The lymphatic system is a network of thin tubular vessels that branches out to almost all parts of the body. Scattered in between these vessels are lymph nodes. The job of the lymphatic system is to fight infection and disease. Cancer of the lymphatic system is called lymphoma.

Hodgkins is one of two main types of lymphoma with non-Hodgkins being the other.

  • Hodgkins lymphoma (Hodgkins disease) commonly affects lymph nodes in the neck or in the area between the lungs behind the breastbone. It can also begin in groups of lymph nodes under the arms, in the abdomen or in the groin.
  • It’s named after the British doctor Thomas Hodgkin who first described the disease in 1832.
  • According to the American Cancer Society, nearly 64,000 new cases of lymphoma will be diagnosed this year. This includes 7,350 cases of Hodgkins lymphoma.
  • Hodgkins lymphoma is very treatable and often curable. Eighty-five percent of patients with Hodgkins live longer than five years after diagnosis.

Risk Factors for Hodgkins Lymphoma

The cause of Hodgkins lymphoma is unknown. However, doctors believe immune system problems as well as age may increase a person’s chance of developing this disease.

  • Hodgkins lymphoma has two peak time frames: between the ages of 15 and 40 and in people over age 55. However, the disease can affect anyone.
  • Males are typically more at risk of developing Hodgkins lymphoma.
  • Those who have been infected with the Epstein-Barr virus are more likely to develop Hodgkins lymphoma.
  • Having a parent or sibling with Hodgkins lymphoma also increases risk of the disease.

Signs and Symptoms of Hodgkins Lymphoma

The signs and symptoms of lymphoma are not specific and may also be associated with other, noncancerous conditions. Talk to your doctor if you have any of these problems.

  • Swollen lymph nodes in the neck, underarm or groin.
  • Unexplained fevers.
  • Drenching night sweats.
  • Unexplained weight loss.
  • Constant fatigue.
  • Skin rash or itchy skin.

Unexplained fevers, night sweats and weight loss are known as “B” symptoms. Ask your doctor about their significance in your case.

Diagnosing Hodgkins Lymphoma

To see if you have Hodgkins lymphoma, your doctor will first examine you to assess your overall health and look for anything unusual. He or she may also perform some or all of the following tests.

  • The doctor will order blood tests to evaluate a variety of factors, including the number of blood cells in your blood and how well your liver and kidneys are working.
  • During a lymph node biopsy, your doctor will perform surgery to take out a lymph node. It will then be examined under a microscope to look for cancer.
  • Several imaging tests will be performed to see if lymphoma has spread to other organs. These tests may include CT, PET or gallium scans.

Staging of Hodgkins Lymphoma

The stage of cancer is a term used to describe its size and whether it has spread.

Knowing this helps doctors plan the best treatment.

  • Stage I: Single lymph node or non-lymph node region is affected.
  • Stage II: Two or more lymph node or non-lymph node regions are affected on the same side of the diaphragm (the muscle under the lungs).
  • Stage III: Lymph node or non-lymph node regions above and below the diaphragm are affected.
  • Stage IV: The cancer has spread outside the lymph nodes to organs such as the liver, bones or lungs. Stage IV can also refer to a tumor in another organ and/or tumors in distant lymph nodes.

Treatment Options for Hodgkins Lymphoma

Treatment options depend on the type of lymphoma, its stage and your overall health. Treatment may include chemotherapy or radiation therapy, either alone or in combination. It may help to talk to several cancer specialists before deciding on the best course of treatment for you, your cancer and your lifestyle

  • A radiation oncologist is a doctor who specializes in destroying cancer cells with high energy X-rays or other types of radiation.
  • A medical oncologist is a doctor who is an expert at prescribing special drugs (chemotherapy) to treat cancer. Some medical oncologists are also hematologists, meaning they have experience treating blood problems.

Understanding Radiation Therapy

Radiation therapy, also called radiotherapy, is the careful use of radiation to safely and effectively kill cancer cells while avoiding nearby healthy tissue.

  • Radiation oncologists use radiation therapy to cure cancer, to control cancer growth or to relieve symptoms, such as pain.
  • Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells are destroyed by the radiation, the body naturally eliminates them.
  • Healthy tissues can also be affected by radiation, but they are usually able to repair themselves in a way cancer cells cannot.

External Beam Radiation Therapy

External beam radiation therapy is a series of outpatient treatments to accurately deliver radiation to the cancer cells. Radiation therapy has been proven to be very successful at treating and curing Hodgkins lymphoma.

  • Radiation oncologists deliver external beam radiation therapy to the lymphoma from a machine called a linear accelerator.
  • Each treatment is painless and is similar to getting an X-ray. Treatments last less than 30 minutes each, every day except for Saturday and Sunday, for three to four weeks.
  • Involved field radiation is when your doctor delivers radiation only to the parts of your body known to have cancer. It is often combined with chemotherapy. Radiation above the diaphragm to the neck, chest and/or underarms is called mantle field radiation. Treatment below the diaphragm to the abdomen, spleen and/or pelvis is called inverted-Y field radiation.
  • Your radiation oncologist may deliver radiation to all the lymph nodes in the body to destroy cancer cells that may have spread to other lymph nodes. This is called total nodal irradiation.
  • Your radiation oncologist may also deliver radiation to the entire body. This is called total body irradiation. It is often done before chemotherapy and a stem cell or bone marrow transplant to eliminate any remaining cancer cells and create space for the new stem cells.

Potential Side Effects

The side effects you may experience will depend on the part of the body being treated, the dose of radiation given and if you also receive chemotherapy. Ask your doctor before treatment begins about possible side effects, and how best to manage them.

  • You may experience very few or no side effects and can continue your normal routine during treatment.
  • You may experience mild skin irritation, hair loss, sore throat, upset stomach, loose bowel movements, nausea and/or fatigue. Most side effects will go away after treatment ends.
  • Tell your doctor or nurse if you experience any discomfort. They may be able to prescribe medication or change your diet to help.
  • Hodgkins lymphoma is often curable, allowing many people with the disease to live long lives after treatment. In some very rare cases, the treatments that cured the cancer may lead to significant after effects. Talk to your doctor about the risks of your treatment.

Lymphoma Treatment

Written by: SERO Board-Certified Physicians

Lymphoma, or “cancer of the lymph glands” is usually very responsive to chemotherapy and radiation, and often curable. According to the American Cancer Society, lymphoma is divided into two basic categories: Hodgkin’s Lymphoma (sometimes called Hodgkin’s Disease) and Non-Hodgkin’s Lymphoma. Treatment of these two “cancers” is similar, but not identical.


Non-Hodgkin’s Lymphoma accounts for approximately 4% of all cancers


Almost 20,000 people will die from Non-Hodgkin’s Lymphoma this year


The five-year survival rate for an individual diagnosed with Hodgkin’s Lymphoma is 86%


Approximately 8,500 people will be diagnosed with Hodgkin’s Lymphoma in 2018

What To Know

    There are multiple types of lymphoma, and some risk factors include gender, age, race and geography. Males are more likely to develop lymphoma than females, African Americans and Asian Americans are less likely to develop lymphoma than white individuals. It’s important to understand that having a lymphoma risk factor does not mean you will develop this type of cancer.

Lymphoma Symptoms

Symptoms of Lymphoma will vary based on type, stage and where is it located in the body. Some people will not experience symptoms until the cancer has grown.

In its stages one and two, Lymphoma is in its early stage. As the disease progresses to three and four it is classified as advanced lymphoma. Early diagnosis and treatment often lead to a better disease prognosis.

  • Fever/chills
  • Swollen lymph nodes
  • Shortness of breath
  • Coughing
  • Chest pain
  • Frequent bruising

Diagnosing Lymphoma

If you, a friend or family member are experiencing symptoms of lymphoma, it’s important to contact your doctor for an evaluation. A person may visit their doctor because they have noticed a bump that has not gone away over a period of time.

Your doctor will review your medical history and gather information regarding symptoms, other medical conditions and possible risk factors. During the exam, your doctor will focus on your lymph nodes, and other areas of your body that may be affected. Blood tests can help determine if, and what type, of lymphoma a person has.

An additional method used to diagnose lymphoma a biopsy of the swollen lymph node. It’s important to understand that oftentimes a swollen lymph node is not due to lymphoma, but rather an infection. It is not unusual for doctors to prescribe antibiotics to see if the lymph node shrinks over a period of time. If there is no improvement in the size of the lymph node following antibiotic treatment, your doctor may move forward with a biopsy. However, if symptoms strongly suggest lymphoma may be present, your doctor may move immediately biopsy the affected node.

Lymphoma Treatment

Hodgkin’s Lymphoma is generally treated with chemotherapy. Radiation is sometimes used to “consolidate” the response to chemotherapy, particularly when only one or two sites are felt to carry significant chance of recurrence. Relatively small doses of radiation are used in this setting.

The category of Non-Hodgkin’s Lymphomas contains several subtypes that are treated differently. Some subtypes are very slow growing, and they are sometimes followed by the physician without therapy. Other sub-types require moderately intensive or very intensive chemotherapy. As in Hodgkin’s Lymphoma, a moderate dose of radiation is sometimes used to “consolidate” the response to chemotherapy.

Since lymphomas are relatively sensitive to radiation, radiotherapy is often used to shrink large tumors that are causing symptoms. This is done as a “palliative” measure, to control symptoms and improve quality of life.

Are you ready to take the next step in your Hodgkin’s Lymphoma or Non-Hodgkin’s Lymphoma treatment? Contact our team of 30+ board-certified physicians to discuss your radiotherapy options. We are proud and honored to serve patients across the Southeast U.S. at our cancer treatment centers in Charlotte, NC and surrounding locations.