(Enfermedad de Hodgkin)
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's disease. Because Hodgkin's disease and its treatment affect the body's ability to fight infection, Ethan hasn't been out in crowds for a while. He's only allowed to go to appointments with his doctors and make brief visits to the library.
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's Disease?
Hodgkin's disease is a type of lymphoma. Lymphoma (say: lim-foh-mah) is cancer of the lymphatic system and 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’s disease 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 children and adolescents younger than 20 are diagnosed with lymphomas each year. For younger children, non-Hodgkins lymphoma is more common than Hodgkin’s disease, but the reverse is true for adolescents.
What Causes Hodgkin's?
No one really knows what causes Hodgkin's disease, but we do know that it can't be caused by getting someone else's germs or by eating the wrong foods. People who have had Epstein-Barr virus, which can cause infectious mononucleosis (mono), may be at a slightly higher risk for Hodgkin's. There is a slightly increased risk of Hodgkin's among family members of patients who carry the disease.
What Are the Symptoms?
Kids who have Hodgkin's disease sometimes 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. However, kids often have no symptoms other than a lump or a bump.
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've lost your appetite, 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's disease, but it's good to be sure.
What Will the Doctor Do?
If your doctor suspects Hodgkin's disease, you will probably have some tests, like blood tests, an X-ray, or a CT 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's disease, your doctor will try to determine the stage of the disease. 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's disease a person has. There are two general types of treatment used for Hodgkin's disease: chemotherapy (say: kee-moe-ther-ah-pee) and radiation therapy (say: ray-dee-ay-shun ther-ah-pee).
Chemotherapy uses strong medicines to fight the disease. 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. The chemotherapy will also make kids more at risk for infection so at times kids 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. There are other medicines used with chemotherapy that 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 chemotherapy. Radiation can also cause side effects such as exhaustion and stomach problems, but it is not painful.
Living With Hodgkin's
Most kids with Hodgkin's disease are cured and go on to lead normal lives. If you have Hodgkin's 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 dance lessons or horseback riding, cheerleading, or orchestra for a while. 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 eventually be able to return to them. And remember that all the hair lost from your treatments will grow back!
Your treatments may make you feel sick or tired or both. But that, too, won't last forever. Once your chemotherapy 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 with your doctor monitor how you're doing, so you can rest easy that your treatment for Hodgkin's disease has been effective. They also are important to watch for late effects of the treatment you have received. Your chances for total recovery are excellent!
Updated and reviewed by: Robin E. Miller, MD
Date reviewed: March 2006
