Married Couples Should Consider Post Treatment Infertility for Hodgkin's Disease/ Lymphoma
Hodgkin's disease is a type of lymphoma, a cancer in the lymphatic system. It is a rare disease, accounting for less than 1 percent of all cases of cancer in the US, and occurs most often in people between the ages of 15 and 34, and in people over age 55.Hodgkin's disease cells can also spread to other organs.Hodgkin's disease — also known as Hodgkin's lymphoma — is an uncommon cancer of the lymphatic system, which is part of your immune system.
In Hodgkin's disease, cells in the lymphatic system grow abnormally and may spread beyond the lymphatic system. As Hodgkin's disease progresses, it compromises your body's ability to fight infection.Non-Hodgkin's lymphoma, the other type, is far more common. In the United States in 2004, there were about 7,880 new cases of Hodgkin's disease, compared with 54,320 new cases of non-Hodgkin's lymphoma.Lymphoma is the third most common cancer in children in the United States. Approximately 10 percent of cancers in children less than 15 years of age are lymphomas.Hodgkin's disease rarely arises before the age of 5.
Hodgkin's disease is a type of lymphoma, a cancer in the lymphatic system. It is a rare disease, accounting for less than 1 percent of all cases of cancer in the US, and occurs most often in people between the ages of 15 and 34, and in people over age 55.Hodgkin's disease causes the cells in the lymphatic system to abnormally reproduce, eventually making the body less able to fight infection. Hodgkin's disease cells can also spread to other organs.Lymphomas first start from errors that occur in the DNA of lymphocytes in either the lymph nodes or other lymphoid tissue (such as the spleen or bone marrow) and spread from there.
Lymphomas that involve a particular type of cell, called a Reed-Sternberg cell, are classified under the heading Hodgkin's disease. There are several different subtypes of Hodgkin's disease, based on how the cancerous tissue looks under a microscope.Lymphomas that do not contain Reed-Sternberg cells are classified under the heading non-Hodgkin's lymphomas.
No one really knows exactly what causes Hodgkin's disease. People who have a brother or sister who has had Hodgkin's disease seem to be slightly more likely to get the disease, as are people who have had an organ transplant or acquired immunodeficiency syndrome (AIDS).
Unlike other lymphomas, whose incidence increases with age, Hodgkin's lymphoma has a bimodal incidence curve; that is, it occurs most frequently in two separate age groups, the first being young adulthood (age 15–35) and the second being in those over 55 years old although these peaks may vary slightly with nationality.
The risk of Hodgkin's lymphoma among persons with a history of infectious mononucleosis and found that the risk of EBV-positive tumors was increased among such persons, whereas the risk of EBV-negative tumors did not differ from the expected risk. These observations indicate a causal association between infectious mononucleosis–related EBV infection and EBV-positive Hodgkin's lymphoma in young adults.However,in absolute terms, the risk of Hodgkin's lymphoma after infectious mononucleosis is only on the order of 1 case per 1000 persons. Consequently, other cofactors acting in concert with infectious mononucleosis–related EBV infection presumably must be present for the infection to give rise to Hodgkin's lymphoma.
Lymph nodes are bean-sized organs located throughout the body and connected by a system of lymphatic vessels. These vessels are like veins, except that instead of carrying blood, they carry lymph (a clear fluid containing waste products and excess fluid from tissues) and immune system cells traveling to lymph nodes from other tissues.
In several ethnic groups, Hodgkin's disease was found to correlate significantly with the mean gene frequency of HL-Al and HL-A8. Vianna. therefore, speculated that, "if Hodgkin's disease does have an infectious component with racial distribution of HL-A antigens controlling the degree of susceptibility and transmission, this could have a profound influence on the results of epidemiological, biological, and immunological studies that attempt to determine the nature of this disorder".
During the years 1934 to 1956, 822 patients with unequivocal histological reports of Hodgkin's disease were studied.Survival studies of a substantial number of patients 5, 10 and 15 years after treatment showed that nearly 40 per cent of those suffering from localized Hodgkin's disease are indeed cured.the crude survival rate to the fifteenth year is compared with the expected survival trend for a normal population of similar distribution by sex and age.
The rate of mortality progressively decreases after the fifth year until between the tenth and fifteenth year the death rate no longer exceeds the rate of death of the comparable normal population group. Hence, none of these survivors who had full radical treatment showed any evidence of residual recurrent cancer. Clinically localized Hodgkin's disease can be regarded as about 40 per cent curable.
Survivors of Hodgkin lymphoma (HL) likely have a significantly increased risk of solid cancers throughout their lives, according to a new study that analyzed several variables influencing risk in this patient population. Results from the international study, published in the Journal of Clinical Oncology, give estimates of risk that can help in risk assessment and screening plans for survivors.
After successful treatment of Hodgkin's lymphoma, about two-thirds of patients who wish to have children manage to do so, Norwegian researchers report.
Dr. Cecilie E. Kiserud of Rikshospitalet-Radiumhospitalet Medical Center, Oslo, and colleagues note in their article in the British Journal of Cancer that the number of pregnancies and births achieved by Hodgkin's patients has rarely been examined.
To investigate further, the researchers surveyed 184 women and 269 men who had been treated for Hodgkin's disease between 1971 and 1998. The women were less than 50 years old and the men less than age 65 years at the time they were given the diagnosis.
Survey responses indicated that 120 (45 percent) of the men and 91 (50 percent) of the women attempted to become parents after their treatment.
Of this group, 76 of the men (63 percent) and 68 of the women (75 percent) had a child without use of IVF or other assisted reproduction techniques. A further 10 men and 1 woman achieved parenthood through assisted reproduction.
The type of treatment was significantly associated with subsequently successful parenthood. The highest probability was in patients treated with radiation only or with chemotherapy that had little toxic effect on reproductive organs.
In addition, in women, age at diagnosis was also a significant factor.
Kiserud told Reuters Health, "Fertility-saving tasks should be discussed with patients at risk of post-treatment infertility." That usually means freezing sperm or ovarian tissue before treatment.
"Females should be informed that both the treatment and their age at treatment influence their fertility potential," she added. The researchers note in their report that women more than 30 years old at diagnosis "constitute a subgroup for whom cryopreservation of ovarian tissue should be considered."
Men may opt for cryopreservation of semen before treatment, they add. However, because sperm production "recovers in most of them, their potential infertility after treatment is easier to deal with.
Age, gender, and Epstein-Barr infection can affect the risk of developing adult Hodgkin's lymphoma.Risk factors for adult Hodgkin's lymphoma include the following:
- Being in young or late adulthood.
- Being male.
- Being infected with the Epstein-Barr virus.
- Having a first-degree relative (parent, brother, or sister) with Hodgkin's lymphoma.
Possible signs of adult Hodgkin's lymphoma include swollen lymph nodes, fever, night sweats, and weight loss.These and other symptoms may be caused by adult Hodgkin's lymphoma. Other conditions may cause the same symptoms. 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 no known reason.
- Drenching night sweats.
- Weight loss for no known reason.
- Itchy skin.
- Feeling very tired.
Prevention is the first important step, but for many people with cancer getting a diagnosis, treatment and care are monumental struggles. For too many it requires knowledge, resources and availability that are sorely lacking, non-existent, over-burdened or out of reach.