The Difference Between Hodgkin And Non-Hodgkin Lymphoma, According To A Doctor

Beloved YouTube star and science writer Hank Green told his followers on May 19 that he has Hodgkin lymphoma. As he explained, he noticed his lymph nodes had become swollen, and that his doctor rushed him in for a biopsy. Although he said it was "bad news" that he had cancer of the lymphatic system, he was relieved that it was Hodgkin lymphoma. "It's one of the most treatable cancers," he said. "It responds very well to treatment, and the goal is cure."

Hodgkin and non-Hodgkin lymphoma are named after Dr. Thomas Hodgkin, who in the 19th century identified patients as having cancer of the lymph nodes. While both conditions are cancers of the lymph nodes, immune system, and sometimes bone marrow, they differ in their treatment, approach, and prognosis, as award-winning hematologist and medical oncologist Chadi Nabhan, M.D., MBA told Health Digest exclusively.

"Non-Hodgkin lymphoma is not one disease," Dr. Nabhan said. "It has many subtypes; almost 60. These types differ based on the shape of the cancer cell, on the molecular features that drive the growth of such lymphoma, and other factors. This is important as each type of non-Hodgkin lymphoma might be treated differently, and its prognosis also differs from others."

Hodgkin lymphoma has large Reed-Sternberg white blood cells that multiply abnormally, whereas these cells aren't present in non-Hodgkin lymphoma, according to the Moffitt Cancer Center.

Green said he was on the lookout for the possibility of getting Hodgkin lymphoma because he had mononucleosis as a child, and also has an autoimmune disease. According to the American Cancer Society, these two factors increase your risk for Hodgkin and non-Hodgkin lymphoma. Hodgkin lymphoma occurs more often in males, and is more common in young adults. Non-Hodgkin lymphoma is mostly found in people over 60. Exposure to radiation and toxic chemicals can increase your risk of non-Hodgkin lymphoma.

Both cancers are characterized by painless lumps under the neck or armpits, and some people might have trouble breathing or cough if the lymphoma is in the chest. People with non-Hodgkin lymphoma will also have abdominal pain or loss of appetite. They might also have personality changes, trouble with cognition, or double vision. There's a chain for the proper diagnosis, starting with a physical exam, followed by a biopsy and blood tests (via Dana-Farber Cancer Institute).

"I tell patients that they must be patient until we assure the correct diagnosis," Dr. Nabhan told Health Digest. "Sometimes, we might need to repeat a biopsy and get more samples of the lymph node or growth to determine accurately the actual lymphoma. This is critical, as it determines prognosis and treatment."

Aside from the diagnosing biopsy, surgery isn't typically needed to treat Hodgkin lymphoma, according to the National Health Service. This type of lymphoma is typically treated with chemotherapy and then radiation, but sometimes people might be prescribed steroids or other medications. Treatment for non-Hodgkin lymphoma could be the same as Hodgkin, but sometimes it's treated with cancer-fighting drugs, targeted immune cells, immunotherapy, or a bone marrow transplant (via Mayo Clinic).

The stage and the type of treatment of non-Hodgkin lymphoma can determine your chance of recovery, according to WebMD. The stage of the cancer, how widespread it is within your body, your overall health, and your age can all factor into your survival rate. From 2008 to 2014, the likelihood of surviving five years after the disease was 75%. For Hodgkin lymphoma, the stage, treatment plan, and person's health also factor into the prognosis. Overall the five-year survival rate is 89% in the United States, according to Cancer.Net.

Although Green said he isn't looking forward to the "unpleasant treatment," he credits advances in medicine for his positive prognosis. "This is the best time in human history to get lymphoma."