'Subtle' red-flag signs of cancer that mostly affects people under 40

Young adults are being educated about a type of cancer called Hodgkin lymphoma, which predominantly affects individuals in their 20s and 30s. Hodgkin lymphoma is a cancer that targets the lymphatic system, one of the body's primary defences against infections.

It's one of the most prevalent cancers among young people. However, the treatment success rate is quite high, with most teenagers and young adults diagnosed with Hodgkin lymphoma being cured.

Symptoms can be easily confused with other health issues, such as chronic fatigue, night sweats, and a persistent cough. There are two main types of lymphoma - Hodgkin lymphoma and non-Hodgkin lymphoma (NHL).

What exactly is Hodgkin lymphoma?

The most common symptom of Hodgkin lymphoma is the swelling of lymph nodes in the neck, armpit, or groin. Usually, this swelling is painless, although some people may experience slight discomfort, reports Wales Online.

The swelling is caused by an accumulation of white blood cells in a lymph node (also known as lymph glands). These lymph nodes, small, pea-sized lumps of tissue scattered throughout the body, contain white blood cells that are vital in fighting infections.

However, it's important to remember that having swollen lymph nodes doesn't necessarily mean you have Hodgkin lymphoma. A common cold, ear infection, tonsillitis, scalp infection, or mouth ulcers can all cause a lymph node to swell.

Symptoms of Hodgkin lymphoma

A painless lump is typically the primary symptom of Hodgkin lymphoma. However, some individuals may experience other more general symptoms, such as:

• night sweats

• unintentional weight loss

• a high temperature (fever)

• a persistent cough or feeling of breathlessness

• persistent itching of the skin all over the body

The symptoms will vary depending on where the enlarged lymph glands are located in the body. For example, if the abdomen is affected, you might have abdominal pain or indigestion.

Some people with lymphoma may have abnormal cells in their bone marrow at diagnosis, which can cause:

• persistent tiredness or fatigue

• an increased risk of infections

• excessive bleeding – such as nosebleeds, heavy periods and spots of blood under the skin

Occasionally, those with Hodgkin lymphoma may feel discomfort in their lymph nodes when consuming alcohol. It's advisable to see a doctor if you're experiencing symptoms, particularly if you have swollen glands that don't seem to be related to an infection.

Who's most at risk?

While the initial mutation that triggers Hodgkin lymphoma is unknown, there are several factors that can increase your risk, according to the NHS, such as:

• age and gender – anyone can get Hodgkin lymphoma but it's more common in people aged 20 to 40 or over 75; it also affects slightly more men than women

• having a medical condition that weakens your immune system, such as HIV

• having medical treatment that weakens your immune system – for example, taking medicine to suppress your immune system after an organ transplant

• being previously exposed to the Epstein-Barr virus (EBV) – a common virus that causes glandular fever

• having previously had non-Hodgkin lymphoma, possibly because of treatment with chemotherapy or radiotherapy

• being very overweight (obese) – this may be more of a risk factor in women than men

• smoking

Hodgkin lymphoma isn't contagious and isn't believed to be hereditary.

How is Hodgkin lymphoma diagnosed?

If you're concerned about symptoms of Hodgkin lymphoma and decide to visit a GP, they will ask about your health and perform a basic physical examination. If necessary, the GP may then refer you to a hospital for further tests.

You may need a lymph node biopsy, which involves removing some or all of an affected lymph node, which is then examined in a lab. Additional tests may include blood tests, bone marrow sample, chest x-ray, CT scan, MRI scan or a PET scan.

The primary stages of Hodgkin lymphoma are:

• Stage 1 – the cancer is limited to 1 group of lymph nodes, such as your neck or groin nodes either above or below your diaphragm (the sheet of muscle underneath the lungs).

• Stage 2 – 2 or more lymph node groups are affected, either above or below the diaphragm.

• Stage 3 – the cancer has spread to lymph node groups above and below the diaphragm.

• Stage 4 – the cancer has spread through the lymphatic system and is now present in organs or bone marrow.

Treatment

There are several treatment options for Hodgkin lymphoma. One approach is to have chemotherapy alone, while another involves having chemotherapy followed by radiotherapy.

In certain cases, chemotherapy may be combined with steroid medication. Some patients may also receive biological medicines as part of their treatment regimen.

Surgery is not usually used as a treatment method, except when performing a biopsy to diagnose Hodgkin lymphoma. Overall, the treatment for Hodgkin lymphoma is highly effective. Most people with this condition eventually achieve a cure.

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