Over 90 percent of people under 45 years of age, diagnosed with Hodgkin’s lymphoma will still be alive and disease free 10 years later, according to an analysis by Dr. Hermann Brenner from the German Cancer Research Center in Heidelberg published in the August 2009 issue of “The Oncologist.” Recurrent disease often remains highly treatable, making it important for survivors to know the key signs and symptoms that could signal a need for immediate medical attention 1.

Lymphadenopathy

Lymphoma is a cancer of the lymph glands and organs that manufacture or process lymph fluid, and the painless swelling of a lymph node, called lymphadenopathy, can herald the recurrence of Hodgkin’s lymphoma. This lump can be at the same place as original site or occurrence, or in any of the body’s lymph chains.

Night Fevers

When fever rises at night, the body is exhibiting a state of inflammation. In Hodgkin's lymphoma, lymphatic tissue becomes inflamed in response to the invading cancer cells and because lymph fluid cannot flow through the inflamed tissue. This inflammation happens primarily during the night and the fever results. Many people sleep through night fevers, but can tell they occurred when their night clothes and sheets are damp the next morning.

Itching without a Rash

Dry, itchy skin can occur for a number of reasons, but when it happens to someone with a history of Hodgkin's lymphoma, a visit to an oncologist, or cancer specialist is in order. The medical term for itching without a rash or irritation of the skin is pruritus without excoriation, and it is another signal of lymphatic inflammation, but it can also be a sign of liver involvement.

Bone Pain

One place Hodgkin's lymphoma can metastasize is bone marrow, and sometimes bone pain, a limp or a spontaneous fracture is the clue that Hodgkin's has recurred. However, before the invasion is extensive, cancerous tissue displacing calcium in the bone will send this mineral into the blood. This increase in blood calcium, or hypercalcemia, causes subtle signs that are important for both Hodgkin's survivors and their families to recognize 2. Abdominal pain, nausea and vomiting, constipation, frequent urination, muscle weakness or aches are symptoms listed by MayoClinic.com as easy-to-spot signs of hypercalcemia 2.cause:

• Abdominal pain
  
• nausea
  
• vomiting
  
• constipation
  
• frequent urination
  
• muscle weakness or aches are symptoms listed by MayoClinic.com as easy-to-spot signs of hypercalcemia 2

But lethargy and sadness can be mistaken for depression, and confusion can be written off as forgetfulness or distraction, when these are additional signs of hypercalcemia 2. It's important for family to feel free to point out to the survivor when they see these emotional symptoms, knowing that they could be warnings of bone involvement and recurrent disease.

Respiratory Distress

Coughing and shortness of breath can be the result of tumors occurring along the lymph chain in the center of the chest, or from extension of the disease into the lung tissue. And even a slight decrease in the oxygen level due to early lung involvement can cause anxiety and panic attacks. Hodgkin's survivors should inform their oncologists of any changes in their personalities, and receive physicals with oximetry and lung scans, based on these symptoms, to ensure early detection and treatment of recurrent disease.