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Your child has been diagnosed with Hodgkin lymphoma. You are likely feeling shocked and scared. You are not alone. Support and treatment are available. Your child’s healthcare team will help you as you make important decisions regarding your child’s health.
Hodgkin lymphoma, also called Hodgkin disease, is cancer of the lymphatic system. The lymphatic system is part of the immune system, which helps the body fight infection. The lymphatic system includes:
Lymph: Infection-fighting fluid made mostly of a certain type of white blood cell called lymphocytes.
Lymph nodes: Small bean-shaped organs that filter lymph and store white blood cells. Lymph nodes are grouped together throughout the body. Some areas where they are found include the neck, armpit, and groin.
Bone marrow: Soft tissue found in the center of bones. Blood cells are made in the bone marrow.
Spleen: Organ that stores certain lymphocytes and filters the blood. It’s located under the ribs on the left side of the body.
With Hodgkin lymphoma, cancer cells form in the lymphatic system. When the cancer cells group together, they form a tumor. The tumor can spread (metastasize) to another part of the body, such as the lungs. The presence of cancer cells makes it hard for the body to fight infection and can cause other health problems.
Children at any age can get Hodgkin lymphoma, but teenagers are affected most often. Hodgkin lymphoma is not contagious, meaning your child can’t pass it to another person.
Hodgkin lymphoma occurs when white blood cells grow abnormally (mutate). What causes this to happen is not fully known. If the cells crowd lymph nodes or other areas of the body, they can cause tumors to form. Mutations in certain genes may affect the way your child’s cells grow. This gene mutation is random and couldn’t have been prevented. In rare cases, other factors, such as exposure to certain viruses, chemicals, or radiation, play a role. But most often, the cause of cancer in children is unknown.
Some common symptoms of Hodgkin lymphoma include fever, night sweats, and swollen lymph nodes in the neck, chest, armpits, or groin. Your child may have experienced some of these symptoms, or other symptoms.
Your child’s healthcare provider examines your child. You will be asked about your child’s health history. Your child may also have one or more of the following:
Blood tests to take samples of blood and examine them under a microscope
Imaging tests to take detailed images of areas inside the body. These may include a chest x-ray, CT scan, PET scan, gallium scan, or bone scan.
Lymph node biopsy to take a sample of lymph node tissue and look at it under a microscope
Bone marrow aspirations and biopsies to take samples of bone marrow from the hipbones
Staging is the process that determines the size of the cancer and how much it has spread. Most cancers have their own staging system. Grading is used to describe how abnormal the cancer cells look when seen through a microscope. The more abnormal the cells are, the faster they grow. Staging and grading help the healthcare team plan treatment for your child. They also help determine the likelihood of cure (prognosis). The process used for Hodgkin lymphoma takes into consideration the following:
The presence of symptoms related to Hodgkin lymphoma
Location of the primary tumor
Tumor size and number of tumors
If the cancer has spread to other areas of the body
How abnormal the cancer cells look under a microscope
The cancer is also broken down into stages 1 through 4 (often written as I through IV). The different stage numbers refer to the tumor’s size and if it has spread. For instance, stage I is a very early stage of cancer. And stage IV means the cancer is widespread. Hodgkin lymphoma is also broken down into further classifications, such as “A” and “B.” “A” means the child has no symptoms. “B” means the child has symptoms, such as fever, night sweats, and weight loss. Your child’s healthcare provider can tell you more if needed. Talk to the healthcare provider if you have any questions about the stage of your child’s cancer.
The goal of treatment is to destroy cancer cells. The kind of treatment your child receives depends on the stage of Hodgkin lymphoma your child has. Treatments may be combined. Your child may require one or both of the following treatments:
Chemotherapy (“chemo”) to destroy cancer cells with powerful cancer-fighting medications. Multiple chemo medications may be used. They are given through a tube (IV) that’s usually put into a vein in the arm or chest. Or, they may be given by mouth or injection.
Radiation therapy to destroy cancer cells with high-energy x-rays.
The goal of supportive treatments is to protect the child from infection, prevent discomfort, and bring the body’s blood counts to a healthy range. During your child’s treatment, he or she may be given antibiotics. These are medications that help prevent and fight infection. Anti-nausea and other medications may also be given. These help ease side effects caused by treatment. Your child may receive a blood transfusion to restore the blood cells destroyed by treatment. Blood is taken from a donor and stored until the child is ready to receive it.
With treatment, Hodgkin lymphoma is often curable. But chemotherapy and radiation may cause some problems, such as damage to certain organs. So your child’s health will need to be monitored for life. This may include clinic visits, blood tests, imaging tests, ultrasounds of the heart, and lung function tests.
Receiving a cancer diagnosis for your child is scary and confusing. It’s important to remember that you are not alone. Your child’s healthcare team will work with you and your child throughout your child’s illness and care. You may also wish to seek information and support for yourself. Doing so can help you cope with the changes cancer brings. Learning about and talking with others who also have a child with cancer may help you and your family cope. Some helpful resources include:
Lymphoma Research Foundation www.lymphoma.org
The Leukemia & Lymphoma Society www.leukemia-lymphoma.org