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by Pollock J

Radiation Therapy for Hodgkin Lymphoma

Radiation therapy uses high energy x-rays to destroy cancer cells. When treating Hodgkin lymphoma, it is more effective when used after chemotherapy. Radiation therapy may be used to:
  • Shrink a large tumor (usually found in the chest)
  • Treat localized tumors
  • Relieve symptoms associated with metastatic lymphoma
A radiation oncologist will customize the treatment dose for individual needs. The goal is to try and kill as much cancer while minimizing harm to healthy tissue.
There are different types of radiation therapy, but external beam radiation is used to treat Hodgkin lymphoma.

External Beam Radiation

In external beam radiation therapy, radiation is produced by a machine positioned outside the body. Short bursts of x-rays are directed at the tumor site. The radiation specialist will direct the radiation beam to affect as much of the tumor as possible. External beam radiation only takes a few minutes and the total treatment time can last 5-8 weeks, depending on the total dose required. In most cases, radiation is given 5 days a week. If needed, radiation therapy can be repeated in the same or different area after the initial course is completed.
Radiation of a Tumor
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External beam radiation methods include:
  • Involved site radiation therapy (ISRT)—Radiation is aimed at the original lymph node where the cancer started and any nearby affected area.
  • Total body irradiation—For those having a peripheral stem cell transplant, total body irradiation is designed to eliminate all traces of lymphoma the body.

Side Effects and Management

Complications of radiation therapy depend on where it is directed, and may include:
  • Chest complications:
    • Cough
    • Shortness of breath
    • Chest pains
    • Problems with swallowing and eating
    • Thyroid problems
    • Heart and lung problems
  • Abdominal and pelvic complications:
    • Bladder irritation—may cause blood in the urine, or pain or burning during urination
    • Anal or rectal irritation—may cause blood in the stool, pain during bowel movements, or stool leakage
    • Vaginal dryness—may cause discomfort during intercourse
    • Erectile dysfunction
    • Infertility—talk to your doctor about options to preserve fertility before starting treatment
  • General complications:
    • Dry, irritated skin
    • Reduced blood cell counts—increases the risk of infection and blood clotting time, and causes anemia-related fatigue
    • Nausea or vomiting
    • Diarrhea
A variety of treatments are available to help manage side effects of radiation therapy. Sometimes adjustments to treatment doses may also be possible. The earlier side effects are addressed, the more likely they will be controlled with a minimum of discomfort.

References

Hodgkin disease. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003105-pdf.pdf. Accessed March 4, 2016.
Hodgkin lymphoma. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hematology-and-oncology/lymphomas/hodgkin-lymphoma. Updated October 2012. Accessed March 4, 2016.
Hodgkin lymphoma (HL). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 8, 2016. Accessed March 4, 2016.
Involved field radiation therapy. Leukemia & Lymphoma Society of America website. Available at: http://www.lls.org/lymphoma/hodgkin-lymphoma/treatment/involved-field-radiation-therapy. Accessed March 4, 2016.
Treatment option overview. National Cancer Institute website. Available at: http://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq#section/%5F57. Updated October 27, 2015. Accessed March 4, 2016.

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