Hodgkin Lymphoma Staging
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How Hodgkin Lymphoma Spreads
Hodgkin lymphoma usually starts in the lymph nodes. When the disease spreads, it tends to follow an orderly pattern, systematically moving from one lymph node to the next.
Your doctors at Cancer Treatment Centers of America (CTCA) will use advanced diagnostic tests to see how the cancer has progressed through the network of lymph nodes. The process of cancer staging helps us develop a Hodgkin lymphoma treatment plan that's right for you.
Hodgkin Lymphoma Stages
The Cotswold system (formerly the Ann Arbor Staging System) characterizes the stages of Hodgkin lymphoma by the number and location of affected lymph nodes.
Early cancer stages (stages I or II) are described by the number of lymph nodes the cancer has affected. The most advanced stage (stage IV) is characterized by the spread of cancer to other parts of the body. These cancer stages are outlined below:
- Stage I Hodgkin Lymphoma: The cancer has only affected one lymph node region or organ.
- Stage II Hodgkin Lymphoma: Two or more lymph nodes are affected. The cancer is either above or below the diaphragm.
- Stage III Hodgkin Lymphoma: The cancer may now affect lymph nodes on both sides of the diaphragm
- Stage IV Hodgkin Lymphoma: The most advanced stage. Cancer cells have moved beyond the lymph system into other tissues and organs such as the liver, lungs or bones.
Additional Hodgkin Lymphoma Staging
Additional letters, A, B, E and S are often used to further describe Hodgkin lymphoma. The letters A and B indicate the presence or absence of certain symptoms. The letters E and S refer to the spread of the cancer beyond the lymph nodes:
- A & B - The letter “B” is used if any of the following symptoms are present: unexplained weight loss, drenching night sweats, or fever. The letter “A” is used if there is no evidence of B symptoms. If the disease is considered “bulky” (with large tumors, greater than 10 cm in size, spanning the chest region), it is designated with an “X.”
- E & S - Extranodal cancers that have spread beyond the lymph nodes into other tissues or organs are indicated by the letter “E.” An extranodal cancer that has spread to the spleen is indicated by the letter “S.” Approximately 30 percent of people with Hodgkin lymphoma will develop an enlarged spleen (splenomegaly).
Your doctor will also determine whether the lymphoma is low grade (indolent or slow growing), intermediate grade (moderate growth rate), or high grade (aggressive or rapid growth).
Planning Your Hodgkin Lymphoma Treatment
Once your CTCA care team knows the location, type, size, stage and grade of Hodgkin lymphoma, we can plan your treatment. We’ll work closely with you to answer your questions about the cancer staging process and plan treatment that’s tailored to your unique needs.
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