Childhood cancers

Hodgkin's disease

Hodgkin's disease, also called Hodgkin's lymphoma, is a disease of the lymph tissues—the main component of the body's infection-fighting immune system. The disease affects both children and adults. It is most common in early adulthood and late adulthood. About 10 to 15 percent of the total cases occur in children age 16 and younger. Survival has improved dramatically because of advances in treatment. Non-Hodgkin's lymphoma is more common in younger children than Hodgkin's disease.

Risk factors
The majority of children and adults with non-Hodgkin's lymphoma have no known risk factors for the disease. It's important for parents to remember that for the most part there is nothing anyone could have done to prevent this cancer. The causes of Hodgkin's disease do not appear to be related to genetic or environmental factors. Risk factors include conditions or diseases that weaken the immune system, including:

	HIV infection
	Taking immune-suppressing drugs after an organ transplant
	Conditions present at birth that affect the immune response

Symptoms
Symptoms vary widely. Some people have no symptoms. The most common symptom is swollen glands that persist over time. Parents should realize that swollen glands usually do not mean cancer. Normally, when glands swell, it's because the child is fighting off a common childhood illness, such as a cold or other type of infection. Therefore, determining the cause of swollen glands requires further investigation. If a tumor is located near the windpipe (trachea) it can produce a cough. Children may also experience fever, night sweats, fatigue and loss of appetite.

Questions to ask your child's doctor

Diagnosis
A medical history and physical exam can help determine if a child needs further evaluation. Because swollen lymph nodes are so common in children and infants, the diagnosis of Hodgkin's disease can be delayed. To determine if the swelling is caused by an infection, a child with swollen glands might be given antibiotics before deciding on additional tests. If antibiotics are ineffective, a biopsy may be performed. This involves removing a small sample of the lymph tissue so it can be examined under a microscope. Additional tests, such as bone marrow aspiration, may be required to further identify the type of cancer. Diagnosing cancer

Treatment
Before cancer is treated, it has to be staged. Staging involves finding out where the cancer is located, the extent of the cancer and whether it has spread. In children, chemotherapy is the primary treatment for this disease. Chemotherapy drugs can be given by mouth, through a vein or injected into a muscle or cerebrospinal fluid. Low-dose radiation therapy can also be used. Treatment can cause side effects. Be sure to discuss these side effects thoroughly with the pediatric oncologist before your child begins therapy.

Bone marrow stem cell transplantation or peripheral stem cell transplantation are for children who relapse during or after treatment for Hodgkin's disease. (For information on bone marrow or peripheral stem cell transplantation, see the National Cancer Institute site.)

Clinical trials, protocols and research

Learn more
• YNHH Health Library: Hodgkin's Lymphoma

Last revised: Jan. 8, 2008 (dh)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.