Radiotherapy
The most common use of radiotherapy to treat indolent non-Hodgkin’s lymphoma (NHL) is when radiation is used to kill or slow down the growth of your affected white blood cells.
Radiotherapy is usually only appropriate for people with early-stage NHL, whose disease is confined to just one or two groups of lymph nodes
Planning the treatment carefully to target the lymphoma and make sure the side effects are minimal plays an important part in radiotherapy. So, as part of this planning process, you might need to visit the clinic several times before treatment begins.
Radiation is also commonly used at low doses in the diagnosis of non-Hodgkin’s lymphoma (NHL), for example when you have X-rays taken. This is referred to as diagnostic imaging and is not radiotherapy
Tell me more about radiotherapy
Therapeutic radiation kills cells in the body by damaging the DNA
Beams of radiation are concentrated directly on areas that are affected by non-Hodgkin’s lymphoma. The radiation causes such severe damage to the DNA of cells in that area that it is impossible for the cells to repair themselves. This kills or slows the growth of the lymphoma cells in that area.
The planning stage of radiotherapy is important to make sure that healthy cells are protected and side effects are minimised
The area to be treated will be carefully mapped out and the treatment machine will be adjusted so that only the lymphoma cells are exposed to a full dose of radiotherapy. This will limit the side effects as much as possible.
Because of the need to target the radiation at exactly the right area of the body, a mould is sometimes made that will help to hold that part of the body still and in position during the treatment sessions.
In this way, normal cells surrounding the lymphoma are spared the full dose, and these cells are usually able to repair themselves more easily than lymphoma cells.
Therefore, radiotherapy can often control or destroy lymphoma cells, while causing only temporary damage to normal cells.
Radiotherapy is usually given on an outpatient basis, and you might need to visit the hospital up to five times a week
Before each treatment, you will be carefully positioned, usually lying on a treatment table. Parts of your body that are not being treated may be covered.
It is important to remain completely still during the treatment.
Each treatment usually lasts only a few minutes and causes no discomfort.
Although you are left alone during the actual treatment, the radiotherapy technicians watch from an observation room and you can to talk to them through a microphone.
A course of radiotherapy usually lasts for between 2 and 6 weeks, but this will depend on your individual circumstances.
What are the side effects of radiotherapy?
Radiotherapy has less effect on the body's healthy cells than it does on the lymphoma cells, but normal cells are often also affected by the treatment. For this reason, there may be side effects from radiotherapy.
Radiotherapy is given to one specific part of your body, so most side effects depend on which part of your body is being treated
For example:
- Treatment to your abdomen can cause nausea (feeling sick) or diarrhoea
- Treatment to your neck or upper chest can affect the lining of your mouth, throat and gullet (or 'oesophagus'), which may cause pain and make swallowing difficult
- Treatment to your head, or any other part of the body with hair on it, can cause hair loss in that area
- Sometimes, your skin in the area being treated is burned by the radiation and turns red and sore
Most people also feel tired and lethargic while they are having radiotherapy. The number of white blood cells in your blood may be reduced, which can make you more prone to infection during the course of treatment.
Side effects can be mild and little more than a nuisance, or they can get worse as treatment goes on
Often, the side effects are mild to start with and become more of a problem as the treatment course goes on. However, all of the side effects mentioned above are temporary, including hair loss. They may last for a few weeks or even several months after the course has finished, but they will go away.
Occasionally, radiotherapy can have long-term effects
Radiotherapy to your pelvis or groin area can affect your fertility, and this is true for both men and women. As far as possible, the testes or ovaries are shielded from the radiation during treatment.
Radiotherapy can also increase the risk of some cancers in the target area, for example, in your skin. It is therefore important that you keep any follow-up appointments and attend regular screening so that any problems can be caught as early as possible. You can also take positive steps to reduce your risk of cancer, such as giving up smoking or always using sunscreens when you’re in the sun.
Long-term breast cancer screening after radiotherapy is an important consideration for women who have had radiotherapy to the breast, especially in those with a history of breast cancer in their family. Men may also be affected and ought to consider screening if there is a family history of breast cancer. Thyroid cancer is also more common after radiotherapy to the neck.
Other long-term effects, for example to the lungs, occur because of scarring, which results when the tissues heal after the radiotherapy.