Hodgkin’s lymphoma is a form of cancer in which malignant cancer cells originate and permeate the body’s lymphatic system. A little-recognized yet critical part of the body, the lymphatic system comprises organs, vessels, and tissues, designed and connected to regulate fluid and particulate matter levels in the body. As blood circulates, small amounts of plasma and matter seep out of the capillaries and into tissues. The lymphatic system pulls this material from tissues and deposits it back into the bloodstream.
In Hodgkin’s lymphoma cases, cancer cells are found in a type of white blood cell known as a B lymphocyte. There is also the presence of the Reed Sternberg cell, which are B lymphocyte cells containing more than one nucleus. As the cancer develops, patients will usually develop enlarged lymph nodes in their groin, arm, or neck (whereas non Hodgkins lymphoma can target any lymph node in the body). They will also likely experience weight loss, fever, and night sweats. And as with many forms of cancer, the resulting tumors may impair normal organ function or other bodily systems. Those with Childhood Hodgkin lymphoma experience anorexia, difficulty breathing, etc. Those with Adult Hodgkin lymphoma can experience night sweats, sensitive skin, etc.
While Hodkin’s lymphoma accounts for just 0.5 percent of new cancers, it is especially prevalent in adolescents ages 15 to 19. And while, according to the National Cancer Institute, treatment can cure Hodgkin’s lymphoma in between 90 and 95 percent of children and 75 percent of adults, the chances of a successful health outcome drop the longer Hodgkin’s lymphoma is undiagnosed and allowed to develop.
Understanding the Risk Factors for Hodgkin’s Lymphoma
Aside from a swollen lymph node, symptoms of Hodgkin’s lymphoma can result from other illnesses, such as some forms of infection. Therefore, doctors cannot make a positive Hodgkin’s lymphoma diagnosis based on symptoms alone. There are several tests used to identify Hodgkin’s lymphoma. However, any diagnosis will begin with a doctor’s review of a person’s medical history, with particular attention to Hodgkin’s lymphoma risk factors.
A medical risk factor is an attribute or behavior that increases your chances of developing a certain disease or medical condition. A risk factor is not a cause, so having a single risk factor does not mean that you will develop the disease or condition definitively. Some risk factors, such as diet, can be changed, while others, such as genetics, cannot.
In the case of Hodgkin’s lymphoma, cancer occurs given a mutation in B lymphocytes. However, why this mutation occurs is unknown. And unfortunately, many of the risk factors associated with this mutation, such as age and gender, cannot be changed.
Hodgkin’s lymphoma is especially prevalent in adolescents. As a child ages, the Hodgkin’s lymphoma prevalence rate increases dramatically. A child 0 to 4 years old is twenty times less likely to be diagnosed with Hodgkin’s lymphoma, while a child 5 to 9 is ten times less likely. By the time a child is between the ages of 10 and 14 years, they are only three times less likely to be diagnosed with this form of cancer.
Hodgkin’s lymphoma is also prevalent among young adults, ages 20-34, and older adults (55+). Depending on a patient’s age cohort, environmental risk factors may vary somewhat. However, several genetic risk factors are common to all cohorts.
Male gender is also a risk factor, though the disproportionate prevalence of Hodgkin’s lymphoma in males declines with age. For example, male children younger than 10 are two to three times more likely to have Hodgkin’s lymphoma than females. This ratio decreases to approximately 1.2 to 1 in children between the ages of 10 and 14. And the incidence rate is similar between genders for adolescents between the ages of 15 and 19.
The prevalence of Hodkin’s lymphoma is approximately the same for white and Black Americans at around 3.1 cases per 100,000 males. However, the prevalence is about half of this in Asians and Pacific Islanders. And at 2.6 per 100,000, it’s also lower among Hispanics.
Some research shows that having parents or siblings with Hodgkin’s lymphoma may have an increased risk of of developing the disease. The risk is higher for people whose siblings have had Hodgkin’s lymphoma than those whose parents have had it. And the risk is higher still for women whose sisters have developed this cancer than if a brother had been diagnosed with it. Conversely, if the individual being diagnosed has a sibling who has had Hodgkin’s lymphoma, their risk of being diagnosed is somewhat lower if the sibling is of the opposite sex or the siblings are two brothers.
For those of any age who have a first-degree relative with Hodgkin’s lymphoma (especially those diagnosed before the age of 30), the risk is higher than those with no family health history of Hodgkin’s lymphoma. According to the National Cancer Institute, the risk is also higher if the siblings are monozygotic twins.
Those previously infected with the Epstein-Barr Virus (EBV) in childhood or adolescence may be at higher risk. This virus causes mononucleosis or “mono,” which typically manifests in symptoms such as:
- Appetite loss
- Sore throat and muscles
- Swollen neck glands
EBV infects B lymphocytes, which is where Hodkin’s lymphoma originates. People infected with EBV may have developed mono or another similar and relatively brief infection. However, there is no vaccine for EBV. Once the symptoms of an EBV-produced illness, such as mono, have passed, EBV will remain latent in a person’s B lymphocytes for the rest of their life.
While EBV infection is quite common, the number of people who develop Hodgkin’s lymphoma after infection is approximately 1 in 1000. EBV infection can lead to a variant of Hodgkin’s lymphoma known as Epstein-Barr virus-positive Hodkin’s lymphoma, which is prevalent in as many as half of childhood cases. It is also just as prevalent in cases involving adults older than 55. However, in cases involving adolescents, it is prevalent in approximately a quarter of Hodgkin’s lymphoma cases and up to 40 percent of adult cases.
There is also some evidence that early exposure to common infections in early childhood may reduce the risk of developing Hodgkin’s lymphoma through adaptive immunity. Accordingly, children with less exposure, such as those without siblings, may be at somewhat higher risk.
People with immunodeficiencies are also far more likely to be diagnosed with Hodgkin’s lymphoma. HIV-positive status in both children and adults is also a Hodgkin’s lymphoma risk factor. Multiple studies indicate that HIV-positive people are ten times more likely to develop Hodkin’s lymphoma than those without, given the immunosuppression HIV-positive people experience.
Children who have recently undergone a solid organ transplant have a higher risk of developing Hodgkin’s lymphoma than the general population. Adult organ recipients who are taking immunosuppressive medications also have a higher risk.
Additionally, children and adults with autoimmune lymphoproliferative syndrome (ALPS) are more than 50 times more likely to develop Hodgkin’s lymphoma. ALPS is a rare disorder characterized by the lymphatic system’s inability to regulate itself, resulting in the overproduction of lymphocytes. This overproduction can enlarge lymph nodes, the kidney, and the spleen. And with an abundance of B lymphocytes, Hodgkin’s lymphoma can develop and take root.
Diagnosis and Treatment of Hodgkin’s Lymphoma
When a doctor has reviewed a patient’s personal and family health history for risk factors, they will conduct a physical examination. How is Hodgkin’s lymphoma diagnosed? If Hodgin’s lymphoma is suspected, they will order several tests, which may include:
- An excisional or incisional biopsy
- Laboratory tests, such as a complete blood count test, an erythrocyte sedimentation rate test, and a chemistry panel
- Imaging examinations, including X-rays, ultrasounds, PET scans, and CT scans
- A bone scan or bone biopsy if the doctor suspects the cancer may have spread to the skeletal system
- Organ function tests, especially if tumor growth lies near an organ and the patient reports pain or functional impairment in the affected area
Given its association prevalence in those positively diagnosed with Hodgkin’s lymphoma, HIV testing can help a doctor further diagnose and determine treatment for the cancer. A doctor may also order a hepatitis test, as some forms of hepatitis are positively associated with non-Hodgkin’s lymphoma. A positive hepatitis C diagnosis, for example, may, along with other factors, help a doctor rule out Hodgkin’s lymphoma.
Hodgkin’s lymphoma is typically treated by either chemotherapy, radiation therapy, or a combination of the two. Doctors determine the exact course of treatment based on the pervasiveness of the symptoms, advancement of the disease, presence and severity of concurrent disorders, and response to initial therapy, among other factors. In the past few decades, most patients have emerged from treatment cured of Hodgkin’s lymphoma, especially those diagnosed and treated before Hodgkin’s lymphoma advanced significantly.
People diagnosed with Hodgkin’s Lymphoma might also be susceptible to mesothelioma, so be mindful of that, as well.
If you or a loved one is experiencing swollen lymph nodes and have some of the Hodgkin’s lymphoma risk factors listed above, you should call Immunity Therapy Center today. We can answer all of your questions about Hodgkin’s lymphoma, determine whether your symptoms result from it or a related disease, and provide you with the high-quality and affordable care you deserve.
Though 90-95 percent of children and 75 percent of adults have been cured after treatment in recent years, those success rates are driven by those who received early treatment. And while the thought of having Hodgkin’s lymphoma is understandably overwhelming, you can maximize your chances of a positive health outcome by contacting a trusted healthcare provider with substantial experience successfully treating Hodgkin’s lymphoma. Contact us today at Immunity Therapy Center and take the first step towards a healthy, cancer-free life.
Written By: Dr. David Alvarez
Dr. David Alvarez is a Board Certified Medical Doctor from Universidad Xochicalco and Certified by the American Heart Association (Advanced Cardiovascular Life Support).
Dr. Alvarez has been collaborating with Dr. Bautista as an Assistant Medical Director at the Immunity Therapy Center for over 6 years. He provides daily on site patient care and participates on the medical board on research and development of patient treatment plans and programs. Dr. Alvarez is a knowledgeable and compassionate Doctor committed to helping patients get to where they want to be health wise through a more holistic and comprehensive approach.
At Immunity Therapy Center, our goal is to provide objective, updated, and research-based information on all health-related topics. This article is based on scientific research and/or other scientific articles. All information has been fact-checked and reviewed by Dr. Carlos Bautista, a Board Certified Medical Doctor at Immunity Therapy Center. All information published on the site must undergo an extensive review process to ensure accuracy. This article contains trusted sources with all references hyperlinked for the reader's visibility.