Radiation therapy for Hodgkin lymphoma
Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is usually used to treat HL. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.
Radiation therapy is sometimes combined with chemotherapy to treat HL. This is called chemoradiation. The 2 treatments are given during the same time period. Radiation may also be given alone for early stage favourable HL if:
- you can’t have chemotherapy because you have other health problems
- the HL is only in one small group of lymph nodes and those lymph nodes are very small
Radiation therapy may also be given alone if you have early stage nodular lymphocyte-predominant HL.
Radiation therapy is given for different reasons. You may have radiation therapy or chemoradiation to:
- destroy the cancer cells in the body
- shrink bulky, or large, tumours before chemotherapy (called neoadjuvant therapy)
- destroy cancer cells left behind after chemotherapy to reducethe risk that cancer will come back (recur) (called adjuvant therapy)
- relieve pain or control the symptoms of advanced HL (called palliative therapy)
External beam radiation therapy
During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it. It may be given to different parts of the body, depending on which organs or areas that the HL affects.
Involved site radiation therapy (ISRT) means that radiation is given only to the lymph nodes where the HL started and any nearby tissue that the HL spread to.
Involved field radiation therapy (IFRT) means that radiation is given only to areas of lymph nodes that have HL. IFRT has a larger treatment area than ISRT.
Extended field radiation therapy means that radiation is given to the areas of lymph nodes that have HL, as well as nearby areas of lymph nodes that don’t have cancer in them. The mantle field includes the lymph nodes in the neck, chest, armpits and sometimes those in the upper abdomen. The inverted Y field includes the lymph nodes in the upper abdomen, the lymph nodes in the pelvis and the spleen. Total nodal radiation means the radiation is given to both the mantle field and inverted Y field. Extended field radiation therapy isn’t often used because most people with HL are now given chemotherapy.
Total body irradiation (TBI) means that radiation is given to the entire body. It is used in preparation for a stem cell transplant.
Side effects can happen with any type of treatment for HL, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation, if chemotherapy is also given and the treatment schedule. Some common side effects of radiation therapy used for HL are:
- skin problems
- sore throat
- taste changes
- nausea and vomiting
- low blood cell counts (called bone marrow suppression)
- fertility problems
Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Questions to ask about radiation therapy
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Great progress has been made
Some cancers, such as thyroid and testicular, have survival rates of over 90%. Other cancers, such as pancreatic, brain and esophageal, continue to have very low survival rates.