Hodgkin's Lymphoma

Introduction :-

• Hodgkin's lymphoma (HL) also known as Hodgkin's disease is a cancer of lymphatic system.
• It was first discovered by Thomas Hodgkin's in 1832.
• HL is a type of lymphoma in which cancer originates from a specific type of WBC called Lymphocytes.
• Lymphoma is a group of blood cancer that develop from lymphocytes.

Definition:-

• "Hodgkin's Lymphoma is also known the cancer of the lymphatic system in which the lymphocytes (WBC cells)grow abnormally and spread beyond the lymphatic system."
• "Hodgkin's lymphoma is a chronic disease the growth of tumor cells take place mainly in the lymphatic node."
• "Hodgkin's lymphoma is a type of lymphoma in which cancer originate from specific type of WBC called lymphocytes."

Types and stages of Hodgkin's disease:-

1. Classical Hodgkin's lymphoma :-(more common type) In this lymphoma people is diagnosed with this disease have large ,abnormal cells called Reed-sternberg cells in their lymph node.
2. Nodular lymphocyte -predominant Hodgkin's lymphoma :-(have better chance of cure) This much rare type of hodgkin's lymphoma involve large ,abnormal cells that are sometimes called Popcorn cells lymphoma.

Staging describe the extent and severity of the disease:-

• Stage 1 (Early stage):- Means that cancer is found in one lymph node region on the cancer is found in only one area of a single organ.
• Stage 2 (locally advanced disease) :- Means that cancer is found in two lymph node region on one side of diaphragm which is the muscle beneath your lung or that cancer was found in one lymph node region as well as in a near by organ.
• Stage 3 (Advanced disease) :- Means that cancer is found in lymph node region both above and below your diaphragm or that cancer was found in one lymphnode area and in one organ on opposite side of your diaphragm.
• Stage 4 (wide spread disease) :- means that cancer was found outside the lymph node and has spread widely to other parts of your body,such as your bone marrow liver or lung.

Causes or etiology of Hodgkin's disease :-

• The main cuase of HL is unknown.
• Disease ha sbeen linked to DNA or genetic mutation. [ Mutation tell the cell to multiply rapidly ,causing many diseased cells that continue multiplying.] 

Risk factor of Disease :-

Factors that can increase the risk of HL :-

• Age :- HL is most often diagnosed in people between 15 to 40 year and these over 55.
• A family History of Lymphoma :- Having a blood relative with lymphoma, increase the risk of developing disease .
• Gender :- male are slightly more likely to develop Hodgkin's lymphoma than are female.
• Epstein Bar Infection :- People who have illness causes by Epstein bar virus such as mononucleosis are more likely to develop HL.
• Weak Immune System.

Sign and Symptoms of Hodgkin's disease :-

• The most common symptoms -swelling of the lymph nodes.
• Night sweats
• Itchy skin 
• fever
• fatigue
• unintended weight loss
• persistent cough,trouble breathing 
• chest pain
• pain in lymph-node after consuming alcohol 
• Enlarged sp;een
• severe Dyspnoea

Diagnostic Evaluation or Investigation:-

• Family history
• physical examination
• Imaging test such as x-ray or CT scan
• Lymph node biopsy for abnormal cells 
• blood test (CBC) to measure of ,RBC,WBC and platelets
• Bone marrow biopsy (to see cancer spread)
• Immunophenotyping to determine the type of lymphoma cells are present.
• lung function test (to determine how well your lungs are working)
• Echocardiogram (to determine how well your heart are working)

Management :-

Hodgkin's lymphoma treatment are right for you depends on the type and stage of your disease and health.

• Chemotherapy :- Chemotherapy is a drug treatment that uses chemicals to kill lymphoma cells (belomycin).Chemotherapy is often combined with radiation therapy in people with eatrly -stage classical type Hodgkin's lymphoma.
• Radiation therapy :- Radiation therapy uses high-energy beams such as x-ray and protons to kill cancer cells.
• Bone marrow transplantation :- also known as stem cell transplant is a treatment to replace with healthy stem cells.
• Other drug therapy :- Drugs used to treat H.D. such as immunotherapy that works to activate your immune system to kill lymphoma cells.  

Nursing Diagnosis:-

1. Risk of infection related to immunodeficiency.
2. Ineffective therapeutic regimen management related to insufficient knowledge.
3. Imbalance nutrition less than body requirement related to malabsorption or pain.
4. Activity intolerance related to weakness.
5. Disturbed body image due to swelling of lymph node or disease condition .
6. Risk for impaired skin integrity due to weakness or immunodeficiency.