Radiotherapy for Hodgkin lymphoma

Radiotherapy only treats the area of the body it’s aimed at. It’s usually given after a course of chemotherapy| for early-stage disease as part of the overall treatment. In more advanced stage disease|, it may be used after chemotherapy to treat areas (usually lymph nodes) where there may still be cancer. 

In children|, this varies slightly. For both early- and advanced-stage disease, the radiotherapy may be given after chemotherapy or surgery to remove the lymph nodes, even if the lymphoma is completely gone. This is given to reduce the risk of the lymphoma coming back and is known as adjuvant treatment. 

The treatment is given in the hospital radiotherapy department, usually as daily sessions from Monday–Friday with a rest at the weekend. The length of treatment will depend on the type and stage of the lymphoma.

Our section on radiotherapy| has more details about this treatment and its side effects.

Planning your treatment Back to top

To make sure the radiotherapy is as effective as possible, it has to be carefully planned. On your first visit to the radiotherapy department you’ll be asked to lie under a large machine called a simulator, which takes x-rays of the area to be treated. A CT scanner may be used to do this. 

Treatment planning is an important part of radiotherapy and may take a few visits. A clinical oncologist (a doctor specialising in radiotherapy treatment for cancer) plans the treatment.

The radiographer, who gives you your treatment, draws marks on your skin and may ask if very small permanent marks (tattoos) can be made. These are only done with your permission and are used to show where the rays are to be directed. 

Let the radiographer know if you don’t want to have permanent marks, so that they can discuss other options for marking the skin. At the beginning of your treatment you’ll be told how to look after your skin in the treated area.

Treatment sessions Back to top

Before each session of radiotherapy, the radiographer will position you carefully on the couch and make sure you’re comfortable. During your treatment, which only takes a few minutes, you’ll be left alone in the room but you can talk to the radiographer who will watch you from the next room. Radiotherapy is not painful but you do have to lie still for a few minutes.

Side effects Back to top

Radiotherapy will nearly always cause tiredness. Other side effects will depend on the part of your body being treated. 

Any treatment to the abdomen can cause stomach upsets such as feeling sick (nausea), vomiting| or diarrhoea. Treatment to the head can cause hair loss|. Radiotherapy to the neck can make your mouth or throat sore|. You may also notice that some foods taste different. These side effects can be mild or more troublesome, depending on the length of your treatment.

Your clinical oncologist can tell you what to expect, and they can prescribe medicines to help with side effects such as sickness or diarrhoea. Our information about diet and cancer| has helpful tips on coping with eating problems caused by treatment. Our cancer support specialists| can also send you information about coping with specific side effects, such as a dry mouth|.

Radiotherapy can have long-term (permanent) side effects. These are rare and will vary depending on the part of the body treated. You can ask your specialist to tell you about any possible long-term effects.

Tiredness

As radiotherapy can make you tired|, you should try to get as much rest as possible, especially if you have to travel a long way for treatment each day. Fatigue is a term often used to describe the tiredness that can occur during and after treatment. It generally begins in the latter half of treatment and can continue for several months after treatment has finished. Balancing rest and activity throughout the day is important, as your body needs rest to recover from the treatment.

Feeling sick (nausea) and being sick (vomiting)

Nausea can usually be effectively treated by anti-sickness (anti-emetic) drugs, which your doctor can prescribe. If you don’t feel like eating very much, you should talk to your doctor or specialist nurse. They may suggest that you try adding nutritious, high-calorie drinks to your diet. You may also be referred to a dietitian who can prescribe these drinks and give advice about how to maintain weight if you’ve lost your appetite. 

We have information on managing nausea and vomiting| and diet and cancer|.

Hair loss

Although radiotherapy can cause hair loss|, this only happens in the area being treated. For example, if you have radiotherapy to the lymph nodes in your neck, you may lose the hair on the back of the neck. Radiotherapy to the nodes in the chest may make the hair on your chest fall out. 

When you’ve finished the course of treatment, your hair will usually grow back. However, for a small number of people hair loss is permanent or the hair that grows back may be patchy. Whether it grows back or not and how long that might take will depend on the amount of radiotherapy you’ve had and the length of treatment. Normally, hair grows back within 6-12 months. We have a section about coping with hair loss|.

All these side effects will usually disappear gradually once your radiotherapy treatment is over. Let your doctor know if they continue.

Radiotherapy does not make you radioactive and it is perfectly safe for you to be with other people, including children, throughout your treatment.

Our section on radiotherapy| discusses this treatment in more detail.