Question: I am 19 and was recently told I have stage IIA Hodgkin's disease. Over a year ago I started experiencing a sharp neck pain whenever I had even a sip of alcohol. Was that pain related to Hodgkin's? If I had been diagnosed earlier, would my chances for survival be different?
Answer: Our review of the medical literature did find a relationship between a sharp, localized pain triggered by drinking alcohol and Hodgkin's disease.This pain, often the first symptom of the disease, was first reported in 1950. Several early studies reported that it occurs in 15 to 30 percent of Hodgkin's disease cases, while subsequent studies in the early 1980s reported that the frequency is actually much lower, ranging from 1.5 percent to 5 percent. Researchers haven't identified the cause of the pain.
The most recent study of the survival rate of 136 Hodgkin's disease patients was reported in June in the Journal of Clinical Oncology. Conducted at the National Cancer Institute in Bethesda, Md., this study reported that 100 percent of Stage IA Hodgkin's patients had a complete response to therapy and experienced no relapses.
Of the state IB, IIA and IIIA patients, 92 percent survived 10 years. Treatments in this study used varying intensities of four anti-cancer drugs, abbreviated by the initials MOPP, as well as radiation therapy. Similar results have been reported at other institutions.
Hodgkin's, a malignancy of the lymph system, affects three out of 100,000 people. The most common symptom is painless enlargement of a group of lymph nodes, usually those in the neck or the armpit. The disease starts outside the lymph nodes, such as in the thymus, spleen or lungs, only 9 percent of the time.
As the disease progresses, the body's immune system is weakened to the point that a simple infection can become life-threat-en-ing.
The stage designations used to describe the extent of the disease indicate which lymph node regions are affected and what symptoms are present.
Stages and symptoms of Hodgkin's disease
Stage 1: Only one lymph node region is affected.
Stage 2: Two or more regions are affected, all either above or below the diaphragm.
Stage 3: Regions affected are both above and below the diaphragm and may involve the spleen.
An "A" following a stage number indicates symptoms of weight loss, fever or night sweats. "B" symptoms are associated with a reduced chance of survival.The Medical Adviser is produced by the Palo Alto Medical Foundation using a data base that contains articles from more than 3,500 medical journals around the world. Send your questions to the Medical Adviser in care of this newspaper. For a fee, the Palo Alto Medical Foundation will conduct a personalized medical literature search. For information, call 1-800-999-1999.
1992, the Palo Alto Medical Foundation
(Dist. by United Feature Syndicate Inc.)
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(Chart)
The lymphatic system
A fluid calledc lymph flows through a network of vessels, nodes and other organs. This system drains fluid from the body's tissues into the blood stream, transports fats from the gastrointestinal tract to the blood streem, and fights infection.
Inside the lymph nodes, white blood cells and antibodies filter out the foreign substances such as bacteria. In Hodgkin's disease, these cells multiply out of control. The resulting enlarged nodes lose their ability to fight infection.
Who's counting: Since 1966, 16,047 medical articles have been written on Hodgkin's disease. Only six discuss alcohol's relationship with the disease.
Kevin Boyd - Medical Information Service Distributed by United Feature Syndicate.