Ethan was feeling down. All of his friends were going to the big game and he couldn't join them. It wasn't because he'd been grounded or because his family had other plans. The problem was more serious than that: Ethan has a type of cancer called Hodgkin lymphoma. Because Hodgkin lymphoma and its treatment affect the body's ability to fight infection, Ethan hasn't been out in crowds for a while.
But despite Ethan's disappointment, he knows he can look forward to the future. His support team of doctors, nurses, friends, and family members has helped him come a long way. Soon he'll be able to do all of the cool things he's missed.
What Is Hodgkin Lymphoma?
Lymphoma (say: lim-foh-mah) is cancer of the lymphatic system. Hodgkin lymphoma is the third most common type of cancer in kids and teens ages 10 to 14. But it is still very rare for kids to get it.
The lymphatic system is the system in the body that is responsible for fighting off infections and keeping you healthy. It's made up of your tonsils, spleen, bone marrow, and chains of lymph nodes (rounded masses of tissue found throughout the body). Although many types of cancer can spread to the lymph system, lymphoma actually begins in the cells of the lymph system itself.
Hodgkin lymphoma is named for Dr. Thomas Hodgkin, who described several cases of the cancer within the lymph system in 1832. About 40 years later, other doctors began to report different types of lymphomas.
In the United States, approximately 1,700 kids and teens younger than 20 are diagnosed with lymphomas each year. In younger children, non-Hodgkin lymphoma is more common than Hodgkin lymphoma, but in teens, Hodgkin lymphoma is more common.
What Causes Hodgkin Lymphoma?
No one really knows what causes Hodgkin lymphoma, but we do know that it can't be caused by getting someone else's germs or by eating the wrong foods. There is a slightly increased risk among family members of people who have the disease.
Some people who have Hodgkin lymphoma at first might think they have the flu. They may have fevers, feel achy, or have swollen glands, which look and feel like bumps, often in the neck or groin area. Others feel tired or find themselves sweating a lot during the night or losing weight without trying. Enlarged lymph nodes in the chest can cause a cough, pain in the chest, or difficulty breathing.
If you have enlarged lymph glands in your neck or your armpit or if you feel like you can't catch your breath, let someone know right away. If you think you are sick, even if it's just a fever or you're losing weight without trying, tell your parent. He or she can take you to a doctor to check out your symptoms. Chances are you just have a viral infection, not Hodgkin lymphoma, but it's good to be sure.
What Will the Doctor Do?
If your doctor suspects Hodgkin lymphoma, you will need some tests, like blood tests, an X-ray, or a CT or PET scan that can take pictures of your lymph nodes and spleen. You may need a biopsy, a test where doctors remove a tiny portion of your lymph tissue to examine it carefully under a microscope. The doctor will make sure that you are comfortable and don't feel pain while having the biopsy.
If it's found that you have Hodgkin lymphoma, your doctor will try to determine the stage of the lymphoma. The stage means how much cancer there is in the body.
There are four stages of lymphoma: stage one is the earliest type, and usually the cancer is in one small part of the body and is the easiest to treat; stage four means the cancer has spread throughout the body.
The treatment plan will depend on the stage of Hodgkin lymphoma a person has. The two general types of treatment used for Hodgkin lymphoma are chemotherapy (say: kee-moe-ther-uh-pee) and radiation (say: ray-dee-ay-shun) therapy.
Chemotherapy (or chemo) uses strong medicines to fight the lymphoma. These medicines are extremely effective in killing off the cancer cells, but they do have side effects, including nausea, vomiting, hair loss, tiredness, and lowering of the blood counts. Chemotherapy will also make a person more at risk for infection, so at times kids getting chemo need to be careful to avoid being around anyone who is sick.
It's important, though, to remember that even though the medicine may make you feel sick, it's actually working to make you well. Most kids are able to tolerate the side effects without too much trouble. Other medicines used with chemotherapy work very well to prevent some of the most unpleasant side effects, like nausea and vomiting.
Radiation involves using especially strong X-rays to kill cancer cells. The radiation is administered through a machine and targeted just at cancer cells. Radiation therapy is usually given in addition to chemo. Radiation can also cause side effects such as exhaustion and stomach problems, but it is not painful.
Most kids with Hodgkin lymphoma are cured and go on to lead normal lives. If you have Hodgkin, you may need to make some short- and long-term changes in your life while you are being treated and getting better.
For example, you may have to be schooled at home or give up football, cheerleading, or orchestra until your treatment is finished. Your body needs to be protected from infection and injury while you are getting chemotherapy, and the best places to do that are at home and in the hospital.
Even though you may have to give up some of your activities for a while, you will be able to return to them. And remember that all the hair lost from your treatments will grow back!
Your treatments might make you feel sick, tired, or both. But that, too, won't last forever. Once your chemo or radiation is over, you will feel much better. But you will still have to see your doctor on a regular basis for years to come. For example, you'll continue to have blood work, X-rays, and CT scans to make sure that the cancer has stayed away.
These regular checkups let your doctor see how you're doing, so you can rest easy that your treatment for Hodgkin lymphoma has been effective. They also are important to watch for any side effects of the treatment that might show up later.