Hodgkin's Disease, Lymphoma and Jacqueline Kennedy

DEAR DR. DONOHUE: Our family would like to know the difference between Hodgkin's disease and non- Hodgkin's lymphoma. Which did Jackie Kennedy have, why wasn't her condition diagnosed in time, and why wasn't it put into remission? How do we prevent these cancers? - T.C.

ANSWER: Lymphomas - Hodgkin's disease is a lymphoma - are cancers of the lymph nodes and lymph-nodelike tissues. They are divided into two main categories: Hodgkin's lymphoma and non- Hodgkin's lymphoma. The two categories have common symptoms, but they each have unique differences in the course of the illness, its outlook and its treatment. Around 100 years ago, microscopic study of lymph-node cancers showed that some of these cancers had a very special kind of cell in them, the Reed-Sternberg cell. Doctors recognized that lymphomas that had this cell behaved differently from other lymphomas, and those cancers were designated as Hodgkin's lymphomas.

Non-Hodgkin's lymphoma strikes about 55,000 people yearly in the United States. It usually occurs around age 50. These cancers are subdivided into a number of varieties, each with its own slightly different characteristics. Common to all is lymph-node enlargement, especially nodes in the neck, under the arms and in the groin. Fever, night sweats, weight loss and fatigue are other common signs and symptoms. Organs other than lymph nodes frequently are involved - brain, lungs, stomach and even skin. Non-Hodgkin's lymphoma is treated with radiation alone or in combination with chemotherapy.

In North America, Hodgkin's lymphoma happens to about 20,000 people each year. It appears in two peaks - one between the ages of 15 and 34, the other after age 50. Lymphnode enlargement is its salient feature too, and about a quarter of patients experience weight loss, night sweats and fever. Itching can be a major feature. Viruses may be involved in its genesis. It is treated with chemotherapy and sometimes radiation.

The outlook for both kinds of lymphoma often is good, and cure can be spoken of for both.

Jacqueline Kennedy suffered from non-Hodgkin's lymphoma. She was the exception to the rule. Her lymphoma was very aggressive and progressed rapidly, despite treatment. That happens in both forms to a few people.

Specific prevention measures are not known.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475. Readers may also order health newsletters from www.rbmamall. com. 2006 North America Syndicate Inc. All Rights Reserved