Hodgkin's disease, also known as lymphomaHodgkin's disease or Hodgkin - kind of malignant tumor that develops from lymphatic tissue including lymph nodes and other organs forming part of the body's defense system (spleen, thymus, bone marrow).
Hodgkin's disease (the most commonHodgkin's name) was named after Thomas Hodgkin, who first described it in 1832. Because lymphatic tissue is in many parts of the body, Hodgkin's disease and may also occur almost anywhere. The disease leads to an increase in the lymph nodes and the compression of the surrounding tissues and organs. Tumor cells can spread through the lymphatic or blood vessels in any part of the body.
This illness is, unfortunately, not rare. In 2002, 3377 cases of Hodgkin's disease in adults have been diagnosed in Russia. In 2004, the US became ill with the disease and about 7,600 died about 1320 patients. Here such here the figures. Although due to the success of the treatment of Hodgkin's disease mortality has declined more than doubled compared with the beginning of the 70s.
Hodgkin's disease can occur in both children and adults, but most often it is detected in two age groups: young age (from 15 to 40 years) and older (over 55 years).
Although the causes of Hodgkin's disease today is not clarified, yet some known risk factors that may contribute to its occurrence:
- in patients undergoing infectious mononucleosis;
- in patients with a depressed immune system (eg, AIDS, Acquired Immunodeficiency Syndrome) and after undergoing an organ transplant.
But do not despair, medicine does not stand still and now studies are underway to clarify the causes of this disease.
To recognize the disease - the first step to victory over it
The reasons are not fully elucidated, but disease symptoms are quite well known, the main thing to see them.
Lymphogranulomatosis standard appearsenlarged lymph nodes mainly in the neck, at least - in other areas, increasing the spleen, the body temperature is near 38 and higher degrees within a few weeks or months, there is a severe debilitating sweating, especially at night, during sleep, dramatic weight loss, accompanied by weakness, pale skin color, and sometimes itching, loss of appetite and general malaise.
Enlarged lymph nodes does not hurt and almostconcerned. Only if the increase occurred at the lymph nodes of the thoracic cavity may cause compression of the trachea, which is often accompanied by cough, and dyspnea.
Most patients with months and years of wear on the neckor a tennis ball under his arm, he gradually increases. In fact, this ball, apple or mandarin, was primarily smaller than a pea - elastic painless lymph node. This call tedious rattling in the mind, infinitely patient deactivated. To go back to sleep, do not get up for work or school, do not go to the doctor. To the doctor to go terribly and this visit is infinitely postponed until it becomes impossible to appear topless in the company of friends, or shoulder is no longer free to be pressed against the chest, or groin node grows to obscene proportions. You can look and not see. And my mother and grandmother are fed in the morning breakfast son sitting without a shirt. It is clear that he is looking at himself in the mirror and did not want to think of the tumors, which slowly grows, damaging internal organs, and eventually leads to death. But the family must not only watch, but also to see, say and bring a close to the doctor.
Therefore, the appearance of these symptoms, immediately seek medical advice and conduct a survey. Although these symptoms may be in other diseases, but it is better not to risk it.
The first step is a thorough medical examination anda thorough examination to rule out infection. On examination the doctor will pay particular attention to the condition of the lymph nodes. Given the fact that most people, especially in children, enlarged lymph nodes is often associated with an infection, the doctor may prescribe antibiotics to reduce the size of these units. If, however, the positive effect of such treatment is not observed, it is necessary to further examination.
The only way to confirm the diagnosisHodgkin's lymphoma or Hodgkin's disease is a biopsy, ie, taking a piece of tumor tissue for examination. To do this, in some cases it is necessary to remove the entire lymph node or a small part of it. Expert examines the resulting material under a microscope. Sometimes the initial biopsy does not allow to confirm the diagnosis, and there is the need to perform repeat biopsy. Be prepared for this and do not panic.
Stages of the disease
Determination of disease stage (extent of the process) is a very important point, because from this largely depends on the choice of treatment and prognosis of the disease.
There are four stages of the disease (according to I IV). How to do it? After confirming the diagnosis of Hodgkin's disease is refined stage of the disease with the help of X-ray examination, ultrasound, computed tomography, magnetic resonance imaging and other advanced techniques. They help to identify other tumor foci, perhaps not seen before.
Path to healing
There is reason for optimism - in recent years,achieved significant results in the treatment of Hodgkin's disease. The goal of the treatment, as the doctors say, is a complete cure. According to statistics, about 90% of the patients cured with chemotherapy and radiation.
After clarification stage of the disease need to takedecision and choose the best treatment. We need to think about all possible options. In the appointment of treatment takes into account everything - age, general condition, tumor type and stage of the disease. It is also important to know about the risks and complications of treatment (alas, not without it).
So, there are two main methods of treatmentHodgkin's disease: chemotherapy (the use of drugs that destroy tumor cells) and irradiation (the use of high energy X-rays with the aim of destruction of tumor cells or reduction in tumor size). Sometimes one treatment is used, occasionally in some cases - both.
At the same time, high-dose chemotherapy withBone marrow transplantation is used only in exceptional cases, the ineffectiveness of other treatments. A surgical method has only a supporting role in the treatment of patients with Hodgkin's disease.
And now in more detail.
Under chemotherapy refers to the use ofanticancer drugs that destroy cancer cells. Typically, these drugs are prescribed by mouth or into a vein. Often during treatment with multiple drugs are used simultaneously.
However, you need to know that antitumordrugs destroy cancer cells also damage healthy cells and can cause complications. These complications are dependent on the type and dose of drugs, as well as the duration of treatment. These include: hair loss, mouth sores, increased frequency of infections, increased bleeding, bleeding, fatigue, loss of appetite, nausea and vomiting. But fortunately these complications are temporary and disappear after cessation of treatment and for the prevention of nausea and vomiting, there are special preparations.
However, some drugs can lead toside effects after termination of treatment, even after a long time. They can touch the heart, lung, growth, reproduction. It is not excluded as the likelihood of a second tumor. These problems definitely need to discuss with your doctor before starting treatment.
By the use of radiation therapy is meant high energy x-rays to destroy tumor cells.
Radiation therapy is usually given afterof 3-6 cycles of chemotherapy. Radiation can also cause serious complications, such as damage to the surrounding healthy tissue in the form of redness, fatigue, loose stool. Patients may experience, as in the previous case, and late complications.
High-dose chemotherapy with bone marrow transplant
Sometimes the standard therapy does not cureHodgkin's disease, and therefore the patient is invited to another treatment. In this case, for the destruction of tumor cells resistant to standard chemotherapy using high dose chemotherapy that affects not only on tumor cells but also on healthy blood cells and bone marrow. Therefore prepared in advance and stored bone marrow cells are returned to the patient through a vein.
Another type of transplant is socalled peripheral stem cell transplantation. In this case, a special apparatus selects only of the patient's blood stem (immature) cells. The remainder of the blood is returned to the patient. This procedure usually takes several hours. Stem cells are then frozen and returned to the patient after treatment.
It is believed that the holding of the above proceduresis best done in the earlier period of the disease, rather than when the tumor has spread too far. If the initial treatment was not possible to completely get rid of the tumor, doctors may recommend a transplant.
Hodgkin's disease in children
Although, in general, in the treatment of Hodgkin's diseaseAdults and children alike, but there are some differences. In that case, if the child is old enough, the treatment it differs little from that of an adult patient. If the child is in the stage of active growth, he is more likely to receive chemotherapy than radiation, because radiation therapy may negatively affect the growth of bones and muscles. The goal of treatment in children is more complicated - a full recovery without long-term consequences. And, fortunately, it is doable. Complete cure children with Hodgkin's disease achieved in 85-100% of cases, including patients with advanced process.
As mentioned earlier, treatmentHodgkin now, in most cases, efficiently. According to the US relative survival rate at 1 year after treatment was 93%, while the 5- and 10-year survival rate - 82% and 72%. For 15 years, overall survival was 63%.
It depends on everything, of course, on the degree of spreadprocess. Thus, in Hodgkin disease stage I the relative survival rate of 90-95%, and II - 90-95%, at III - 85-90% and IV - about 80%. Many patients live more than 5 years. The results continue to improve due to the continuous improvement of treatment.
Treatment completed - ahead
Unfortunately, each type of treatment for Hodgkin's diseaseaccompanied by complications. Some of them may be permanent, such as loss of the ability to fertilize. But as they say, forewarned - is forearmed, and if you know in advance about the possible complications, it is possible to speed up the recovery process and reduce their severity.
The main thing to remember is that each bodyunique, including unequal treatment response and emotions. Thus, the same tumor disease vary in different patients, and no one can predict how a particular patient will respond to a particular type of treatment. After all, a person may have preserved immune system, a healthy food culture, excellent support from family members and a strong belief in yourself that will help him to overcome all obstacles and overcome the disease.
But the treatment of the disease fighting limogranulematozomIt is not limited, and after treatment is necessary to be attentive to itself. Monitoring of patients with Hodgkin's disease after treatment is very important. The doctor will explain what research and how it is often necessary to carry out, including blood tests, X-rays of the chest, a CT scan and other methods to identify long-term side effects and complications, as well as early detection of recurrence (return) of the disease.
A good fact is that the majority ofPatients with Hodgkin's disease is completely cured. However, as mentioned earlier, many years after completion of therapy patients may experience serious side effects and complications of varying severity. The most serious complication may be the occurrence of a second tumor. Also, some chemotherapy drugs or a combination of irradiation with increased risk of developing acute leukemia after treatment.
There may be other types of tumors ofwith radiotherapy. For example, young women (under 30 years) who received radiation therapy to the chest area, have a fairly high risk of developing breast cancer a few years after the end of exposure. Such women should be carefully observed and examined for early detection of breast cancer. They are encouraged to perform mammography, clinical examination and breast self-examination. Both men and women who received radiation therapy to the chest area, also have an increased risk of lung and thyroid cancer. Although there is no accepted lung cancer screening programs, and the thyroid gland, this category of patients is subject to frequent inspection and examination. It should also be remembered that the risk of developing these cancers is higher in smoking patients who are treated for Hodgkin's disease.
Less serious, but an important issue related toside effects of chemotherapy and irradiation is infertility. Men often lose the ability to produce sperm. Typically, the process is restored, but not always. In women after treatment with chemotherapy can also stop the process of ovulation and menstruation. After cessation of treatment, these processes can be restored, but they can not come to normal. A radiation therapy to the area in general is resistant ovarian sterilization, if the ovaries have been surgically removed from the irradiation zone. Sad.
Another problem - the fight against infections. Since the immune system of patients with Hodgkin's disease is not functioning properly, these people should pay attention to the prevention of infectious diseases, have to do vaccination, including vaccination against influenza. Furthermore, regarding any infection, they must immediately receive appropriate treatment.
In the course of cancer treatment candamaged thyroid and heart. Many people who have had exposure to the area of the thyroid gland, there is insufficient production of thyroid hormones. Therefore, these patients require replacement therapy. Thyroid function should be investigated, at least annually. Irradiation of the heart can damage the arteries supplying the heart muscle with oxygen. People who received radiation therapy to the chest, increased risk of heart problems. These patients are advised not to smoke and should follow a diet aimed at reducing the risk of heart problems.
All people who have undergone treatment for the diseaseHodgkin should for many years and even decades to be under close medical supervision, to implement their recommendations and to report symptoms appear immediately.
Treatment of Hodgkin's disease, as we already know,aimed at the destruction of all signs of cancer. However, if only a partial effect is achieved, it should be possible to use another type of therapy, such as bone marrow transplantation. After all, no one is immune from the recurrence (return) of the disease.
If a relapse of Hodgkin's disease still manifested(Even after a long period of time), the further treatment is inevitable. It will depend on that therapy that the patient has received previously. For example, if previously used in the treatment of chemotherapy, we can try to assign other chemotherapy drugs. If radiation therapy is applied to a specific area, then re-exposure to the same area is no longer assigned. We must look for other solutions.