br />
Since the 1960s, most children and teens with cancer have been treated at special centers designed for them. Being treated in these centers offers them the advantage of having a team of specialists who are experienced with the differences between adult and childhood cancers, as well as the unique needs of children with cancer. This team usually includes pediatric oncologists, surgeons, radiation oncologists, pathologists, pediatric oncology nurses, and nurse practitioners. Childhood cancer centers also have psychologists, social workers, child life specialists, nutritionists, rehabilitation and physical therapists, and educators who can support and educate the entire family.<br />
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Most children with cancer in the United States are treated at a center that is a member of the Children’s Oncology Group (COG). All of these centers are associated with a university or children’s hospital. As we have learned more about treating childhood cancer, it has become even more important that treatment be given by experts in this area. In these centers, doctors treating children with Hodgkin disease often use treatment plans that are part of clinical trials. The purpose of these studies is to find the most effective treatment that causes the fewest side effects.</div>
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Childhood Hodgkin Lymphoma

Childhood Hodgkin lymphoma is a type of cancer that develops in the lymph system, which is part of the body's immune system. The lymph...

Monoclonal Antibodies for Hodgkin's Disease

ancorez hodgkin's disease 12:31 PM

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Monoclonal antibody therapy is a common type of immunotherapy. The body's immune system naturally produces antibodies. When produced in the laboratory, these substances can be programmed to make tumor cells more visible to the immune system and to block their growth signals.<br />
<br />
One example, monoclonal antibodies (MAbs or MoAbs), are laboratory-produced antibodies (proteins) that locate and bind to specific substances (antigens) on cancerous cells, and eventually destroy the cells.<br />
<br />
Some monoclonal antibodies are now being used to treat Hodgkin's disease:<br />
<br />
<b>1. Rituximab (Rituxan®)</b><br />
<br />
This antibody attaches to a substance called CD20 found on some types of lymphoma cells, which seems to cause the lymphoma cell to die. Rituximab may be used to treat nodular lymphocyte predominant Hodgkin disease (NLPHD), often with chemotherapy and/or radiation therapy.<br />
<br />
Rituximab is given as an IV infusion in the doctor’s office or clinic. When it is used by itself to treat lymphoma, it is usually given once a week for 4 weeks, which may then be repeated several months later. When it is combined with chemotherapy, it is most often given on the first day of each chemo cycle.<br />
<br />
<b>2. Brentuximab vedotin (Adcetris™)</b><br />
<br />
This drug is an anti-CD30 antibody attached to a chemotherapy drug. Hodgkin's lymphoma cells usually have the CD30 molecule on their surface. The antibody acts like a homing signal, bringing the chemo drug to the lymphoma cells, where it enters the cells and causes them to die when they try to divide into new cells.<br />
<br />
This drug has been shown to help many people whose hodgkin's lymphoma has come back after other treatments, including a stem cell transplant (see next section), as well as people who can’t have a stem cell transplant. It is also being studied to see if it can be given with chemotherapy and if can be helpful earlier in the course of the disease.<br />
<br />
Brentuximab is given as an infusion into a vein (IV) every 3 weeks. Common side effects include nerve damage (neuropathy), low blood counts, fatigue, fever, nausea and vomiting, infections, diarrhea, and cough. Rarely, more severe side effects occur during infusions, such as trouble breathing and low blood pressure.<br />
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<span style="font-family: Verdana, sans-serif;"><b>Side Effect</b></span><br />
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Common side effects are usually mild but may include chills, fever, nausea, rashes, fatigue, and headaches. Rarely, more severe side effects occur during infusions, such as trouble breathing and low blood pressure. Even if these symptoms occur during the first rituximab infusion, it is very unusual for them to recur with later doses. Rituximab can cause dormant (inactive) hepatitis B infections to become active again, sometimes leading to severe liver problems or even death. Your doctor may check your blood for signs of hepatitis before starting this drug. This drug may also increase the risk of certain infections for several months after the drug is stopped.</div>
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Monoclonal Antibodies for Hodgkin's Disease

Monoclonal antibody therapy is a common type of immunotherapy. The body's immune system naturally produces antibodies. When produced...

Chemotherapy for Hodgkin's Disease

ancorez hodgkin's disease 10:02 PM

<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmNpKD9tdrl2ni-oOiJhF6e20dFStMNrZT6ecKo1mkB3v5efbJyT0kTgZC2LrLgaMeVkuheafi1adPf2arp0qqDSFhHrMwISAOloGWYIUiQbqgQFBYZMSzbrthf9EJd4XRaad88aTf2Bw/s1600/Chemotherapy+for+Hodgkin's+Disease.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmNpKD9tdrl2ni-oOiJhF6e20dFStMNrZT6ecKo1mkB3v5efbJyT0kTgZC2LrLgaMeVkuheafi1adPf2arp0qqDSFhHrMwISAOloGWYIUiQbqgQFBYZMSzbrthf9EJd4XRaad88aTf2Bw/s200/Chemotherapy+for+Hodgkin's+Disease.jpg" width="149" /></a></div>Chemotherapy uses anticancer (cytotoxic) drugs to kill cancer cells. The drugs are called cytotoxic medications. Chemotherapy is referred to as body-wide, or systemic, therapy because the drugs travel throughout the entire body. Cytotoxic drugs may be taken by mouth or given by injection. Treatment may be administered at a medical center, doctor's office, or even a patient's home.<br />
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For Hodgkin lymphoma you have several chemotherapy drugs together during a course of treatment. Some chemotherapy combinations include a course of steroids. You usually have radiotherapy as well as chemotherapy for Hodgkin lymphoma.<br />
<br />
A course of chemotherapy is made up of a number of cycles. At the beginning of each cycle you have treatment, usually over 1 to 3 days depending on the particular drugs. Then you have a break of a few weeks before another cycle begins. You don’t usually have to stay in hospital for treatment.<br />
<br />
Specific Drugs and Drug Combinations Used in Hodgkin's Disease<br />
The chemo regimens for Hodgkin disease combine several drugs because different drugs kill cancer cells in different ways. The combinations used to treat Hodgkin disease are often referred to by abbreviations that are easier to remember than the drugs’ full names. The most common regimen in the United States is a 4-drug combination called ABVD, which consists of:<br />
<ul><li>Adriamycin® (doxorubicin)</li>
<li>Bleomycin</li>
<li>Vinblastine</li>
<li>Dacarbazine (DTIC)</li>
</ul>Other common regimens include:<br />
<br />
<b>1. Stanford V</b><br />
<ul><li>Doxorubicin (Adriamycin)</li>
<li>Mechlorethamine (nitrogen mustard)</li>
<li>Vincristine</li>
<li>Vinblastine</li>
<li>Bleomycin</li>
<li>Etoposide</li>
<li>Prednisone</li>
</ul><br />
<b>2. BEACOPP</b><br />
<ul><li>Bleomycin</li>
<li>Etoposide (VP-16)</li>
<li>Adriamycin (doxorubicin)</li>
<li>Cyclophosphamide (Cytoxan®)</li>
<li>Oncovin® (vincristine)</li>
<li>Procarbazine</li>
<li>Prednisone</li>
</ul>Radiation is given after chemo in the Stanford V regimen, and it is sometimes given after the ABVD or BEACOPP regimens as well. Other chemotherapy combinations may also be used for Hodgkin disease. Most use the same drugs as listed above, but they may include different combinations and be given on different schedules.<br />
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<span style="font-family: Verdana, sans-serif;"><b>Possible Side Effects</b></span><br />
<br />
All chemotherapy drugs have side effects but they vary from person to person. Some people have very few side effects at all. Your doctor can prescribe medicines to control or reduce side effects such as sickness or diarrhoea. It is important to remember that most effects are temporary. They will go away when your treatment is finished. All the drugs have different side effects so it is helpful to ask your doctor or nurse which are most common with the chemotherapy drugs you will have.<br />
<br />
There are some side effects that are quite common with many chemotherapy drugs. These are:<br />
<ul><li>Low numbers of blood cells</li>
<li>Feeling and being sick</li>
<li>A sore mouth and mouth ulcers</li>
<li>Hair loss or thinning</li>
<li>Feeling tired and run down</li>
<li>Diarrhoea</li>
</ul>The links above take you to information about coping with these side effects in the main cancer drugs section.  There is also information about the side effects of specific chemotherapy drugs. There is information about many of the drugs used to treat Hodgkin lymphoma, including a page on ABVD and individual pages about:<br />
<ul><li>Doxorubicin (also called Adriamycin)</li>
<li>Bleomycin</li>
<li>Etoposide (also called VP16)</li>
<li>Vincristine (also called Oncovin)</li>
<li>Dacarbazine</li>
<li>Vinblastine</li>
<li>Procarbazine</li>
<li>Cyclophosphamide</li>
<li>Mustine</li>
</ul><br />
If you are having medicines to control side effects and they are not working, do tell your doctor or chemotherapy nurse. There are lots of different anti sickness and anti diarrhoea medicines, for example. A different type may work better for you.<br />
<br />
<span style="font-family: Verdana, sans-serif;"><b>Serious Side Effects</b></span><br />
<br />
Serious side effects can also occur and may vary depending on the specific drugs used. They include:<br />
<ul><li>Neutropenia is a severe drop in white blood cells. Neutropenia increases the chance for infection from suppression of the immune system and is a potentially life-threatening condition. Drugs known as granulocyte colony stimulating factor (G-CSF) are used to help boost white blood cell count. These drugs, which include filgrastim (Neupogen) and pegfilgrastim (Neulasta) can help lessen the risk for neutropenia occurrence and, if neutropenia does occur, to reduce its length and severity.</li>
<li>Anemia is a lack of red blood cells. Erythropoietin stimulates red blood cell (hemoglobin) production and can help reduce or prevent this side effect. It is available as epoetin alfa (Epogen, Procrit) and darbepoetin alfa (AranespIn patients with cancer, these drugs should be used to only treat anemia associated with chemotherapy and to increase hemoglobin levels to no more than 12 g/dL. Treatment should stop as soon as chemotherapy is complete. These drugs may not be safe or appropriate for all patients.</li>
<li>Infection. Patients must take precautions against infections (see "Infection Prevention" in Transplant section).</li>
<li>Liver and kidney damage</li>
<li>Abnormal blood clotting (thrombocytopenia)</li>
<li>Allergic reaction</li>
</ul><br />
<span style="font-family: Verdana, sans-serif;"><b>Long-Term Complications</b></span><br />
<br />
Long-term complications include the following:<br />
<ul><li>Fatigue and general aches and pains are called somatic symptoms. Fatigue is especially common after chemotherapy and can even last for years.</li>
<li>Many women stop menstruating after chemotherapy. The risk for infertility is highest for women with advanced stage Hodgkin’s disease who are treated after age 30. Studies indicate that the risk for infertility is higher with BEACOPP than with ABVD. Researchers are studying whether taking oral contraceptives during chemotherapy can reduce the risk.</li>
<li>Bone thinning (osteoporosis) may be related to steroid treatments such as prednisone.</li>
<li>Heart failure may occur with the use of anthracyclines (such as doxorubicin).</li>
<li>Bleomycin (Blenoxane) is particularly toxic to the lungs. Vinblastine may also pose a risk when used in combination with radiation therapy.</li>
</ul><br />
Chemotherapy (usually ABVD) plus involved-field radiation, referred to as combined modality, is a common treatment approach for patients with more advanced-stage disease and for those who have early-stage bulky (large mass) disease. Chemotherapy with low-dose radiation is also used in children with excellent results, even for late stage cancer.</div></div>

Chemotherapy for Hodgkin's Disease

Chemotherapy uses anticancer (cytotoxic) drugs to kill cancer cells. The drugs are called cytotoxic medications. Chemotherapy is referred to...

Radiation Therapy for Hodgkin's Disease

ancorez hodgkin's disease 5:12 AM

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Radiotherapy uses high energy rays to kill cancer cells. It may be used when there are Hodgkin cells in one or two areas of lymph nodes in one part of the body (stage 1 or 2). Or for advanced Hodgkin lymphoma to shrink large lymph nodes. Radiotherapy is usually given before or after chemotherapy treatment.<br />
<br />
To treat Hodgkin disease, a carefully focused beam of radiation is delivered from a machine outside the body. This is known as external beam radiation. Most often, radiation treatments are given 5 days a week for several weeks. Before the treatments start, the radiation team takes careful measurements to determine the dose needed and the correct angles for aiming the radiation beams. The treatment is much like getting an x-ray, but the radiation is more intense. Each treatment lasts only a few minutes, although the setup time – getting you or your child into place – usually takes longer. Radiation itself is painless, but some younger children may need to be sedated to make sure they don’t move during the treatment.<br />
<br />
Radiation therapy is often very good at killing Hodgkin disease cells. Decades ago, this was the best treatment available for Hodgkin disease, but over the years doctors realized it could lead to long-term side effects. As it became clear that chemotherapy was also effective, doctors began to use less radiation. Today, if radiation therapy is used, only the involved areas are treated with radiation to try to limit side effects.<br />
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<b><span style="font-family: Verdana, sans-serif;">Radiation Treatment Approaches</span></b><br />
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The two main types of radiation therapy are extended field radiation and involved field radiation.<br />
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Extended field radiation targets the diseased lymph nodes and surrounding healthy lymph nodes. Extended-field radiation is rarely given in combination with chemotherapy. Specific subtypes of extended field radiation are used depending on the location of the disease:<br />
<ul>
<li>If HD is above the diaphragm, “extended field radiation” is delivered to the neck, chest, and under arms (called the mantle field). Radiation is sometimes expanded to include lymph nodes in the upper abdomen.</li>
<li>If cancer is below the diaphragm, an "inverted Y" field is sometimes used, in which radiation is directed at lymph nodes in the upper abdomen, spleen, and pelvis.</li>
<li>Inverted Y-field radiation therapy combined with mantle-field radiation is called total nodal radiation.</li>
</ul>
<br />
Involved field radiation targets only lymph node regions that are known to have cancer, not the adjacent, uninvolved lymph node regions. Involved-field radiation is usually given after several rounds of chemotherapy.<br />
<br />
In general, recent research suggests that extended-field radiation adds little survival advantage and carries a greater risk of serious side effects. Involved-field radiation is now becoming the preferred method. Some researchers recommend that involved-field radiation therapy plus chemotherapy should become the standard treatment for patients with early-stage Hodgkin’s disease who have a good prognosis. More research is needed before standard practice guidelines can be implemented.<br />
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<span style="font-family: Verdana, sans-serif;"><b>Side Effects</b></span><br />
<br />
The most common side effects of radiotherapy during and just after treatment are:<br />
<ul>
<li>Reddening of the skin in the treatment area</li>
<li>Tiredness</li>
<li>Loss of hair in the treatment area</li>
</ul>
<br />
Your skin may look slightly sunburnt in the area that has been treated. Don't use any creams or lotions unless the radiotherapy centre has given them to you. There is detailed information about skin care during radiotherapy in the main radiotherapy section. Tiredness usually comes on towards the end of a course of treatment. It may take some weeks or even months to go completely after your course of treatment is over. There is more about radiotherapy tiredness in the radiotherapy section.<br />
<br />
Other side effects of radiotherapy vary depending on which part of the body is being treated. If your treatment is to the abdomen, you may feel sick or have diarrhoea. These effects can get worse towards the end of your treatment and will then gradually clear up after it has finished. If you are having extended field radiotherapy, you will probably find that tiredness and sickness are the most troublesome side effects. Ask your doctor for anti sickness medicines to take before your treatment. They do help.<br />
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<b><span style="font-family: Verdana, sans-serif;">Possible Side Effects</span></b><br />
<br />
The side effects of radiation therapy depend on where the radiation is aimed. Some people have skin changes similar to sunburn, which slowly fades away. Other possible short-term side effects include fatigue, dry mouth, nausea, or diarrhea. Radiation given to several areas, especially after chemotherapy, can lower blood cell counts.<br />
<br />
Long-term side effects: Radiation therapy can also have long-term side effects. The most serious of these is the development of another cancer in the part of the body that was exposed to radiation. Other possible long term problems include:<br />
<ul>
<li><b>Risk of a second cancer</b><br />
People treated for Hodgkin lymphoma with radiotherapy have an increased risk of developing another cancer later in life. The highest risk is of breast cancer, caused by radiotherapy to the chest. Doctors usually only treat the centre of the chest these days, rather than a large T shape across the chest and shoulders, as they used to do. The total radiation dose used is lower. So the risk of a second cancer is lower than it used to be. For some people it may not be necessary to have radiotherapy after the chemotherapy. Your doctor will discuss with you the different treatment options in your case.<br />
<br />
Children treated with radiotherapy for Hodgkin lymphoma also have an increased risk of developing another cancer later in life. For some children it may not be necessary to have radiotherapy after chemotherapy treatment. Researchers and doctors are currently doing research trials to see which children need radiotherapy after chemotherapy and which children don't need it. Your child's doctor will discuss this with you and your child. If you had radiotherapy for lymphoma as a child and are worried about your possible cancer risk, you can make an appointment to see your lymphoma specialist to talk about this issue. Or if you've lost touch with your specialist, you can see your GP.<br />
<br />
Women who have had radiotherapy to the chest for Hodgkin lymphoma, including as a child, may have yearly breast screening from 8 years after treatment, or from age 25 years (whichever is later). This is the group with the largest cancer risk at the moment. It is possible for men treated with radiotherapy to the chest to get breast cancer, but it is much, much rarer. For men and women who had chest radiotherapy, there is also a smaller risk of thyroid cancer, lung cancer, or cancer of the food pipe (oesophagus). If you are at all worried, speak to your specialist.</li>
<li><b>Heart problems</b><br />
Radiotherapy to the chest for Hodgkin lymphoma can increase the risk of heart disease in later life. Nowadays, doctors use reduced treatment fields and doses as much as possible to reduce any effects on the heart. But it is important to be aware of this side effect, particularly if there is heart disease in your family. You can help to reduce your risk by having a healthy diet, exercising regularly, and not smoking.</li>
<li><b>Changes in the way your thyroid gland works</b><br />
After radiotherapy to the neck for Hodgkin lymphoma, some people can develop a condition of the thyroid gland, called hypothyroidism. The thyroid gland stops producing enough thyroid hormones and people need to take thyroid hormone (thyroxine) tablets.</li>
<li><b>Infertility from inverted Y radiotherapy</b><br />
If you have inverted Y radiotherapy, you may become infertile.</li>
<li><b>Inflammation of the lungs (pneumonitis)</b><br />
Radiotherapy to the chest can cause inflammation of the lungs called radiation pneumonitis. The inflammation can cause a long term cough, and sometimes breathlessness.</li>
</ul>
<br />
Radiation to the chest or neck can damage the thyroid gland, which can affect its ability to make thyroid hormone. This can lead to fatigue and weight gain. Treatment with thyroid hormone pills can help with this. Radiation to the chest also increases the risk of heart disease (such as heart attacks) and lung problems, while radiation to the neck may increase the risk of stroke many years later.<br />
<br />
In children, radiation that reaches the bones may slow their growth. Depending on where the radiation is given, this could result in deformities or a lack of growth to full height. Radiation to the lower part of the body in children and young adults might also affect fertility later in life.<br />
<br />
To reduce the risk of side effects, doctors carefully calculate the exact dose of radiation needed and aim the radiation beam as accurately as they can. Shields may also be placed over nearby parts of the body to protect them from the radiation. In girls and young women, the ovaries may be moved out of the way with minor surgery before radiation is given to help preserve fertility.<br />
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<span style="font-family: Verdana, sans-serif;"><b>Complications of Radiation</b></span><br />
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<ul>
<li><i>Fatigue</i>. Fatigue is significant and chronic in many survivors. It is more highly associated with intensive chemotherapy, but it also may be a late response to radiation treatment.</li>
<li><i>Heart Disease and Stroke</i>. Radiation is associated with a future risk of heart disease, which includes atherosclerosis (hardening of the arteries) and diseases of the heart valves. Lower doses pose less risk. Recent research suggests that adults who survived childhood Hodgkin’s disease have a four times higher risk of having a stroke than healthy patients.</li>
<li><i>Impaired Growth in Children</i>. Children and adolescents are at special risk for impaired bone growth.</li>
<li><i>Infections</i>. Infections may be a particular problem with radiation combined with chemotherapy. All patients should be vaccinated against the bacteria that often cause pneumonia and meningitis, and against the influenza virus.</li>
<li><i>Infertility</i>. Radiation therapy to the pelvic area can adversely affect later fertility in women and men. Such negative effects may be worse in women; sperm usually recover within 5 years.</li>
<li><i>Secondary Cancers</i>. Second cancers (such as breast, stomach, lung, melanoma) may develop later in areas within or at the edge of the radiation area. Thyroid, respiratory tract, and digestive tract secondary cancers may affect patients who were treated as children. Lung cancer in survivors is highly associated with smoking after treatment, and no survivor should smoke. The risk for breast cancer increases significantly in women who receive chest radiation. The risk can persist for 25 years or more after radiotherapy, and lifetime monitoring (including frequent mammograms) is essential.</li>
<li><i>Thyroid Disorders</i>. Hypothyroidism (underactive thyroid) occurs in a number of patients treated with radiation treatments. There is also a 5% chance for hyperthyroidism (overactive thyroid).</li>
</ul>
<br /></div>
</div>

Radiation Therapy for Hodgkin's Disease

Radiotherapy uses high energy rays to kill cancer cells. It may be used when there are Hodgkin cells in one or two areas of lymph nodes ...

Hodgkin's Disease Treatment

ancorez hodgkin's disease 9:20 AM

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Which treatment options are appropriate for your Hodgkin's lymphoma depends on your type and stage of disease, your overall health and your preferences. The goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission.</div>
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When lymphoma is diagnosed, several doctors and other health professionals work together to decide on the most appropriate treatment. The team of doctors and health professionals is called a multi-disciplinary team (MDT). The members of the team specializes in different areas of Hodgkin lymphoma treatment and support. The team usually includes the following people.</div>
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<ul>
<li>A medical oncologist (a specialist in drug treatment for lymphoma)</li>
<li>A pathologist (a specialist in cancerous blood cells)</li>
<li>A transplant specialist</li>
<li>A clinical oncologist (a specialist in radiotherapy)</li>
<li>A specialist cancer nurse</li>
<li>A pharmacist, social worker, psychologist and counsellor</li>
</ul>
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<span style="font-family: Verdana, sans-serif; font-size: large;"><b>Types of Treatment</b></span></div>
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<b>The treatment of Hodgkin lymphoma</b> (Hodgkin’s disease) is usually very successful and many people are cured. How much treatment you need depends on the stage of your disease. The main types of treatment are:</div>
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<b><span style="font-family: Verdana, sans-serif;">1. Stem cell transplant </span></b></div>
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A stem cell transplant is a treatment to replace your diseased bone marrow with healthy stem cells that help you grow new bone marrow. A stem cell transplant may be an option if Hodgkin's lymphoma returns despite treatment.</div>
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During a stem cell transplant, your own blood stem cells are removed, frozen and stored for later use. Next you receive high-dose chemotherapy and radiation therapy to destroy cancerous cells in your body. Finally your stem cells are thawed and injected into your body through your veins. The stem cells help to build healthy bone marrow.</div>
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<span style="font-family: Verdana, sans-serif;"><b>2. Radiation </b></span></div>
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Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells. For classical Hodgkin's lymphoma, radiation therapy can be used alone, but it is often used after chemotherapy. People with early-stage lymphocyte-predominant Hodgkin's lymphoma typically undergo radiation therapy alone.</div>
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During radiation therapy, you lie on a table and a large machine moves around you, directing the energy beams to specific points on your body. Radiation can be aimed at affected lymph nodes and the nearby area of nodes where the disease might progress. The length of radiation treatment varies, depending on the stage of the disease.</div>
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Radiation therapy can cause skin redness and hair loss at the site where the radiation is aimed. Many people experience fatigue during radiation therapy. More serious risks include heart disease, stroke, thyroid problems, infertility and other forms of cancer, such as breast or lung cancer.</div>
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<span style="font-family: Verdana, sans-serif;"><b>3. Chemotherapy </b></span></div>
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Chemotherapy is a drug treatment that uses chemicals to kill lymphoma cells. Chemotherapy drugs travel through your bloodstream and can reach nearly all areas of your body.</div>
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Chemotherapy is often combined with radiation therapy in people with early-stage classical type Hodgkin's lymphoma. Radiation therapy is typically done after chemotherapy. In advanced Hodgkin's lymphoma, chemotherapy may be used alone or combined with radiation therapy.</div>
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Chemotherapy drugs can be taken in pill form or through a vein in your arm. Several combinations of chemotherapy drugs are used to treat Hodgkin's lymphoma. Side effects of chemotherapy depend on the specific drugs you're given. Common side effects include nausea and hair loss. Serious long-term complications can occur, such as heart damage, lung damage, fertility problems and other cancers, such as leukemia.</div>
</div>

Hodgkin's Disease Treatment

Which treatment options are appropriate for your Hodgkin's lymphoma depends on your type and stage of disease, your overall health a...

Signs and Symptoms of Hodgkin's Disease

Gaptek_ancorez hodgkin's disease 1:17 PM

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The most common sign of both <a href="http://cancer-666.blogspot.com/" target="_blank">Hodgkin's disease</a> (HD) and non-Hodgkin's lymphoma (NHL) is a painless swelling in one or more of the lymph nodes of the neck, collarbone region, armpits, or groin. But it is important to remember that most lymph node swelling—especially in children—is caused by an infection, not by lymphoma. Affected lymph nodes usually return to normal size within a few weeks or months after an infection has cleared. Physicians often observe swollen lymph nodes during this time to see if they change in size following antibiotic treatment. However, if a lymph node(s) is larger than one inch in size (> 1 in), and if there are other suspicious symptoms, the physician may choose to perform an immediate biopsy to rule out or confirm a diagnosis of cancer.<br />
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<b>Hodgkin's disease</b> has a characteristic pattern of lymphatic spread that may aid in diagnosis. The disease typically invades the lymph nodes of the neck, collarbone, armpits, and/or chest above the diaphragm (large abdominal muscle that controls breathing) without "skipping" a nodal group.<br />
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If HD or NHL involves lymphatic tissue within the abdomen the belly may become swollen, and even resemble pregnancy in some female patients. Fluid may build up within the abdominal cavity, and swelling near the intestines may block the normal passage of feces. Such blockage may cause sensations of abdominal pressure or pain.<br />
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<span style="font-size: large;"><b>A. Risk factors</b></span></div>
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Doctors seldom know why one person develops Hodgkin lymphoma and another does not. But research shows that certain risk factors increase the chance that a person will develop this disease.<br />
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The risk factors for Hodgkin lymphoma include the following:<br />
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<b><span style="font-family: Verdana,sans-serif;">Age:</span></b> <i>Hodgkin lymphoma</i> is most common among teens and adults aged 15 to 35 years and adults aged 55 years and older.<br />
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<b style="font-family: Verdana,sans-serif;">Certain viruses:</b> Having an infection with the Epstein-Barr virus (EBV) or the human immunodeficiency virus (HIV) may increase the risk of developing Hodgkin lymphoma. However, lymphoma is not contagious. You can't catch lymphoma from another person.<br />
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<b><span style="font-family: Verdana,sans-serif;">Family history:</span></b> Family members, especially brothers and sisters, of a person with Hodgkin lymphoma or other lymphomas may have an increased chance of developing this disease.<br />
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<b style="font-family: Verdana,sans-serif;">Weakened immune system:</b> The risk of developing Hodgkin lymphoma may be increased by having a weakened immune system (such as from an inherited condition or certain drugs used after an organ transplant).<br />
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Having one or more risk factors does not mean that a person will develop Hodgkin lymphoma. Most people who have risk factors never develop cancer.<br />
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<span style="font-size: large;"><b>B. Symptoms</b></span></div>
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<u>Hodgkin lymphoma</u> can cause many symptoms:<br />
<ul>
<li>Becoming more sensitive to the effects of alcohol or having painful lymph nodes after drinking alcohol</li>
<li>Coughing, trouble breathing, or chest pain</li>
<li>Fever that does not go away</li>
<li>Itchy skin</li>
<li>Soaking night sweats</li>
<li> Swollen lymph nodes (that do not hurt) in the neck, underarms, or groin</li>
<li>Weight loss for no known reason</li>
<li>Weakness and tiredness that don't go away</li>
</ul>
Most often, these symptoms are not due to cancer. Infections or other health problems may also cause these symptoms. Anyone with symptoms that last more than 2 weeks should see a doctor so that problems can be diagnosed and treated. </div>
</div>

Signs and Symptoms of Hodgkin's Disease

The most common sign of both Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) is a painless swelling in one or more of t...

The stages of Hodgkin's lymphoma

Gaptek_ancorez hodgkin's disease 12:56 PM

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The stage of the <a href="http://cancer-666.blogspot.com/" target="_blank">cancer</a> means whether your cancer is localised in one area of the body or is in more than one area. The tests and scans you have to diagnose your lymphoma will give some information about the stage. Your doctor uses the stage to work out the treatment you will need.<br />
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After <b>Hodgkin's lymphoma</b> is diagnosed, a patient will be staged: that is, they will undergo a series of tests and procedures that will determine what areas of the body are affected. These procedures may include documentation of their histology, a physical examination, blood tests, chest X-ray radiographs, computed tomography (CT)/Positron emission tomography (PET)/magnetic resonance imaging (MRI) scans of the chest, abdomen and pelvis, and usually a bone marrow biopsy. Positron emission tomography (PET) scan is now used instead of the gallium scan for staging. In the past, a lymphangiogram or surgical laparotomy (which involves opening the abdominal cavity and visually inspecting for tumors) were performed. Lymphangiograms or laparotomies are very rarely performed, having been supplanted by improvements in imaging with the CT scan and PET scan.<br />
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On the basis of this staging, the patient will be classified according to a staging classification (the Ann Arbor staging classification scheme is a common one):<br />
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<b>Stage I</b> is involvement of a single lymph node region (I) (mostly the cervical region) or single extralymphatic site (Ie);<br />
<b>Stage II</b> is involvement of two or more lymph node regions on the same side of the diaphragm (II) or of one lymph node region and a contiguous extralymphatic site (IIe);<br />
<b>Stage III</b> is involvement of lymph node regions on both sides of the diaphragm, which may include the spleen (IIIs) and/or limited contiguous extralymphatic organ or site (IIIe, IIIes);<br />
<b>Stage IV</b> is disseminated involvement of one or more extralymphatic organs.<br />
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The absence of systemic symptoms is signified by adding 'A' to the stage; the presence of systemic symptoms is signified by adding 'B' to the stage. For localized extranodal extension from mass of nodes that does not advance the stage, subscript 'E' is added. Splenic involvement is signified by adding 'S' to the stage.</div>
</div>

The stages of Hodgkin's lymphoma

The stage of the cancer means whether your cancer is localised in one area of the body or is in more than one area. The tests and scans...

Types of Hodgkin Lymphoma

Gaptek_ancorez hodgkin's disease 12:44 PM

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The report of the biopsy may indicate the <a href="http://cancer-666.blogspot.com/" target="_blank">type of Hodgkin Lymphoma</a> that has occurred. There are five main types of Hodgkin Lymphoma. They differ in whom it affects, the parts of the body more likely to be affected, and in what stage it is usually diagnosed.<br />
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<b>1. Lymphocyte Depleted Hodgkin Lymphoma (LDHL)</b></div>
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The Lymphocyte depletion subtype is a very rare form of <b>Hodgkin Lymphoma</b> that makes up only about 1% of those affected by the disease. It affects older people and is often diagnosed in an advanced stage when the lymphoma has affected different organs of the body. It is also more common in those who are HIV affected.<br />
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<b>2. Lymphocyte-rich Classic Hodgkin Lymphoma (LRCHL)</b></div>
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This is another uncommon subtype that makes up about 5-6% of Hodgkin patients. It is more common in males and affects people most commonly in their thirties or forties. Most individuals are diagnosed in early stages and response to treatment is excellent.<br />
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<b>3. Mixed Cellularity Hodgkin Lymphoma (MCHL)</b></div>
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This is another common type of <i>Hodgkin Lymphoma</i>. 15-30% of those affected have mixed cellularity disease. This type is more common in developing countries. People of any age may be affected. Males and females are equally affected. This type of disease is more likely to involve the abdomen than the more common nodular sclerosing variety, and less likely to involve nodes within the chest.<br />
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<b>4. Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)</b></div>
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Now considered to be a special type of Hodgkin disease that is different from the other types mentioned above, this variant accounts for 4-5% of all cases of Hodgkin disease. According to pathologists this type has many similarities with Non-Hodgkin Lymphoma (NHL). In all clinical aspects, however, the features are similar to the lymphocyte-rich type of Hodgkin lymphoma. Most individuals are diagnosed early and do very well after treatment.<br />
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<b>5. Nodular Sclerosing Hodgkin Lymphoma (NSHL)</b></div>
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This is the most common type of <u>Hodgkin Lymphoma</u>. In the developed countries 60-80% of the people affected by Hodgkin disease have the Nodular Sclerosing subtype. It is commoner in females and mostly affects younger people – adolescents and young adults. The disease mainly affects nodes in the neck or armpits, or within the chest. </div>
</div>

Types of Hodgkin Lymphoma

The report of the biopsy may indicate the type of Hodgkin Lymphoma that has occurred. There are five main types of Hodgkin Lymphoma. Th...

Definition and Description of Hodgkin's Disease

Gaptek_ancorez hodgkin's disease 5:24 PM

<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><h1>Definition</h1><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjr1QZfeSOdo-HUMiDWmMsEi3rWbgFcUyekqNzU9CwzM67fGBFRm37x4YHoBz77TdARGsImSMeE2HcuNZp2g2MHqnd_10rIHAODysvvvLWMpt6YUeD5WKgur2OYhWlBohCJeDRoM8Gqoseo/s1600/Definition+and+Description+of+Hodgkin%27s+Disease.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjr1QZfeSOdo-HUMiDWmMsEi3rWbgFcUyekqNzU9CwzM67fGBFRm37x4YHoBz77TdARGsImSMeE2HcuNZp2g2MHqnd_10rIHAODysvvvLWMpt6YUeD5WKgur2OYhWlBohCJeDRoM8Gqoseo/s320/Definition+and+Description+of+Hodgkin%27s+Disease.jpg" width="243" /></a><br />
Hodgkin's disease is a <a href="http://cancer-666.blogspot.com/">cancer</a> of the lymphatic system, which is part of your immune system.<br />
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In Hodgkin's lymphoma, cells in the lymphatic system grow abnormally and may spread beyond the lymphatic system. As Hodgkin's lymphoma progresses, it compromises your body's ability to fight infection.<br />
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Hodgkin's lymphoma is one of two common types of cancers of the lymphatic system. The other type, non-Hodgkin's lymphoma, is far more common.<br />
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Advances in diagnosis and treatment of Hodgkin's lymphoma have helped to give people with this diagnosis the chance for a full recovery. The prognosis continues to improve for people with Hodgkin's lymphoma.<br />
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<h2>Description</h2><br />
Hodgkin's disease, or Hodgkin's lymphoma, was first described in 1832 by Thomas Hodgkin, a British physician. Hodgkin clearly differentiated between this disease and the much more common non- Hodgkin's lymphomas. Prior to 1970, few individuals survived Hodgkin's disease. Now, however, the majority of individuals with this cancer can be cured.<br />
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The lymphatic system is part of the body's immune system, for fighting disease, and a part of the blood- producing system. It includes the lymph vessels and nodes, and the spleen, bone marrow, and thymus. The narrow lymphatic vessels carry lymphatic fluid from throughout the body. The lymph nodes are small organs that filter the lymphatic fluid and trap foreign substances, including viruses, bacteria, and cancer cells. The spleen, in the upper left abdomen, removes old cells and debris from the blood. The bone marrow, the tissue inside the bones, produces new red and white blood cells.<br />
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Lymphocytes are white blood cells that recognize and destroy disease- causing organisms. Lymphocytes are produced in the lymph nodes, spleen, and bone marrow. They circulate throughout the body in the blood and lymphatic fluid. Clusters of immune cells also exist in major organs.<br />
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Hodgkin's disease is a type of lymphoma in which antibody- producing cells of the lymphatic system begin to grow abnormally. It usually begins in a lymph node and progresses slowly, in a fairly predictable way, spreading via the lymphatic vessels from one group of lymph nodes to the next. Sometimes it invades organs that are adjacent to the lymph nodes. If the cancer cells spread to the blood, the disease can reach almost any site in the body. Advanced cases of Hodgkin's disease may involve the spleen, liver, bone marrow, and lungs.<br />
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There are different subtypes of Hodgkin's disease:<br />
<ul><li>lymphocyte depleted (less than 5% of cases)</li>
<li>lymphocyte predominant (5-10% of cases)</li>
<li>mixed cellularity (20-40% of cases)</li>
<li>nodular sclerosis (30-60% of cases)</li>
<li>unclassified</li>
</ul></div></div>

Definition and Description of Hodgkin's Disease

Definition Hodgkin's disease is a cancer of the lymphatic system, which is part of your immune system. In Hodgkin's lymphoma, ce...

CanCer-666