Hodgkin illness, also known as Hodgkin lymphoma or HL, is a cancer of the blood and lymphatic system. It's the most typical type of blood cancer and also the third most typical childhood cancer. The illness is named for Thomas Hodgkin (1798-1866), the British doctor who first described it in 1832.
Hodgkin illness is one of the two main types of lymphoma, a type of cancer that originates in lymphocytes, that are a particular kind of white blood cells in the immune system. It's unusual in that it primarily affects two various age groups, adolescents and young adults between the ages of fifteen and thirty-five, and older adults over age fifty-five. Hodgkin begins in the lymphatic system, a group of organs and tissues that are component of the immune system and also help to type new blood cells.
The lymphatic system includes lymph nodes, little organs composed of lymphoid tissue situated at numerous points throughout the body that are joined by lymphatic vessels; the spleen, a little organ on the left side of the abdomen; the bone marrow; and the thymus gland, which is just beneath the neck. Hodgkin disease begins when a type of lymphocyte known as a B cell turns into an abnormal type known as a Reed-Sternberg cell.
These abnormal cells continue to reproduce themselves until they form a tumor. In most cases this first tumor develops in one of the lymph nodes above the diaphragm (the thin sheet of muscle that divides the chest cavity from the abdominal cavity); nevertheless, the tumor can develop in a group of lymph nodes or elsewhere in the lymphatic system.
The illness usually spreads from lymph node to lymph node along the lymphatic vessels rather than skipping about the body. In the later stages of the disease, it spreads outside the lymphatic system to other organs. You will find two fundamental subtypes of Hodgkin illness: classic, which accounts for 95 percent of cases, and nodular lymphocyte predominant Hodgkin illness (NLPHD), which accounts for the remaining 5 percent. NLPHD differs from classic Hodgkin diseae in that it occurs primarily in lymph nodes in the neck and armpits, and its big abnormal cells are known as “popcorn” cells simply because they appear like pieces of popped popcorn under the microscope.
Hodgkin lymphoma is really a relatively rare type of cancer, affecting two or three people in every 100,000. It accounts for less than 1 percent of cancers worldwide. As of 2008, there had been about 500,000 people in the United States with some form of lymphoma, but only 143,000 had Hodgkin illness. According to the National Cancer Institute (NCI), about 8,200 new cases of HL are diagnosed in the United States each year, and 1,350 individuals die from the illness annually.
The rates for Hodgkin disease vary according to race and sex. The highest rates are in Caucasian males (3.2 cases per 100,000), followed by African American males (3.0 cases per 100,000), Caucasian females (2.6 cases per 100,000), African American females (2.1 cases per 100,000), Asian American males (1.4 cases per 100,000), and Asian American females (1 situation per 100,000). About 10 percent of cases of Hodgkin are diagnosed in kids below the age of fourteen; 85 % of these are boys. Even though the cause of Hodgkin illness is nonetheless unknown, researchers have identified several factors that increase a person’s risk of developing this type of cancer:
Although researchers know that Hodgkin disease begins using the formation and multiplication of abnormal cells, they don't but know what triggers this formation. Some scientists think that certain kinds of viral infections, genetic factors, or environmental toxins might be involved. The signs and symptoms of Hodgkin illness include:
The doctor generally begins by taking a medical history, because you will find many causes other than Hodgkin for swollen lymph nodes, fever, and a few of the other early signs and symptoms of the illness. In some cases, a patient with classic Hodgkin has no early signs and symptoms, and the disease is found during a routine chest x ray. In most cases the disease is diagnosed by a tissue biopsy. The doctor removes a small piece of tissue from a swollen lymph node either by cutting directly into the swollen node or by withdrawing a tissue sample through a fine needle.
In addition to looking for abnormal cells in the tissue sample, the doctor might use certain types of chemical tests to search for proteins attached towards the surface of the abnormal cells. In addition to a tissue biopsy, the physician may order blood tests or a bone marrow biopsy. Blood tests are helpful in evaluating the kind of chemotherapy that could be best for the patient.
In addition, imaging tests could be used to determine the location and extent of the illness. These tests might include x-ray studies, magnetic resonance imaging (MRI), computed tomography (CT) scans, positron emission tomography (PET) scans, and a gallium scan. This final kind of test makes use of a radioactive element given intravenously to identify affected lymph nodes.
The first step in treating any kind of cancer is called staging. Staging is a description of the location of the cancer, its size, how far it has penetrated into healthy tissue, and regardless of whether it has spread to other components of the physique. Hodgkin disease is classified into four stages:
Stage I and Stage II Hodgkin illness could be treated with radiation therapy, chemotherapy, or a combination of both. Only low-dose radiation therapy is used in girls and ladies, simply because regular doses of radiation will increase their threat of breast cancer in later life.
Stages III and IV. Chemotherapy might be used by itself to treat advanced-stage Hodgkin as well as being combined with radiation therapy. You will find 5 different combinations of drugs that are currently utilized; some of these are fairly toxic and have severe side effects. The drug combination preferred by most medical doctors in the United States is known as ABVD, the initials of the 4 drugs that are administered.
Sufferers who're not cured by radiation therapy and chemotherapy, or whose illness recurs right after chemotherapy, might be treated having a combination of high-dose chemotherapy and bone marrow transplantation. The bone marrow transplantation is needed simply because the high doses of anti-cancer chemicals will damage the patient’s personal bone marrow and result in a life-threatening shortage of the red and white blood cells produced in the bone marrow.
Hodgkin illness is potentially curable, although the treatments that are currently used increase the patient’s threat of developing a second type of cancer later in life. As of 2008, 90 % of patients with Stage I or II illness lived for 5 years right after treatment. The five-year survival rates for Stages III and IV are 84 % and 65 percent respectively. In between 20 and 25 percent of all sufferers diagnosed with Hodgkin will die of the illness. In the first fifteen years after treatment, recurrent Hodgkin will be the major trigger of death among patients; after fifteen years, death from other causes is more common.
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