Less common and not as well known as non-Hodgkin lymphoma, classic Hodgkin lymphoma is another of the main types of lymphoma, or cancer that develops in the lymphatic system. While symptoms tend to be nonspecific and easily linked to other health conditions, knowing the number-one sign of lymphoma and other common symptoms people experience can help you get the right treatment when needed.
According to the American Cancer Society (ACS), there will be about 8,920 new cases of Hodgkin lymphoma (also called Hodgkin disease) diagnosed this year. There are a few key differences between Hodgkin and non-Hodgkin lymphoma. Non-Hodgkin lymphoma can develop in lymph nodes anywhere in the body, while Hodgkin lymphoma usually starts in the upper body, according to Moffitt Cancer Center. Hodgkin lymphoma also tends to progress in a more predictable way than non-Hodgkin lymphoma.
Meet the experts: Sameh Gaballa, M.D., an oncologist and associate member in the Moffitt Cancer Center Department of Malignant Hematology; Jack Jacoub, M.D., a hematologist and oncologist.
Hodgkin lymphoma is most commonly diagnosed in early adulthood, specifically in people between 20 and 39, and in people age 65 and up, according to the National Library of Medicine. As with all forms of cancer, there is a range in severity and health outcomes with Hodgkin lymphoma. The five-year survival rate for all stages of this cancer is 80%, but it improves to 93% when it’s detected early, per ACS data. That’s why early detection is so important.
Oncologists stress that if you’re experiencing any of the symptoms below, chances are that Hodgkin lymphoma is not actually the cause. “Statistically speaking, your symptoms are going to be due to a virus or even an autoimmune condition,” said Jack Jacoub, M.D., a hematologist and oncologist. “But these symptoms need to be investigated.” If a physician does determine that they are linked to Hodgkin lymphoma, it could be an indicator that the disease has progressed, he added.
Read on for the signs that oncologists say you should have on your radar.
Common signs of Hodgkin lymphoma
Painless swollen lymph nodes
As mentioned above, Hodgkin lymphoma impacts the lymph system, which is part of your immune system. Your lymph nodes are small structures that work like filters for foreign substances like cancer cells and infections, according to the ACS. They’re located throughout your body and contain immune cells that can help to fight infection by attacking and destroying pathogens.
Illnesses are common causes of swollen lymph nodes, Dr. Jacoub said. “If you have an infection in your throat, lymph nodes in your neck will swell up,” he said. But you can also get swollen lymph nodes with lymphoma, especially in the neck, armpits, or groin, according to Sameh Gaballa, M.D., an oncologist and associate member in the Moffitt Cancer Center Department of Malignant Hematology.
“Typically, these are painless. They feel rubbery, although sometimes they feel solid or firm,” Dr. Jacoub said. If you find an unexplained lump or you’re simply concerned, it’s best to reach out to your doctor, who can further investigate.
Fever
You can develop a fever from a range of different things, including a simple virus. But a fever from Hodgkin lymphoma will usually show up and stick around, although it may not last 24/7, Dr. Gaballa explained. “It could come in episodes and not go away,” he said. “It may be weeks and you’re still getting these occasional fevers.”
Fevers linked with Hodgkin lymphoma may even come on at the same time every day, Dr. Jacoub said. “There can be a timing pattern where, at five or six in the evening, someone will have a fever. It will happen repeatedly,” he explained. “An unexplained fever like this is a concern.”
Fatigue
Fatigue can be a hard thing to pin down; everyone feels exhausted from time to time. But there are a few signs that fatigue could be due to Hodgkin lymphoma instead of something like a virus. “Typically, if you have an infection, the fatigue would last for a few days and then go away,” Dr. Gaballa said. “For something like lymphoma, it will come in episodes and not go away.”
Further complicating things is that not everyone with Hodgkin lymphoma will experience fatigue. “Some people don’t describe any fatigue, and some people describe disabling fatigue,” Dr. Jacoub said.
Night sweats
You can get night sweats from a range of things, including having a fever or hormonal fluctuations, like going through menopause. But doctors agree that night sweats linked to Hodgkin lymphoma are unique—and intense.
“These are drenching night sweats,” Dr. Gaballa said. “It’s as if you’re taking a shower with your clothes on. It’s not like a little sweat here and there.” These may happen for a few days, go away, and then come back, gradually happening more often, he said. “Initially, it may happen every couple of weeks, and then it’s more persistent,” Dr. Gaballa added.
Unexplained weight loss
There are a few different explanations for why you might start losing weight for no reason with Hodgkin lymphoma. One is that you just may not feel as hungry as usual when you have the disease, Dr. Jacoub said.
But your body may also be working hard to fight the condition and burning more energy than usual along the way, he added. “Your body may not be able to keep up with the caloric intake,” Dr. Jacoub explained.
Itchy skin
It’s possible to develop itchy skin with Hodgkin lymphoma. “There are a lot of different theories on why that might be the case,” Dr. Jacoub said.
One theory is that the itchiness happens when the body releases cytokines, which are chemicals released by the immune system in response to lymphoma and other health issues. Those cytokines can irritate nerve endings in the skin, causing that itchy feeling.
People with Hodgkin lymphoma may have itchiness in their hands, lower legs or feet, or throughout their entire body, according to Moffitt Cancer Center.
Rash
Rash isn’t the most common symptom of Hodgkin lymphoma, but oncologists say it can happen. “This is often a rash that will not go away,” Dr. Gaballa said. “But not everyone gets the same thing.” These usually look like small patches of dry, red skin that show up on the torso, butt, or other areas of the body, he said.
Rashes can even come and go around the same time of day, similar to fevers, Dr. Jacoub added. Just know this, per Dr. Gaballa: “It’s not common to only present with a rash.”
When to call your doctor
Due to the rarity of Hodgkin lymphoma, it’s unlikely that this is what your symptoms point to. But staying informed will help you and your care team narrow down any potential diagnoses. If you experience any of the above symptoms at the same time and they don’t seem to be going away, or you are simply feeling off, it’s always best to consult your physician.
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