Hodgkin Disease Overview

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Treating Hodgkin Disease TOPICS

Radiation therapy for Hodgkin disease

Radiation therapy is the use of high-energy x-rays to kill cancer cells. Radiation therapy for Hodgkin disease is given as a focused beam of radiation from a machine outside the body. This is called external beam radiation. Radiation is sometimes used with chemotherapy (chemo).

Most often, radiation treatments are given 5 days a week for several weeks. Before the treatments start, the radiation team decides the dose needed and the correct angles for aiming the radiation beams. The treatment is much like getting an x-ray, but the radiation is more intense. Each treatment lasts only a few minutes, although the setup time – getting you or your child into place – usually takes longer. Radiation itself is painless, but some younger children may need to be sedated to make sure they don’t move during the treatment.

Radiation therapy is most useful when Hodgkin disease is only in one part of the body. Decades ago, this was the best treatment for Hodgkin disease, but over the years doctors found it could lead to long-term side effects. As it became clear that chemo also worked well, doctors began to use less radiation. Today, if radiation is used, only the involved areas are treated with radiation to try to limit side effects.

For involved field radiation, only the lymph node areas that contain Hodgkin disease are treated. This is the preferred form of radiation to treat Hodgkin disease. Chemo is often given first, followed by involved field radiation to areas that showed cancer. This approach may also be used by itself to treat some cases of nodular lymphocyte predominant Hodgkin disease.

People who are getting a stem cell transplant may get radiation to the whole body (known as total body irradiation) along with high-dose chemo to try to kill lymphoma cells throughout the body. To learn more, see the section, “High-dose chemotherapy and stem cell transplant for Hodgkin disease.

Possible side effects

The side effects of radiation therapy depend on where the radiation is aimed. Some people have skin changes that look like sunburn, which slowly fades away. Other problems can include tiredness, dry mouth, upset stomach, diarrhea, and lowered blood cell counts.

Long-term side effects: Radiation treatment can also have long-term side effects. The most serious of these is getting another cancer in the part of the body that was treated with radiation.

In children, another possible side effect of radiation is the failure of the bones to grow the way they should. This could result in a lack of growth to full height, or even bone deformities. Doctors use as little radiation as they have to in children.

Radiation to the chest or neck can damage the thyroid gland, which can lead to tiredness and weight gain. Treatment with thyroid hormone pills can help with this.

Radiation to the chest also increases the risk of heart disease, while radiation to the neck may increase the risk of stroke many years later.

To reduce the risk of side effects, doctors carefully figure out the exact dose of radiation needed and aim the beam to hit the cancer and limit damage to nearby normal tissues.

For more on long-term side effects, see the section, “Moving on after treatment for Hodgkin disease.”

Monoclonal antibodies

Antibodies are proteins made by the body’s immune system to help fight infections. Man-made versions, called monoclonal antibodies, can be designed to attack a target, such as a substance on the surface of lymphocytes (the cells in which lymphomas start).

Some monoclonal antibodies are now being used to treat Hodgkin disease. These drugs include brentuximab vedotin (Adcetris™) and rituximab (Rituxan®). The drugs are given as an IV infusion, in the doctor’s office or clinic.

Common side effects are usually mild but may include chills, fever, nausea, rashes, fatigue, and headaches. Rarely, more severe side effects occur.

Last Medical Review: 02/05/2013
Last Revised: 02/07/2014