Hodgkin’s Lymphoma: An Environmental Scan

Table of Contents

3.8 Staging

Once a diagnosis is confirmed, the cancer is evaluated for the stage of the disease. The standard reference to staging for HL comes from the Ann Arbor system with Cotswold modifications. The stage of any cancer represents how much the disease has spread throughout the body. Specifically, the stage is determined based on several factors such as whether or not the lymphoma is on one or both sides of the body and if the cancer has spread to multiple lymph nodes or beyond the nodes into the spleen, bone marrow or other organs. For HL, there are 4 stages represented by the Roman numerals I, II, III and IV. The stage of HL is helpful in predicting the prognosis or how well the individual is expected to do in treatment, in addition to informing specific treatment approaches. Stage I and II represent less advanced disease and suggests the disease is localized to a limited area. Conversely, stages III and IV represent more advanced or widespread state of HL.

In addition to the Roman numerals, the stage of HL may also have the letters A, B, X or E added. As previously stated, the majority of people present to the physician with no specific symptoms and in that case would have the letter A. For those with symptoms affecting the entire body such as weight loss, fevers or night sweats, they would receive the letter B. The letter, E is also an important piece of the staging information as it indicates the HL has spread from a lymph node into the surrounding tissue and finally X specifies bulky disease. (For more in-depth details of the staging of HL see Appendix F).