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Physiological Effects of Hodgkin's Disease
In this paper I shall give an overview of Hodgkin's disease while focusing on its physiological effects. Specifically, the paper consists of an overview of the disease, describes how the disease affects the body cells and tissues, and how the treatment attacks the disease and affects the body, besides reviewing the treatments available.
Hodgkin's disease is one of the two (and less severe) types of cancer of the lymphatic system; the other type being non-Hodgkin's lymphoma. The disease is named after the British physician, Thomas Hodgkin, who first discovered the condition in 1832. Hodgkin's disease commonly occurs in young adults (between the ages of 15 to 35) and in older people (over 50-year-olds. However, about 10%-15% of cases have been diagnosed in children below 16 years of age. Statistics also show that more men than women are afflicted by it. ("What are the Key Statistics ... " 2004) Estimates by the American Cancer Society indicate that over 7,500 new cases of Hodgkin's disease are diagnosed every year in the United States. Due to advances in the treatment of cancer in recent years, the survival rate for Hodgkin's is good and approximately 90% of Hodgkin's patients who are diagnosed at an early stage are cured. (Ibid.)
The first symptom of the disease is usually swelling of lymph nodes in the neck or armpit. Other symptoms include fever, chills, night sweats, weight loss, fatigue, and loss of appetite. ("The Hodgkin's Disease," 2000) The cause of the disease is not yet known although certain risk factors such as lowered immunity and infectious mononucleosis have been identified by researchers. ("What are the Risk Factors..." 2004) Hodgkin's is diagnosed by biopsy and is distinguished from non-Hodgkin's lymphoma by the presence of Reed-Sternberg cells -- large cells that contain several nuclei.
How the Disease Affects the Body
Hodgkin's disease, like other cancerous diseases, is basically a disease of the body cells. Body cells are constantly repairing and reproducing themselves. In order to do so, division of cells takes place. Normal cells divide in an orderly and controlled manner; in cancerous cells the process gets out of control and the cells continue to divide, resulting in the formation of abnormal growths called tumors. Hodgkin's also develops in the same way, i.e., when the cells of the lymphatic tissue called lymphocytes become cancerous. ("The Lymphatic System" 2004)
The lymphatic tissue is present in many parts of the body; hence Hodgkin's can start almost anywhere. However, it usually starts in lymph nodes in the upper part of the body -- the most common sites being the lymph nodes in the chest, neck, or under the arms. Hodgkin's disease may result in enlargement of the lymphatic tissue, which can then cause pressure on important structures. The disease, if left untreated, can spread through the lymphatic vessels to other lymph nodes. In majority of the cases, Hodgkin's spreads to nearby lymph nodes only, although in rare cases, the affected lymph cells can get into the bloodstream and spread to almost any other site in the body, including the liver and lungs ("Hodgkin's Disease: Overview" 2004)
In Hodgkin's disease the B-cells are affected that turn into the Reed-Sternberg Cell.
Unlike the non-Hodgkin's Lymphoma (NHL), the Hodgkin's disease usually progresses in an orderly way from one lymph node region to the next and typically spreads downward from the initial site. ("How is Hodgkin's Lymphoma ... " 2004)
How the Treatment affects the Disease and Body?
The aim of treatment of Hodgkin's disease is to destroy or eliminate the cancerous cells. This can be done through Chemotherapy or by Radiation therapy.
In Chemotherapy, drugs are used for killing cancer cells. The drugs can be taken orally in pill or liquid form, or they can be injected. The objective, in whatever way the drug is administered, is the same: that the drug should enter the bloodstream and circulate in the body to reach and destroy cancer cells. Although chemotherapy drugs are designed to specifically attack and kill cancer cells, i.e., cells that are dividing rapidly, they also attack and kill normal cells that grow rapidly to replace dead cells such as cells of the bone marrow, the lining of the mouth and intestines, and the hair follicles. That is why some of the typical side effects of chemotherapy include hair loss, mouth sores, lowered resistance to infection, easy bruising, and fatigue.
("Chemotherapy," 2004). Other side effects of chemotherapy such as nausea and vomiting occur due to the drugs' effect on the cells of intestinal lining and parts of brain which control the appetite. (Ibid.) Most of the side effects of chemotherapy are temporary but certain others such as their effect on the heart, lungs, fertility and growth of children may be permanent.
Radiation therapy is the other major treatment for Hodgkin's disease. It employs the use of high-energy rays to destroy cancer cells (usually those of the lymph nodes) or retard their growth. It works best when the disease is localized and is often combined with chemotherapy in treatment, though alternately. Like chemotherapy, radiation works by destroying the cancer cells. Although the radiation beam is narrowly focused to destroy the cancer cells, it invariably destroys some surrounding healthy tissue too. This is one of the major drawbacks of radiation therapy and leads to side effects whose severity depend on the location of radiation, the duration of therapy and the dosage. ("Radiation Therapy," 2004)
Several advances have been made in treating Hodgkin's disease in recent years. Due to the effectiveness of treatment, Hodgkin's is now considered to be one of the less serious cancers and the success rate of treatment for the disease is over 90%, if diagnosed early.
The major mode of treatment (for about 90% of newly diagnosed patients) is still chemotherapy and/or radiation therapy. ("How Is Hodgkin's Disease Treated?" 2004) Apart from the standard drugs in current chemotherapy, new anti-Hodgkin's drugs are being developed that are likely to be more effective against cases of re-lapse. The modern trend in chemotherapy is towards "gentler" treatment involving lower doses of a larger number of drugs in order to avoid serious and long-term side effects. ("What's New ... " 2004).
Immunotherapy is another promising new field of anti-cancer treatment. It involves the use of monoclonal antibodies that target cancer cells by themselves or through radioactive molecules attached to them. Immunotherapy has the advantage of being no-toxic and is usually used in combination with chemotherapy. Other new treatments for Hodgkin's that are still in the experimental stage include the attempt to produce vaccines and the development of gene therapy. ("New Approaches to Treatment," 2002)
The standard modern treatment in difficult to treat or recurring cases of Hodgkin's disease is the autologous bone-marrow transplant. In the procedure, the patient's own bone marrow is taken out and stored by freezing it; next, high doses of chemotherapy are used to destroy the cancer cells as well as the remaining bone marrow. The stored marrow is then injected back into the bloodstream, which returns to the bone and starts to grow again -- enabling the production of white blood cells to fight infection. ("Autologous Bone Marrow ... " 2004)
'Autologous Bone Marrow Stem Cell Transplantation" (2004). American Cancer Society. Retrieved on September 28, 2004 from http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Autologous_Bone_Marrow_Stem_Cell_Transplantation_and_Peripheral_Blood_Stem_Cell_Transplantation_20.asp?rnav=cri 'Chemotherapy." (2004). American Cancer Society. Retrieved on September 28, 2004 from http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Chemotherapy_20.asp?rnav=cri 'Do We Know What Causes Hodgkin's Disease?" (2004). American Cancer Society. Retrieved on September 28, 2004 from http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_Do_we_know_what_causes_Hodgkins_disease_20.asp?rnav=cri
"Hodgkin's Disease." (2000) The Columbia Encyclopedia, Sixth Edition. Columbia University Press: New York.
'Hodgkin's disease: Overview" (2004) Oncology Channel Retrieved on September 28, 2004 from http://www.oncologychannel.com/hodgkins / 'How is Hodgkin's Lymphoma and the Non-Hodgkin's Lymphomas Different?" (2004) Lymphoma Information Network. Retrieved on September 28, 2004 from http://www.lymphomainfo.net/lymphoma/comparison.html
'How Is Hodgkin's Disease Treated?" (2004). American Cancer Society. Retrieved…[continue]
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This has been the traditionally used mode of treatment for non-Hodgkin's Lymphomas, but the fact remains that there have not been many clinical trials conducted that would reveal the benefits of CHOP in comparison to various other chemotherapy options for the treatment of CLL, which is a very slowly growing form of cancer and is therefore conversely very difficult to treat and cure because of the fact that all