Hodgkin's Disease

Hodgkin's Disease is a malignant tumor of the lymph nodes. It was named after the British physician Thomas Hodgkin, who first described the disease in 1832. Hodgkin's disease is found throughout the world and may develop in both males and females at any age, although young adults are most commonly affected. It accounts for about 1% of all malignant tumors.

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Cause and Symptoms of Hodgkin's Disease

The cause of Hodgkin's disease is unknown, but one widely supported theory is that it may be initiated by a virus. However, the disease is not transmitted from person to person, and numerous attempts to isolate an infectious agent from diseased people have not been successful.

The symptoms of Hodgkin's disease are highly variable and may mimic a wide variety of other disorders. The first symptom is usually a painless enlargement of one or more lymph nodes in the neck, although lymph nodes in any part of the body may be the first to be involved. Sometimes, the disease is widespread by the time it is first discovered, and X-rays may reveal unsuspected involvement of lymph nodes deep within the chest and abdomen.

Generalized symptoms developed early in the course of Hodgkin's disease. These symptoms include malaise; loss of weight; anemia and its associated symptoms of easy fatigability and pallor; and fever, which may alternate with periods of normal temperature. As a consequence of the widespread distribution of lymphatic tissue in the body, virtually every organ may become involved as the disease progresses, including the spleen, the bones, the skin, and the lungs. Death is usually the result of the encroachment of tumors on the vital organs and the systemic effects of the disease, which often lead to complicating infections.

Treatment and Prognosis of Hodgkin's Disease

Since Hodgkin's disease usually involves many areas of the body, surgery is of limited value. However, both X-ray therapy and drugs produce rapid shrinkage of the tumors and usually alleviate the generalized symptoms. Although such treatment may significantly prolong life, it is rarely curative.

X-ray therapy is most valuable when the disease is confined to a single group of accessible lymph nodes, such as those of the neck. In such patients, the results of intensive therapy with high-energy X-rays have been particularly promising. Various drugs produce comparable results in most cases, and since they affect tumor tissue throughout the entire body they are more effective in treating advanced cases, in which the tumors are widespread. The most effective drugs in treating Hodgkin's disease are the alkylating drugs, such as nitrogen mustard.

Treatment, whether by X-rays or drugs, is most effective when begun early in the course of the disease. Significant improvement may result from several courses of treatment, but the disease usually recurs in time and eventually becomes resistant to treatment. The average duration of life after the disease is first diagnosed is five years, but occasionally patients may survive for many years. It is uncertain, however, that such patients are permanently cured, since the progression of the disease, like its symptoms, is highly variable.

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