the nodes must be involved in only one side of the diaphragm. The diaphragm is a muscle lying beneath the lungs. It moves up and down allowing air to move in and out of the lungs.Stage 3. Stage 3 disease is associated with lymphoma involvement on both sides of the diaphragm. The spleen is frequently involved at this stage. If the spleen is involved the abdomen may become tender or enlarged, with or without symptoms of abdominal fullness and distension. Stage 4. When Hodgkin’s disease enters stage 4, disease can spread through the body to area outside of the lymphatic system. Disease may be present in the liver, bone marrow, gastrointestinal tract, lungs, brain or skin. Spread of disease into these organs can inhibit organ function, leading to organ failure. If Hodgkin’s disease spreads to the bones, the bones may become weak and brittle. And the lymph nodes in the centre of the chest may be enlarged causing obstruction of the superior venacava vein. This can result in the accumulation of fluid in the region of the chest causing severe swelling and breathing difficulties.Futhermore spread to the lungs may cause airway obstruction resulting in shortness of breath and/or a persistent cough. If swollen nodes cause compression of the oesophagus, swallowing and eating may become difficult. If Hodgkin’s disease spread to bone marrow, the production of blood cells may be inhibited. This may result in anaemia.TreatmentChemotherapyChemotherapy is the treatment of choice for individuals with stage 3 or 4 disease. Chemotherapy may be recommended in Stage 1 and 2 disease if b-type symptoms are present, or the tumours are large. Depending on the stage of disease, radiotherapy may be used in conjunction with chemotherapy to maximise cancer cell death. There are many different chemotherapy regimes used to treat Hodgkin’s disease.RadiotherapyRadiotherapy is conventionally the treatment of choice for early stage disease. Radioth...
