Hodgkin's is treated with radiation therapy

March 29, 1994|By Dr. Simeon Margolis | Dr. Simeon Margolis,Special to The Sun

Q: Our 25-year-old son had been perfectly well but went to our family doctor because of enlarged lymph glands in his neck. A diagnosis of Hodgkin's disease was made by examining one of the glands after its removal. We were shocked and understand that Hodgkin's disease is a form of cancer. We would like to know our son's chances of being cured.

A: Hodgkin's disease belongs to a group of lymphatic tissue growths, or neoplasms, collectively called the malignant lymphomas. Specific findings during the microscopic examination of tissue distinguishes Hodgkin's disease from other types of lymphomas, termed non-Hodgkin's lymphomas, which are more common and generally more cancerous. The incidence of malignant lymphomas in this country appears to be rising, and their cause remains unknown.

The onset of Hodgkin's disease in your son is quite typical. It occurs most frequently between ages 15 and 35 or after age 50, and men are affected about twice as often as women. The first symptom of the disease is a painless swelling of the lymph nodes, most often on one side of the neck, but at times in the armpits or the groin. The neoplasm spreads rather predictably to adjacent lymphatic tissue; for example, from the lymph nodes in the neck to those in the chest and from there to lymph nodes and the spleen in the abdomen.

Hodgkin's disease is potentially curable in all patients; but the more the disease has spread, the smaller the likelihood of a complete cure. The treatment plan begins with determining the extent of the disease (clinical staging), particularly involvement of abdominal lymph nodes, the spleen and tissues outside the lymph system, such as the bone marrow or liver.

Common staging procedures include computed tomography, X-rays of the abdominal lymph nodes after injection of dye into the lymphatic system in the legs, and at times exploratory surgery of the abdomen.

FTC Large amounts of radiation (X-ray treatments), given over a four- to five-week period, are effective in curing localized Hodgkin's disease (disease that has not spread to other sites). Nearly 90 percent of patients with disease localized to the neck are cured by radiation therapy. When the disease has spread from a single site, the treatment may involve radiation to a larger area, chemotherapy, or a combination of the two.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

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