Radiotherapy for non-Hodgkin lymphoma
Radiotherapy treats cancer by using high-energy rays that destroy cancer cells while doing as little harm as possible to normal cells. Radiotherapy only treats the area of the body that the beams are aimed at.
Radiotherapy treatment is usually directed at specific parts of the body. It may be used when the lymphoma cells are contained in one or two areas of lymph nodes in the same part of the body.
For some people with indolent NHL in just one group of lymph nodes, radiotherapy may be the only treatment that’s needed.
Sometimes radiotherapy is used after chemotherapy, especially if the lymphoma is in just one area of the body and was very large before chemotherapy was given.
If indolent NHL returns in just one area of the body, radiotherapy may sometimes be used instead of chemotherapy.
Radiotherapy is given in the hospital radiotherapy department, usually as daily sessions from Monday to Friday, with a rest at the weekend. The length of your treatment will depend on the type and stage of the lymphoma, but it’s normally no more than three weeks.
Our section on radiotherapy gives more detailed information about this treatment.
To make sure radiotherapy is as effective as possible, it has to be carefully planned by a clinical oncologist - a doctor who specialises in radiotherapy treatment for cancer. Your treatment will be planned on your first visit to the radiotherapy department.
Usually, you’ll have a CT scan of the area to be treated. The CT scan takes images from different angles to build up a three-dimensional picture of the treatment area. The radiographers (who operate the machines that give you your treatment) may also take measurements from you. These measurements, and the information from the scans, are then fed into a planning computer, which is used to help the doctors plan your treatment precisely.
You may not need a CT scan if the area to be treated is in the skin or near the skin’s surface.
The radiographer may draw tiny marks on your skin and/or ask you if they can make small permanent marks (tattoos). These are only done with your permission and are used as reference points to help set up your treatment each day. If you don’t want to have permanent marks, let the radiographer know so they can discuss other options with you.
Before each session of radiotherapy, the radiographer will help you into the position you were in when the radiotherapy was being planned, and make sure you are comfortable. During your treatment, which only takes a few minutes, you will be left alone in the room but you will be able to talk to the radiographer, who will watch you from the next room. Radiotherapy isn’t painful but you will have to lie still for a few minutes while your treatment is given.
Radiotherapy often causes tiredness. Other side effects will depend on the part of your body being treated. Treatment to the tummy area (abdomen) can cause nausea (feeling sick), vomiting (being sick) 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 how much treatment you receive. Your clinical oncologist will tell you what to expect and can prescribe medicines to help.
Radiotherapy can have long-term side effects. These are rare and depend on the part of the body being treated. Your specialist can tell you more about any possible long-term effects.
Fatigue is a term often used to describe the tiredness that can occur during and after treatment. It generally begins towards the end of treatment and can continue for several weeks after treatment finishes.
Feeling sick (nausea)
Your doctor can prescribe anti-sickness (anti-emetic) drugs to treat nausea. If you don’t feel like eating, you can replace meals with nutritious high-calorie drinks, which are available from most chemists or can be prescribed by your doctor.
Radiotherapy can cause hair loss 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 your neck. Radiotherapy to the nodes in the chest may make the hair on your chest fall out. Hair usually grows back after treatment. It can take up to 12 months, depending on the dose of radiotherapy you had and the length of treatment.
Most side effects you have should disappear gradually once your treatment finishes. Let your doctor know if they continue.
Radiotherapy doesn’t make you radioactive. It’s safe for you to be with other people, including children, throughout your treatment.