What other questions would be helpful to determine the source of these symptoms?
Some of the questions include if the patient has experienced a rapid loss of weight in the past six months. The second question is whether the patient has experienced drenching night sweating which leads to their nightclothes or bed sheets being so wet until they need to change them. The other question can be if the patient has experienced unexplained fever with a high temperature of 38 0 C or above (Cancer.Net, 2017) .
The health care provider (HCP) has ordered a chest x-ray because he is suspicious of Hodgkin lymphoma. What is the rationale for this order?
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Hodgkin lymphoma is lymph nodes disorder that epitomized by the presence of the Reed-Sternberg cell. It is known to be rampant in men as compared to women, that is, it is twice more widespread in men than women. One of the major symptoms that indicate the clinical manifestation of Hodgkin lymphoma is the presence of a lymph node which is both enlarged and painless (Cancer.Net, 2017) . Additionally, even in the absence of other symptoms such as drenching night sweats, bruises and itching skin, and fatigue, symptoms such as intermittent fever and chills together with enlarged and painless lymph node, are sufficient enough to suspect Hodgkin lymphoma. As such conducting a chest x-ray to detect the enlarged lymph nodes and measure their masses is a right move by the health care provider (HCP).
How will you respond to Mr. J’s concerns?
Mr. J is concerned that he is going to succumb to Hodgkin lymphoma in the next six months. However, as an HCP, I would inform Mr. J that Hodgkin lymphoma can be treated and full recovery is realized. Unlike Non-Hodgkin lymphoma, this disease is very treatable since it is fairly predictable in its spreading mechanism. Particularly, it is usually restricted to the lymph nodes and spread from one lymph node to another. Thus if adjacent lymph nodes are removed there is a possibility of eliminating the cancerous cells.
What constitutes a definitive diagnosis of Hodgkin lymphoma?
Hodgkin lymphoma is a very curable disease, but to cure it a definitive diagnosis needs to be established. The definitive diagnosis of Hodgkin lymphoma is provided by lymph node biopsy. It involves testing a sample lymph node tissue for the presence of Reed-Sternberg cells.
What are some manifestations associated with non-Hodgkin lymphoma?
Some of the common manifestations of Non-Hodgkin lymphoma include painless swelling around the lymph node-bearing part of the body (CTCA, 2018). Additionally, symptoms such as chills, unexpected weight loss, fatigue, chest pains, shortness of breath, frequent infection, and easy bruising or bleeding are indicators of Non-Hodgkin lymphoma (CTCA, 2018). In addition to these symptoms, Non-Hodgkin lymphoma patients also have B symptoms such as unexplained weight loss in six months, intermittent fever, and drenching night sweats (CTCA, 2018).
The lymph node biopsy is positive for the Reed-Sternberg cell. What type of treatment is indicated?
If the lymph node biopsy is positive for Reed-Sternberg cells, then Mr. J is suffering from Hodgkin lymphoma. The main treatments for Hodgkin lymphoma are chemotherapy and radiation therapy. The most widely used form of chemotherapy in treating Hodgkin lymphoma is ABVD ( adriamycin ( doxorubicin ), bleomycin , vinblastine , dacarbazine ) drug combination (American Cancer Society, 2019). Depending on the case, they can be used as standalone or combined. Other forms of treatment include immunotherapy and stem cell transplant. However, these are used in the case where other forms of treatment have failed to work. Moreover, surgery is rarely used as a treatment for Hodgkin lymphoma except for the case of biopsy and staging.
References
American Cancer Society. (2019). Treating Hodgkin Lymphoma. Retrieved from https://www.cancer.org/cancer/hodgkin-lymphoma/treating.html
Cancer.Net. (2017). Lymphoma - Hodgkin - Symptoms and Signs. Retrieved from https://www.cancer.net/cancer-types/lymphoma-hodgkin/symptoms-and-signs
Cancer Treatment Centers of America (CTCA). (2018). Non-Hodgkin Lymphoma Symptoms & Signs | CTCA. Retrieved from https://www.cancercenter.com/non-hodgkin-lymphoma/symptoms/
