Hodgkin’s lymphoma is a cancerous tumor that is formed from white blood cells, leukocytes, connecting with multiplied Reed-Steinberg cells. They are present in the patient’s lymph nodes, which was the initial indicator of the disease. Symptoms of the disease include nocturnal fevers and profuse sweating, which was present in the patient’s medical history. In addition, the location of the tumor in the neck region is typical of this disease. B-lymphocytes begin to unnaturally multiply in excessive numbers and collect in a tumor in the lymphatic system, for example, in the tonsils. It should also be noted that the age of the patient is close to one of the statistical peaks of the manifestation of this disease. The first period of its manifestation refers to the third decade of life, which almost falls under the age category of the test subject.
Despite certain high-risk sites of manifestation, Hodgkin’s lymphoma can appear anywhere in the human body. This is due to its principle of connection with the lymphatic system of a person passing through the whole body. More common lymphomas of another type are formed in the tumor with the help of lymphocytes without specific Reed-Steinberg cells. It is by them that Hodgkin’s disease is identified (Wang et al., 2019). The exact explanation for the growth of lymphocytes in both cases is not explained by anything other than the program embedded in the DNA for the reproduction of certain cells (Weniger & Küppers, 2021). Hodgkin’s lymphomas may be easier to treat and treat because they are easier to detect at an earlier stage and predict disease progression (Brice et al., 2021). Non-Hodgkin’s lymphomas are subdivided into the more common B-cell lymphomas and the rarer T-cell lymphomas (Singh et al., 2020). They are also identified by swollen lymph nodes, but affect adults more than young people under 30 years of age. Moreover, these lymphomas, unlike Hodgkin’s disease, can also appear in organs, and not only in the lymph nodes, for which they are called extranodal.
The staging system developed at Ann Arbor is suitable for both Hodgkin’s and other types of lymphomas. The first stage of the development of the disease is counted from the identification of an accumulation of leukocytes in one lymphatic region or in some non-lymphatic region of the body (Sapkota & Shaikh, 2020). The next stage is recorded when two or more areas of the lymphatic system affected by lymphoma can be counted in the body, or lesions of the lymphatic and extralymphatic regions at the same time. The second stage is characterized by the spread of lymphomas only on one side of the diaphragm, but the third stage of the spread of the disease suggests that both sides of it are affected. The last stage means that one area of the body or one organ is fully involved. Associated symptoms include weight loss, unexplained fever, and fever. An external sign according to the characteristics of Ann Arbor indicates an external tumor reaching up to 10 cm in diameter (Lewis & Lilly, 2020). The fourth stage is also associated with disease and damage to the entire lymph node system.
One of the most common therapies in the treatment of Hodgkin’s disease is radiation, which is able to remove cells with X-rays, choosing exactly those that belong to cancerous ones. Radiation exposure can be applied to the patient both from the outside and from the inside in the area affected by the tumor (McCarten et al., 2019). Side effects such as nausea, digestive problems and loss of appetite should be considered. An analogue of radiation therapy can be offered medical intervention also known as chemotherapy. Taking medications that target growing leukocyte cells can also affect non-cancerous cells, which also entails a series of side effects. It would be logical to start with medical treatment to stop the disease and then, if necessary, resort to radiotherapy. Subsequently, it would be possible to consolidate the positive results of one form or another of biological therapy. This type of therapy involves the introduction of immune cells or antibodies into the body in order to stimulate the immune system to fight cancer cells on its own. GVD chemotherapy is a combination of three drugs, gemcitabine, vinorelbine; and Doxil, which must be used together (Driessen et al., 2021). This treatment can be used even after stem cell transplants, given for three weeks in a month. In addition, pembrolizumab, which is an antibody suitable for the treatment of cervical lymphomas, should be included as part of the course of chemotherapy. A side effect of this drug, better known by the brand name Keytruda, is fever, diarrhea, muscle pain, nausea, and itching.
People with Hodgkin’s lymphoma are at risk of getting other cancerous or similar diseases in the long run. Unfortunately, this risk is only exacerbated by the use of chemicals that are required to heal the body. The patient is at risk of getting the next cancer about a decade after the first lymphoma is cured. Radiation therapy can cause shortness of breath, which is only exacerbated by side effects of a similar nature due to medication and can last for years. Later manifestations of lymphoma may be prolonged digestive dysfunction associated with various infections of the lymph node system. Finally, in the process of receiving treatment and experiencing a difficult illness, due to the entire load on a person, the cardiovascular system is seriously affected, which is a fairly common complication.
The vast majority of people pass the five-year survival threshold after treatment for lymphoma, and this prognosis can be applied to the patient as well. However, the risk of complications in the form of recurrent malignancy is still relevant. Despite this, lymphoma can be cured completely, which is likely at the level of tumor development in the patient, but several cycles of mixed chemotherapy are required.
The Lymphoma Research Foundation’s website is dedicated to providing free information to raise awareness of Hodgkin’s disease and to provide a sense of togetherness for those who suffer. Within the framework of the organization, peer support mechanisms, webinars, and even financial support are being formed (“Awaiting or recent diagnosis,” n.d.). There is also a permanent hotline with answers to questions and advice. Another resource for this 31-year-old patient is the charity and research organization Young Lives with Cancer Cancer (“Hodgkin Lymphoma,” n.d.). The resource is focused on supporting youth and children facing the disease, and selects both informational manuals and live help from a consultant. The assistance provided by the foundation can help the families of patients financially, legally or by appointing a social service specialist.
Awareness of the context surrounding the disease when prescribing treatment seems to me especially important after reading the case. The prescription of drugs for oncological patients is always associated with great responsibility, where the prescription of a drug is not only beneficial but also poisonous for the patient, compromising their health. The realization that the patient must look for ways to inform himself about his condition and to work independently with the disease was also valuable to me. Studying the resources that could be recommended within the framework of the case, I realized that there is a whole network of resources for psychological and material support for people who encountered this disease early.
References
Brice, P., de Kerviler, E., & Friedberg, J. (2021). Classical Hodgkin lymphoma. The Lancet 398(10310), 1518-1527. Web.
Driessen, J. D., Tonino, S. H., Moskowitz, A. J., & Kersten, M. J. (2021). How to choose first salvage therapy in Hodgkin lymphoma: traditional chemotherapy vs novel agents. Hematology, ASH Education Program 1, 240-246. Web.
Lewis, W. D., & Lilly, S. (2020). Lymphoma: Diagnosis and treatment. American Family Physician 101(1), 34-41. Web.
Lymphoma Research Foundation. (n.d.) Awaiting or recent diagnosis. Web.
McCarten, K. M., Nadel, H. R., Shulkin, B. L., & Cho, S. Y. (2019). Imaging for diagnosis, staging and response assessment of Hodgkin lymphoma and non-Hodgkin lymphoma. Pediatric Radiology 49, 1545–1564. Web.
Sapkota, S., & Shaikh, H. (2020). Non-Hodgkin lymphoma. Europe PMC. Web.
Singh, R., Shaik, S, Negi, B. S., Rajguru J.P., Patil, P.B., Parihar, A. S., & Sharma, U. (2020). Non-Hodgkin’s lymphoma: A review. Journal of Family Medicine and Primary Care 9(4), 1834-1840. Web.
Wang, H.-W., Balakrishna, J. P., Pittaluga, S., & Jaffe, E. S. (2019). Diagnosis of Hodgkin lymphoma in the modern era. British Journal of Haematology 184(1), 45-59. Web.
Weniger, M. A., Küppers, R. (2021). Molecular biology of Hodgkin lymphoma. Leukemia 35, 968–981. Web.
Young Lives with Cancer. (n.d.) Hodgkin lymphoma. Web.