Thyroid diseases after treatment of Hodgkin's disease

Article Abstract:

Hodgkin's disease, a malignant disorder of the lymphatic system, is often treated with radiation. Today, most patients can look forward to long-term survival. However, among patients treated with radiation for Hodgkin's disease, there is a high incidence of thyroid diseases, including hypothyroidism (underactive thyroid), Grave's disease (overactive, or hyperthyroid), eye disorders (ophthalmopathy), transient hyperthyroidism, and thyroid cancer. To determine the type and the incidence of thyroid diseases among patients formerly treated with radiation for Hodgkin's disease, records of 1,787 patients were reviewed; 810 patients received radiation only; 920 received radiation and chemotherapy; and 57 patients received chemotherapy only. The subjects were treated between January 1961 and April 1989; the average follow-up time was about 10 years. Almost half of the patients eventually developed hypothyroidism, with women and children at greater risk than men. Iodine used in imaging the lymphatic system (lymphangiography) may predispose patients to radiation injury to the thyroid. Most patients treated after 1973 also underwent CT scanning with contract material that contained iodine. Mild hypothyroidism may predispose patients to hypercholesterolemia (high cholesterol) and consequently to atherosclerosis (plaque build-up inside the arteries) and cardiovascular disease. Excluding the thyroid from the field of radiation may prevent thyroid disorders, but frequent involvement of the lymph nodes near the thyroid suggest that this would increase the risk of treatment failure. Beginning thyroid replacement hormones early may improve the outlook, and continued follow-up is essential. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Thyroid diseases

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Second cancers after Hodgkin's disease in childhood

Article Abstract:

Projected estimates of the risk of cancer following successful treatment of childhood Hodgkin's disease may be overestimated because of incomplete follow-up and the development of safer therapies. A 1996 study found that, in comparison to the general population, people treated for childhood Hodgkin's had up to 79 times the risk of developing certain cancers. This study also used actuarial figures to estimate that the risk of cancer increased dramatically 15 years after treatment for Hodgkin's, and was particularly high for breast cancer among women over 30. However, follow-up averaged only 11.4 years, probably because data on many participants was censored or unavailable. An improved system of tracking patients should be developed for such studies. In addition, cancer therapy may now be safer than when this study began. Alternate estimates suggest the risk of second cancer in children treated without alkylating drugs is less than 5% 15 years after treatment.

Editorial, Risk factors, Pediatric diseases, Cancer, Chemotherapy, Hodgkin's disease in children

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A 78-year-old man with a sigmoid stricture after radiation treatment for prostatic cancer

Article Abstract:

A 78-year-old man was admitted to a hospital with a history of chronic diarrhea and evidence of a constriction in his colon. He had received radiotherapy for prostate cancer four years before and developed abdominal cramps and diarrhea seven months before admission. Medical examination revealed a mass in his colon, which was surgically removed. Analysis of the tissue revealed that he had a B cell lymphoma. Fibrous tissue deposited between the colon and bladder probably caused the constriction and this may have been a complication of the radiotherapy.

Diagnosis, Intestines, Lymphomas, Intestinal obstruction

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