Hodgkin lymphoma [HODJ-kin lim-FOH-muh] — also called Hodgkin disease — is a very rare kind of lymphoma or cancer of the lymphatic [lim-FAT-ik] system. Children with Hodgkin lymphoma have cells in their lymphatic system that get damaged or changed in a way that makes them grow and multiply when they shouldn’t. Cancer cells replace healthy cells, which damages the organs in the body and stops them from working properly.
The Lymphatic System
The lymphatic system fights germs and moves fluids into the bloodstream. It helps keep blood moving around your child’s body and keeps your child from getting sick. The lymphatic system also helps your child get nutrients from food. Inside of the lymphatic system, there are bundles of tissue called lymph nodes that filter the fluid that the lymphatic system is moving around in your child’s body. There are lymph nodes all over the body that contain white blood cells to help fight germs and keep out certain diseases.
Hodgkin lymphoma isn’t the only form of lymphoma. All other kinds of lymphoma are called non-Hodgkin lymphoma. The difference between Hodgkin lymphoma and non-Hodgkin lymphoma is the type of cell in which the cancer starts.
There are 2 kinds of lymphoma that appear in children:
- Hodgkin lymphoma. This kind of lymphoma is present if there is a type of cell in the lymphatic system called a Reed-Sternberg cell. The Reed-Sternberg cell is larger than the cells around it and it can be viewed under a microscope.
- Nodular lymphocyte-predominant Hodgkin lymphoma. This kind of lymphoma is caused by cells that are different than the Reed-Sternberg cells found in the more common Hodgkin lymphoma. Doctors may classify the disease further based on how the cells in your child appear under a microscope.
Children who have Hodgkin lymphoma may have these symptoms:
- Swollen lymph nodes that don’t cause any pain. Lymph nodes may swell in the collarbone, neck, chest, groin, or armpit.
- Fever that isn’t a result of another condition.
- Loss of weight.
- Lethargy or fatigue.
- Itchy skin.
Keep in mind that these symptoms can also be caused by other conditions, and don’t always mean that your child has Hodgkin lymphoma. Tests are needed to diagnose this condition and rule out other causes.
The exact cause of Hodgkin lymphoma is not known, but doctors have found some things that could increase your child’s risk of getting this kind of cancer. These things include:
- Epstein-Barr virus infection. The Epstein-Barr virus causes mononucleosis [mon-uh-noo-klee-OH-sis] — also called “mono” — and has been linked to several types of cancer.
- HIV infection.
- Other diseases. Other diseases can damage the immune system or make it weaker.
- Inheritance. A child has a greater chance of getting Hodgkin lymphoma if other family members or ancestors have been diagnosed with the disease.
There are many different tests that may be used to figure out if your child has Hodgkin lymphoma, such as:
- Physical exam and medical history. The doctor will examine your child’s body for signs of swollen lymph nodes and other signs of the disease. The doctor will ask you and your child questions about other illnesses and symptoms your child has experienced.
- CT scan. A CT scan is an imaging test where pictures are taken of the inside of the body using x-rays.
- PET scan. The PET test (Positron Emission Tomography) is a test that uses a dye injected into your child’s bloodstream to highlight areas where the cancer may be growing.
- X-ray. An x-ray is an imaging test where a picture is taken of the inside of your child’s body using an electromagnetic ray.
- Complete blood count and other blood tests. Samples of blood may be taken from your child’s arm and then examined by a pathologist for signs of Hodgkin lymphoma.
- Lymph node biopsy. This is a type of procedure used to remove parts of a lymph node and test them for cancer. All or part of a lymph node may be taken out for viewing under a microscope.
- Immunotherapy [im-yuh-noh-THER-uh-pee]. Immunotherapy is a type of therapy used to strengthen the immune system. This can help build resistance to a disease or help the body better fight the cancer.
Once your child’s doctors diagnose Hodgkin lymphoma, they will also assign the cancer a stage of I, II, III, or IV. The stage is a way of describing how much the cancer has grown and spread. Earlier stages mean that the cancer has not yet spread to other parts of the body. An early stage usually means that the cancer will be easier to treat. There are other symbols that doctors use to stage cancer based on its location and growth. Talk to your provider if you need more help understanding your child’s condition.
Additional scans and tests may be needed to figure out the cancer’s stage. Doctors may perform tests that take pictures or samples from the inside of your child’s body.
Treatment for Hodgkin lymphoma depends on the stage of your child’s cancer, what kind of lymphoma they have, and their other medical conditions. Treatments may have side effects that cause pain which needs to be managed. Your doctor will work with you and your child’s medical team to decide on a treatment plan that considers all of these issues.
Some treatment options for Hodgkin lymphoma include:
- Chemotherapy [kee-moh-THER-uh-pee]. Chemotherapy is a type of treatment where drugs that stop cancer from growing are put into your child’s bloodstream or taken by mouth. Chemotherapy can kill both cancer cells and your child’s normal cells and may come with painful side effects.
- Radiation therapy. Radiation therapy is a type of treatment where doctors aim a high-energy beam that causes cancer cells to die or stop growing. Radiation can also damage normal cells and come with painful side effects that depend on where the therapy is given to your child.
- Steroids. Some kinds of steroids can help treat cancer as well as the side effects of cancer treatment.
- Stem cell transplants. Stem cell transplants replace damaged cells with healthy ones.
- Other clinical trials and treatments that are being developed. Your doctor may offer you the chance to try out a new treatment method that is in the process of being developed. These clinical trials may have unexpected side effects, but they have other advantages as well. Talk to your doctor about any ongoing clinical trials that you might be interested in trying for your child.
This is not a complete list of treatment options that may help cure your child’s Hodgkin disease. Your doctor can help you find the right treatment for your child’s situation.
Some people may be able to prevent Hodgkin lymphoma by reducing their risk of getting:
- An Epstein-Barr virus infection. This virus is passed through the saliva of infected people.
- An HIV infection. HIV infections may be prevented by avoiding behaviors or activities that allow HIV-infected fluids — such as semen, vaginal secretions, blood, and breast milk — into the body.
- Other diseases. Other diseases can damage the immune system or make it weaker. Ask your doctor about these diseases.
If Hodgkin lymphoma is detected early, your child’s doctor may be able to help your child prevent a more serious outcome.