Hodgkin's Disease - Causes, Symptoms and Therapy

Hodgkin's disease; Hodgkin's lymphoma

Our lymphatic system can be affected by malignant tumors - the best known is Hodgkin's lymphoma. The disease is according to the English pathologist Thomas Hodgkin M.D. (1798- 1866) named. He was a very innovative and socially committed physician who was one of the first to bring the stethoscope to England, which described acute appendicitis 50 years before its discovery and discovered in 1832 the "Hodgkin's Disease" as it is still known in English today.

contents

• Hodgkin's disease; Hodgkin's lymphoma
• definition
• Symptoms of Hodgkin's lymphoma
• Causes of Hodgkin's lymphoma
• treatment

definition

Hodgkin's disease is listed in the International Classification of Diseases under the code C81. listed as Hodgkin's lymphoma (lymphogranulomatosis), with various sub-forms such as the Nodular sclerosing (classic) Hodgkin's lymphoma (C81.1), the mixed cell (classical) Hodgkin's lymphoma (C81.2), the lymphocyte arms (classic) Hodgkin Lymphoma (C81.3) and lymphocyte-rich (classical) Hodgkin's lymphoma (C81.4). Characteristic of all forms of Hodgkin's lymphoma is the occurrence of Hodgkin cells and the so-called Sternberg Reed giant cells. Hodgkin's disease is one of the malignant lymphomas (lymph node cancer).

Swelling of the lymph nodes in the neck is often one of the first symptoms in Hodgkin's disease. (Image: Beßler / Havlena)

Symptoms of Hodgkin's lymphoma

According to the German Cancer Research Center (DKFZ), Hodgkin's disease begins in the majority of cases in the lymph nodes around the neck and neck. Patients or physicians are the first to notice swelling of the lymph nodes on the neck, under the armpits and in the groin area, but other areas may also be affected. Thus, in about one third of those affected lymph node swelling behind the sternum, where the so-called mediastinal lymph nodes are affected, reports the DKFZ. In such cases, breathing difficulties and persistent irritable cough are often symptoms. In all forms of the disease, the lymphoma cells could theoretically leave the lymphatic system via the bloodstream and infect the liver and other organs, as well as the bone marrow.

Typical of tumors is the additional occurrence of general symptoms such as night sweats, weight loss and fever. Moreover, cancers are basically characterized by uncontrolled cell growth, which in the case of lymphogranulomatosis emanates from altered B lymphocytes. From these develop the Hodgkin cells, which fuse to the polynuclear Sternberg Reed giant cells, which can be seen even in the histological examination of affected lymph nodes under the microscope, reports the DKFZ. In addition, a lack of special white blood cells (lymphopenia) occurs in the course of the disease, which may be decisive in a diagnosis.

Hodgkin's lymphoma is a special form of lymphoma that can theoretically develop in all the lymph nodes of the body. (Image: Hernie / fotolia.com)

Causes of Hodgkin's lymphoma

As so often with tumors, so far only risk factors in the context of causal research can be assumed. To what extent lifestyle-related risk factors or environmental risks for their development
Hodgkin's lymphoma remains responsible, according to the Robert Koch Institute (RKI) remains unclear. Long-lasting cigarette smoking is suspected as a risk factor, but the connection has not yet been finally clarified. According to the RKI, innate or acquired peculiarities of the immune system and viral infections are also discussed as possible triggers. Recent studies have shown, for example, an involvement of Epstein-Barr virus (EBV), the pathogens of Pfeiffer's glandular fever (infectious mononucleosis), in the development of Hodgkin's lymphoma. Other viruses may be involved in the development of Hodgkin's lymphoma, according to the RKI.

Last but not least, hereditary factors are considered as possible causes of the disease, as Hodgkin's disease often occurs within a family.

treatment

The disease is subdivided into different subforms and stages, which are crucial for the adequate form and level of therapy (chemotherapy and radiotherapy). Basically, the treatment is to be aligned with the stage of the disease. According to the DKFZ, patients with Hodgkin's lymphoma at an early stage (I and II) are usually treated with a chemotherapy lasting approximately two months and consisting of several medications and a subsequent radiation treatment. The treatment can often be done on an outpatient basis and a hospital stay is usually not necessary. Which combination of the individual drugs and which number of treatment cycles is chosen, also depends on the general health of those affected and the presence of certain risk factors. Such risk factors include, for example, very extensive lymph node involvement or involvement of tissue outside the lymph nodes, spleen, thymus, and lymphoid tissue of the mucous membranes (e.g., liver involvement)..

There is no way around most Hodgkin's lymphoma chemotherapy. Only diseases at a very early stage can be successfully treated by radiation without the use of chemotherapy. (Image: Zerbor / fotolia.com)

If lymphocytic-predominant Hodgkin's lymphoma is present in stage IA, according to the DKFZ, even a single radiotherapy can be considered if there are no other risk factors. In Hodgkin's disease later in the disease stage (III and IV), according to the DKFZ, however, intensive chemotherapy is planned for all patients and only if, after such treatment, even larger tumor remnants are detectable, patients will also receive radiation.

The chemotherapy and radiation treatment are very stressful for the body and could be associated with significant side effects, so sufferers should definitely inquire with the attending physicians about possible risks, so the hint of the DKFZ. Overall, medicine has made significant progress in the treatment of Hodgkin's disease in recent decades, with much better prognosis. As part of naturopathy, only a strengthening of the immune system can be recommended as a preventive measure. (tf, fp, updated 26/06/2017)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)