Long term and late effects

Usually, side effects gradually disappear after lymphoma treatment. But some people may have side effects that become long-term or that develop months or years after treatment.

Your risk of this depends on:

  • your treatment
  • your age
  • whether you are male or female.

Your doctor or nurse can give you more information. If you have a side effect, they can give you advice and support. If you have a risk of future side effects, they can explain what to check for and how to look after yourself. You may have regular tests to look for some types of side effects.

Hodgkin lymphoma and treatment can make you less able to fight infections. Your doctor may offer you vaccinations to protect against some infections. Always ask whether a vaccination is safe for you before having it. You should not have live vaccines.

If you need a blood transfusion at any time after your diagnosis, you should only have irradiated blood (treated with x-rays). This is still important after your treatment ends and for the rest of your life, even if you have no signs of lymphoma.

Effects after treatment

Some people have side effects during their lymphoma treatment and for a few weeks after. Usually, these effects reduce and eventually disappear.

But some people may have side effects that continue for months after treatment and that some-times become long-term. Other people may have late side effects that develop months or years after treatment.

Not everyone has long-term or late effects. And many side effects get better over time. This can depend on different factors, such as the type of treatment. Your lymphoma doctor or nurse can give you more information.


Tiredness

Recovering from chemotherapy can take time. You may feel tired for many months after treatment is over. Occasionally, tiredness may last for a year or two.

Physical activity can help improve energy levels and reduce tiredness. Short walks are a good way to start. Being active also helps you sleep better and can improve anxiety and depression.

Sometimes tiredness is a sign of depression, sleep problems, pain, or changes in the thyroid gland. These are problems that can be treated. If tiredness is not going away, talk to your doctor.

Coping with fatigue

Denton describes how he coped with fatigue (tiredness) during his treatment for prostate cancer.

About our cancer information videos

Coping with fatigue

Denton describes how he coped with fatigue (tiredness) during his treatment for prostate cancer.

About our cancer information videos


Immune system

Your immune system protects you against infection. Hodgkin lymphoma and treatment for it can affect how your immune system works. This can make you less able to fight infections.

Your lymphoma doctor may advise you to have vaccinations to protect you against infections such as flu or pneumonia. Ask them for advice about when you should have vaccinations.

Some vaccines have small amounts of a live virus or bacteria in them. They are called live vaccines. You should not have live vaccines if you have had Hodgkin lymphoma. Ask your doctor whether a vaccination is safe for you to have before having it.


Irradiated blood products

If you need a blood transfusion at any time after your diagnosis, you should only have irradiated blood. This includes if you need blood products called red cells, platelets or granulocytes. This is still important after your lymphoma treatment ends and for the rest of your life, even if the lymphoma is in remission.

Irradiated blood products are treated with x-rays to get rid of white blood cells called lymphocytes. Rarely, these lymphocytes can cause a serious reaction in people with Hodgkin lymphoma.

Your lymphoma doctor will give you a card that explains this. You should show the card if you ever need treatment at hospital or need a blood transfusion. Some people also wear a medical ID bracelet or chain that carries information about this. This is useful if you need emergency treatment and aren’t able to explain your medical history. Your pharmacist can give you more information.


Peripheral neuropathy

If the feeling in your hands or feet was affected by chemotherapy, you will usually find this slowly gets better after treatment ends. This may take up to two years. Sometimes nerves do not fully recover and you may continue to have difficulty with fiddly tasks, such as picking up very small objects or doing up small buttons. People generally find these kinds of changes become less noticeable over time as they adapt and find ways of coping with them.


Early menopause or menopausal symptoms in women

Most women reach the menopause between the ages of 47 and 53. But after treatment for lymphoma, some women may have an earlier menopause. Your lymphoma doctor can tell you if this is likely.

Symptoms of the menopause can include hot flushes, night sweats, joint pain, reduced sex drive, vaginal dryness, and disturbed sleep. It can also cause mood swings and feelings of anxiety. If you have any of these symptoms, tell your doctor. You may have blood tests to check for signs of the menopause. Some women have hormone replacement therapy (HRT) to reduce menopausal symptoms. Your doctor will explain any possible benefits and risks of HRT.


Thyroid changes

The thyroid is a small gland in the front of your neck. It makes hormones that help to control and influence the way your body functions.

Some people who have radiotherapy to the neck develop changes in their thyroid gland a few years after treatment. The thyroid stops producing enough hormones. This is called an underactive thyroid or hypothyroidism. It can cause symptoms such as weight gain, tiredness and constipation.

Your lymphoma doctor will explain if your treatment could cause thyroid changes. You will have a blood test once a year to check how your thyroid is working. You may need daily tablets if your thyroid is underactive.


Second cancer

Chemotherapy and radiotherapy can lead to a slightly increased risk of developing a second cancer later in life. However, treatments are designed to limit these risks as much as possible.

Women under the age of 30 who have had radiotherapy to the chest area have a higher risk of breast cancer. They should have screening for breast cancer at an earlier age than usual.

Screening usually involves a physical check-up and an x-ray (mammogram) or MRI scan of each breast. Your doctor or nurse will explain what to expect.


Effects on the heart

Some lymphoma treatments may cause heart problems later in life. This includes some types of chemotherapy and, rarely, radiotherapy to the chest area.

Your doctor will explain if there is a risk your treatment may cause heart problems. You may have heart tests before and during chemotherapy to check how well your heart is working. After treatment, you may have regular heart tests to check for signs of heart changes.


Effects on the lungs

The chemotherapy drug bleomycin can cause changes to the lungs that may affect your breathing. These changes may happen during treatment and usually get better over several months or years after treatment ends. Sometimes bleomycin causes permanent damage to the lungs. Lung changes are more likely if:

  • you also have radiotherapy to the chest area
  • you are over the age of 60
  • you have other lung problems.

If you smoke, quitting will improve your lung health and reduce the risk of breathing problems.

High doses of oxygen can make breathing problems worse in people who have had bleomycin. If you need oxygen treatment or an operation, always let your doctor or nurse know that you have had bleomycin.

Back to After treatment

Follow up

After treatment for lymphoma, you’ll have follow-up appointments with your doctor or specialist nurse.