Radiation Therapy for Non-Hodgkin Lymphoma

Radiation therapy uses high-energy rays to kill cancer cells.

When might radiation therapy be used for non-Hodgkin lymphoma?

Radiation might be used to treat non-Hodgkin lymphoma (NHL) in some different situations:

• It can be used as the main treatment for some types of NHL if they are found early (stage I or II), because these tumors respond very well to radiation. 
• For more advanced lymphomas and for some lymphomas that are more aggressive, radiation is sometimes used along with chemotherapy.
• People who are getting a stem cell transplant may get radiation to the whole body along with high-dose chemotherapy, to try to kill lymphoma cells throughout the body.
• Radiation therapy can be used to ease (palliate) symptoms caused by lymphoma that has spread to internal organs, such as the brain or spinal cord, or when a tumor is causing pain because it’s pressing on nerves.

How is radiation therapy given?

When radiation is used to treat NHL, it’s most often done with a carefully focused beam of radiation, delivered from a machine outside the body. This is known as external beam radiation. External beam radiation treatment for NHL might include beams made of photons (most common), protons or electrons depending on the situation. 

Before your treatment starts, your radiation team will take careful measurements to find the correct angles for aiming the radiation beams and the proper dose of radiation. This planning session, called simulation, usually includes getting imaging tests such as CT or MRI scans. 

Most often, radiation treatments are given 5 days a week for several weeks. The treatment is much like getting an x-ray, but the radiation is stronger. The procedure itself is painless. Each treatment lasts only a few minutes, although the setup time – getting you into place for treatment – usually takes longer.

Radiation can also be given as a drug in some cases. (See Immunotherapy for Non-Hodgkin Lymphoma for more details.)

Possible side effects

The side effects of radiation therapy depend on where the radiation is aimed. Common side effects include: 

• Skin changes in areas getting radiation, ranging from redness to blistering and peeling
• Feeling tired
• Nausea 
• Diarrhea

Nausea and diarrhea are more common if the abdomen (belly) is treated with radiation. 

Radiation given to several areas, especially after chemotherapy, can lower blood cell counts and increase the risk of infections.

Radiation to the head and neck area can lead to mouth sores and trouble swallowing. Some people later have problems with dry mouth.

Often these effects go away shortly after treatment is finished.

Side effects tend to be worse if radiation and chemotherapy are given together.

Radiation techniques are much more advanced and can limit the radiation exposure to nearby organs, but long-term serious side effects are possible:

• Radiation to the chest might damage the lungs and lead to trouble breathing. It can also affect the heart, and may increase the chance of a heart attack later on. 
• Radiation to the neck can lead to thyroid problems later in life. This can lead to fatigue and weight gain.
• Side effects of brain radiation therapy may become serious 1 or 2 years after treatment and may include headaches and problems such as memory loss, personality changes, and trouble concentrating.
• Other types of cancer can form in the area that received radiation. For example, radiation to the chest may increase the risk of lung cancer (especially in people who smoke) and of breast cancer, but this is rare.