Hodgkin's treated by drugs, radiation Disease affects lymph nodes, spleen

ON CALL

December 03, 1991|By Dr. Simeon Margolis

Q: My brother was recently told that he has Hodgkin's disease. I would appreciate more information on this disease and how it is treated.

A: Hodgkin's disease is a type of lymphoma (malignant tumors of the lymphatic system) that includes lymph nodes and the spleen. Hodgkin's disease accounts for about one in 100 cancers in this country, and most commonly occurs in people between the ages of 15 and 35, or older than 50. Painless, progressive enlargement of lymph nodes in the neck is often the first manifestation of the disease. Lymph nodes under the arms, in the groin, and within the abdomen or chest may also be involved. Large tumors may cause coughing by compressing the trachea (windpipe) or difficulty in swallowing from pressure on the esophagus. Many patients with Hodgkin's disease complain of weakness, tiredness, fever, night sweats, loss of appetite, weight loss and itching. The diagnosis is made by examination of tissue, usually from a lymph node, removed by a minor surgical procedure (biopsy). Following diagnosis, a number of specialized tests are carried out to determine the extent of involvement of lymphatic tissues elsewhere in the body. This step, referred to as staging, is essential to plan appropriate therapy.

Hodgkin's disease in younger individuals usually begins in one group of lymph nodes and spreads gradually to nearby lymphatic tissues. As a result, the disease is potentially curable if radiation treatment to a localized area of disease is begun before the tumor has spread. When the disease is more widespread, it is treated with one or more drugs (chemotherapy) or by a combination of chemotherapy and radiation. These two forms of treatment have led to a cure in about 75 percent of patients whose Hodgkin's disease has not spread widely throughout the body.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine and associate dean for faculty affairs at the school.

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