In the wake of ‘Everyday Health’ host Ethan Zohn’s announcement that his cancer has relapsed, Everyday Health’s medical director wants to raise awareness for her friend’s condition.
Two years ago, Everyday Health co-host Ethan Zohn battled a rare cancer — and won. After several rounds of chemo and a stem cell transplant, he was declared officially in remission in April of 2010. Then, two months ago, he got the devastating news that no survivor ever wants to hear: His cancer, a form of lymphoma called Hodgkin disease, which affects lymphocyte cells in the immune system, had relapsed. Now, at 37, he’s gearing up for another fight — one he’s more determined than ever to win.
Having spent time with Ethan, and knowing the kind of person he is, I’m confident he has it in him to do just that. Hodgkin lymphoma, even relapsed, is often very responsive to treatment with a five-year survival rate of 85 percent.
Partly because Hodgkin lymphoma is rare (affecting fewer than 9,000 people a year), there’s a lot to be discovered about the disease, so doctors don’t know for certain what causes it or how to prevent it. Here, five things we do know.
1. Young males are the group most commonly affected by Hodgkin lymphoma. It can occur at any age but is thought to most often strike between the ages of 15 and 40 – as was the case with Ethan, who was 35 at the time of his initial diagnosis. Other factors that may raise your risk include certain viral infections like mononucleosis (a.k.a. mono) and HIV, or genetic and environmental traits such as socioeconomic status, geography, and family history. Risk is thought to be greater in individuals who are well-educated and middle class, who live in North America or parts of Europe, or whose siblings have had Hodgkin disease.
But many of those risk factors are vague and broad, and having any of them is not a guarantee that you will get Hodgkin lymphoma, just as not having them will not guarantee that you won’t. Symptoms to watch out for include glands or lymph nodes in the neck, armpits, or groin that are swollen but not painful; fatigue; weight loss; recurrent fever; itchiness; and profuse night sweats. Enlarged lymph nodes in the chest can also cause a persistent cough or trouble breathing. If you have any of these symptoms, consult with your doctor. You may need to be evaluated with a combination of blood tests and X-rays; a biopsy of a swollen gland could confirm the diagnosis.
2. Hodgkin lymphoma is one of the most “curable” cancers out there.It has a high survival rate and is generally very responsive to therapy. Treatment depends on the type of tumors and whether the cancer is advanced or aggressive, but it may include chemotherapy, radiation, or both. In patients who don’t respond well to these options, or in patients like Ethan, in whom the cancer has returned, high-dose chemotherapy may be necessary. This requires that the patient undergo a stem cell transplant, which Ethan had back in 2010 and hopes to have again later this year. Stem cells are the starter cells in the bone marrow that give rise to red blood cells, white blood cells, and immune cells. When high-dose chemo is given, these stem cells are destroyed and must be replaced with new ones from the transplant.
Hodgkin lymphoma recurs in about 20 to 35 percent of patients, but in many cases, the cancer will respond well to more treatment. However, patients with a relapse may not have the same symptoms they had when their cancer was first diagnosed and need to be monitored closely for signs of recurrence and long-term complications of treatment.
3. Life doesn’t stop when treatment starts — and neither should you. Ethan has been emphatic that he will continue to live a fulfilling life as he faces cancer a second time. He even plans to run the New York City Marathon this weekend. That’s obviously not recommended for everyone, but recent studies have shown that exercise can play an important role in a patient’s physical and mental recovery after cancer. Your doctors will advise you on how much physical activity you can endure before, during, and after therapy, but staying active, especially if you’re already active, like Ethan, is an important part of the journey.
4. There will be good days and bad days — and that’s okay. Ethan has said that he was initially very angry to find out that his cancer had relapsed, and that he and his girlfriend, Everyday Health co-host Jenna Morasca, have felt everything from fear and anxiety to gratitude and love during these last two months. It is completely normal — healthy, even — for a patient who is diagnosed with cancer to go through a whole host of emotions like this. In fact, it’s unrealistic to believe that someone should stay “positive” all the time, and it’s not clear that doing so has an effect on prognosis anyway. It’s okay for a patient’s emotions to vary depending on the day. What’s not okay is if someone is so optimistic that they believe they can beat cancer without undergoing traditional therapies, or if someone is so despondent that they can’t muster the energy to undergo treatment.
5. Hodgkin lymphoma doesn’t affect just the person who’s diagnosed — it takes a toll on loved ones, too. People undergoing cancer treatment need the support of friends and family, not only to help with tasks such as paying the bills or mowing the lawn, but also for emotional strength. Ethan is lucky to have a strong community of caregivers around him — he’ll need to lean on his family and Jenna as he tackles this new challenge. And they’ll likely need to lean on each other, too. Caring for someone with Hodgkin lymphoma can be both physically and emotionally overwhelming, so loved ones need to be sure to tend to themselves, too. They should take breaks from time to time and remember to get sleep, exercise, and eat regularly. Both the patient and the caregivers may also benefit from counseling or group therapy.
Ethan, you are strong and courageous and have beaten this disease before. I know you can do it again. I’m thinking of you, Jenna, and the rest of your family. You know how to reach me if there’s anything I can do.
Mallika Marshall, MD, is medical director for Everyday Health and a practicing physician at the Massachusetts General Hospital Chelsea Urgent Care Clinic. A veteran television correspondent, Dr. Marshall has been a regular medical contributor for CBS’ Early Show and the CBS Evening News. She is currently a contributing medical reporter for New England Cable News.