Alcohol Related Pain and Hodgkin Lymphoma

Question:

Dear OncoLink "Ask The Experts,"

My initial Hodgkin's symptom was arm pain. It took 9 months to get diagnosed. The pain was increased with minimal amounts of alcohol ingestion. I am 9 months in remission after ABVD. What does the alcohol do to cause the pain?

Answer:

Babis (Charalambos) Andreadis, MD, MSCE, Associate professor of clinical medicine at the University of California at San Francisco and a member of the Helen Diller Family Comprehensive Cancer Center at UCSF, responds:

There is a well-known phenomenon of alcohol-related lymph node enlargement in people with Hodgkin lymphoma. This swelling likely caused pressure on a nerve, resulting in the arm pain you experienced. The biological basis for this is unknown, but probably has to do with irritation of the malignant cells by alcohol directly, causing the release of inflammatory cytokines that then attract normal reactive cells to the lymph node.

A few resources related to this concern:

ACS: Signs and Symptoms of Hodgkin Lymphoma - https://www.cancer.org/cancer/hodgkin-lymphoma/detection-diagnosis-staging/signs-and-symptoms.html

Bobrove, A. M. (1983). Alcohol-related pain and Hodgkin's disease. Western Journal of Medicine138(6), 874.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1010854/pdf/westjmed00202-0092.pdf

Bryant, A. J., & Newman, J. H. (2013). Alcohol intolerance associated with Hodgkin lymphoma. CMAJ185(8), E353-E353.  https://www.cmaj.ca/content/185/8/E353

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