Hodgkin’s lymphoma is a type of blood-cancer that is named after the researcher Thomas Hodgkin who documented its pathology in 1832. The condition occurs in four stages, and further, there are five staging categories. All these details help monitor the progress of the condition closely and derive the prognosis or long-term outlook for the patient. Compared to Non-Hodgkin lymphoma, Hodgkin Lymphoma is more predictable, easily treatable and shows good survival rates, thanks to rapid advances in treatment methods, over the years.
Hodgkin Lymphoma or HL, is a type of blood-cancer that affects the lymphatic system. In this condition, one of the types of white-blood-cells called lymphocytes, which circulates both in the blood and lymphatic system, grow abnormally. They crowd out the healthy WBCs in the blood, and in the lymphatic system, they accumulate in various lymph-nodes throughout the body as well as lymphoid-organs such as spleen and thymus-gland. The condition can also spread to organs outside the lymphatic system (that is other than spleen and thymus-gland, which includes liver, lungs, heart, etc).
Since lymphocytes are critical to the overall immunity of the person, HL can affect the person’s immunity making him/her prone to infection and disease.
HL progresses in stages that shows how the disease has progressed. The treatment methods chosen, and prognosis for the patient depend on which stage of the condition he/she is in.
In addition to the above 4 stages, there is also a type of HL that deserves mention.
Refractory disease is the name given to HL when it does not respond to initial therapy. Recurrent disease is the name given to HL that has come back after it was treated. The relapse may happen shortly after treatment, or a few years later.
In addition to 4 stages, there are 5 staging categories. These refer to how the condition has progressed beyond the lymph nodes, and also what are the symptoms present and absent then. These categories are denoted by letters.
A – This indicates that no symptoms have developed.
B – This is used when symptoms include unexplained weight loss, fever and intense sweating in the nights.
E – This indicates extra-nodal cancers. That is, the condition has spread beyond the lymph nodes into other tissues or organs.
S – This is used when the cancer has definitely spread to the spleen. In nearly 30 percent of the cases, the patient will have an enlarged spleen and this condition is called splenomegaly.
X – This is used when the condition is considered “bulky,” with tumours as large as 10 cms and above, spanning the chest region.
So, a combination of stage and category is used to identify the condition in a particular patient. For example, 1E, 2E, 3S, 4S, etc.
In the past, patients treated for HL often developed long-term health issues including leukaemia, breast cancer, myelodysplastic syndrome, thyroid disease, heart disease, lung cancer, lung disease and infertility. Most of these conditions were caused by treatment methods used for HL.
Since 1975, the survival rates for people diagnosed with HL has been steadily going up. While the 5-year survival rate in 1975 was 69.9%, it was 85.4% in 2009. In fact, the death rate for people with HL has dropped by 4.5% every year between 2010 and 2019. (Source: NCI)
The progress is attributed to improvements or advances in treatment methods. Previously, treatment involved heavy doses of radiation and chemotherapy. These methods would destroy the cancer cells as well as healthy cells in the vicinity, triggering secondary cancers and other complications over time. But over the years, treatment for HL has become very advanced. This includes:
The survival rates have improved over the years thanks to various factors:
So today, for people across different stages of HL, survival rates are as follows:
Five-year survival rates by stage are as follows. This is a relative survival rate and what this means is explained in the 1st point:
All the above figures are very heartening, and indicate that of all types of blood-cancer, HL has the most positive prognosis or outlook, or is the most treatable, with a high chance of survival. Most patients do make it out of the condition, getting back to a normal, healthy and long life.
In spite of the above conclusions, it is important to note that there are a whole lot of factors that affect the prognosis, given that all patients are not alike. Factors that decide the actual survival and recovery are:
It is also important to note that all the figures and factors mentioned above are all purely historical. Which means, this is what the records till date tell us. However, with rapid advances in treatment methods, these figures and factors could change for the better.
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