• Nodular lymphocyte-predominant
• Classical: Most Hodgkin Lymphomas are the classical type. The classical type is broken down into 4 subtypes:
  • Nodular Sclerosing Hodgkin Lymphoma.
  • Mixed Cellularity Hodgkin Lymphoma.
  • Lymphocyte Depletion Hodgkin Lymphoma
  • Lymphocyte-rich Classical Hodgkin Lymphoma

A doctor should be consulted if any of the following problems do not go away:

• Painless, swollen lymph nodes in the neck, underarm, or groin
• Fever for unknown reason.
• Heavy sweating at night.
• Weight loss for unknown reason.
• Itchy skin
• Feeling very tired.

Having a risk factor does not mean that you will get cancer and likewise not having risk factors does not mean that you will not get cancer.

People who think they may be at risk should discuss this with their doctor.

Risk factors for Hodgkin Lymphoma include the following:

• Being in young or late adulthood
• Being male
• Being previously infected with the Epstein-Barr virus
• Being HIV positive
• Having received an organ transplant and taking medications to suppress the immune system
• Having an identical twin or first-degree relative (parent, brother, or sister) with Hodgkin Lymphoma

The following tests and procedures may be used:

• Patient history and physical examination
• Blood tests
• Lymph node biopsy: The removal of all or part of a lymph node for testing. One of the following types of biopsies may be done:
  • Excisional biopsy: The removal of an entire lymph node.
  • Incisional biopsy: The removal of part of a lymph node.
  • Core biopsy: The removal of part of a lymph node using a wide needle.
• Bone marrow biopsy: A small sample (biopsy) of bone marrow is taken from the hipbone. This is usually done under a local anesthetic and takes about 10 minutes. It can feel quite uncomfortable, but you will be given medication to relieve the pain if you need it.
• Radiological studies: like x-ray, CT (computed tomography) scans of neck, chest, abdomen, and pelvis or CT/PET (positron emission tomography scan) may be done to determine extent of disease.

The stage of a cancer is a term used to describe its size and whether it has spread beyond its original area. Knowing the extent of the cancer and the type| helps the doctors to decide on the most appropriate treatment|

The most commonly used staging system for Hodgkin lymphoma is outlined below:

• Stage 1: 1 group of lymph nodes is affected.
• Stage 2: 2 or more groups of lymph nodes are affected on the same side of the diaphragm (the sheet of muscle underneath the lungs).
• Stage 3: Lymph nodes above and below the diaphragm are affected.
• Stage 4: The lymphoma has spread outside the lymph nodes to organs such as the liver, bones, or lungs.

Stages 1-2: are known as early-stage disease and stages 3-4 are known as advanced stage disease.

The prognosis (chance of recovery) and treatment options depend on the following:

• The patient’s symptoms.
• The stage of the cancer
• The type of Hodgkin Lymphoma.
• Blood test results.
• The patient’s age, gender, and general health.
• Whether the cancer is recurrent (has come back after treatment) or progressive (continues to develop even during treatment)

Treatment of newly diagnosed Hodgkin Lymphoma may include the following:

• Combination chemotherapy (more than one chemotherapy medications) with or without radiation therapy, depending on stage
• Radiation therapy alone in certain early-stage cases

Treatment of recurrent Hodgkin Lymphoma (if the disease comes back) may include the following:

• Combination chemotherapy.
• Combination chemotherapy followed by high-dose chemotherapy and stem cell transplant.
• Radiation therapy with or without chemotherapy to relieve symptoms but not to cure the disease (palliative purposes).

You will need regular checkups after treatment for Hodgkin Lymphoma. Your doctor will watch your recovery closely and check for recurrence of the lymphoma.

Checkups ensure that any changes in your health are noted and treated quickly. These visits may include a physical exam, blood tests, chest x-rays, and other procedures.

Between scheduled visits, you should contact the doctor right away if you have any health problems.