Hodgkin’s Disease Staging

By using exams and tests, a doctor can tell the stage of a person's Hodgkin's disease. The stage tells the doctor how much and how far the disease has spread. Staging is one of the most important factors in deciding what treatment to have for the disease.

The staging system used most often for Hodgkin's is called the "Cotswold's Modification of the Ann Arbor staging system." The stage of a person's lymphoma is indicated by Roman numerals I, II, III, and IV.

The letter "B" is added if the person has B symptoms (fever, night sweats, weight. If a person does not have these B-symptoms, the letter "A" is added after the Roman numeral. If the Hodgkin's disease has spread from a lymph node to a neighboring organ, the letter "E" is added.

• Stage I. Stage I means that the Hodgkin's disease is only in one group of lymph nodes, or it has started in one organ and has not moved to another part of the body.

• Stage II. Stage II means two groups of lymph nodes show cancer. The two groups of lymph nodes must be on the same side of the diaphragm in the body; all disease is in either the upper or lower half of the body. This means that if the lymph nodes in the neck and underarms both show cancer, it is Stage II. However, if the lymph nodes in the groin and neck show cancer, it is not Stage II, because those two parts of the body are on different sides of the diaphragm.

• Stage III. Stage III means there are two groups of lymph nodes with Hodgkin's disease on different sides of the diaphragm, such as the neck and groin. There might also be spread of the cancer from the lymph nodes to nearby tissues.

• Stage IV. Stage IV means the Hodgkin's disease has moved to distant organ(s) outside of the lymphatic system. Other lymph nodes in the body may or may not show signs of the cancer. Typical Stage IV disease is when Hodgkin's lymphoma is found in the bone marrow or in organs (lung, stomach, bone) away from the involved lymph glands.