Hodgkin's Disease is a relatively infrequently occurring malignancy (no more than 30 or 40 cases a year in Rhode Island) and yet most people have heard something about it. This disease of the lymph nodes was first described by a 19th century English physician whose life is as fascinating as the disease named for him. A brilliant student and anatomist, Thomas Hodgkin became a pathologist in London where his keen powers of observation and insight made possible his important discovery. However, because of discrimination against Quakers, he never advanced in the ranks of academic medicine of the time. He strongly supported universal health coverage of the poor and he sponsored free care clinics. He was a vocal abolitionist who established educational scholarships for runaway slaves that made their way to England. He set out to establish free medical clinics in Palestine (with money supplied by Lord Montefiore) and succumbed to typhus. He is buried outside of what is now Tel Aviv in the outskirts of Jaffa. His long unattended grave has been rehabilitated with a new monument set up by the British Medical Society.

Hodgkin's Disease is a disease that attacks young people, usually between the ages of 10 and 25, which probably accounts for its notoriety. Forty years ago the standard textbook of medicine categorized Hodgkin's Disease as an invariably fatal illness. Today the disease is almost uniformly curable. It is a triumph of oncology in the latter half of the twentieth century. We found that radiotherapy to the affected lymph nodes could produce a cure. We also found that combination chemotherapy could produce a cure.

In the last twenty years we have learned that the consequences of our success included a whole new wave of malignant tumors in the cured individual. Young woman who receive radiation to the chest for Hodgkin's Disease are at risk of developing breast cancer later in life. Other cancers being seen in these cured Hodgkin's patients included another form of lymphoma and leukemia, more often associated with having received chemotherapy. Our understanding of the unintended consequences of curing Hodgkin's Disease has lead to an intense investigation to determine the minimum amount of treatment, either chemotherapy and/or radiation which could still achieve the high levels of cure that we have been able to sustain. This is the goal of current research in clinical trials for Hodgkin's Disease that are being performed in national studies. This is an infrequently occurring cancer. It is necessary, therefore, to enroll as many patients as possible in the national clinical trials so that the answers to our questions about low dose chemotherapy and/or restricted radiation can be answered. Based on the results of these trials, future patients can expect to be cured of their Hodgkin's Disease without sustaining a risk of a second malignancy.

For more information and answers to specific questions contact the Rhode Island Cancer Council at Tel@ricancercouncil.org or call us at (401) 728-4800 or toll free 866-879-4100.

IT IS EASIER TO PREVENT CANCER THAN TO TREAT IT.

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