Having radiotherapy for non-Hodgkin lymphoma

About radiotherapy for non-Hodgkin lymphoma (NHL)

Radiotherapy is a treatment for some people with non-Hodgkin lymphoma (NHL). It uses high energy rays similar to x-rays to destroy cancer cells.

The length of your treatment course depends on the type and ​stage​ of your NHL.

When you might have it

Your treatment depends on what type of NHL you have. If you know what type you have, you can read more about your treatment by selecting your type from the menu page. 

Find your NHL type

For low grade NHL

Low grade NHL tends to grow slowly. You might have radiotherapy as your main treatment. You have it to the affected lymph nodes if your NHL is stage 1 or stage 2. 

For high grade NHL

High grade NHL tend to grow faster. You might have radiotherapy after treatment with chemoimmunotherapy.

As part of a stem cell transplant

You might have total body irradiation (TBI) as part of a ​stem cell transplant​. TBI means you have radiotherapy to your whole body. This to kill off remaining lymphoma cells. 

Palliative radiotherapy

Palliative treatment aims to control symptoms of advanced lymphoma rather than cure it. You sometimes have radiotherapy to control symptoms of advanced NHL.

How often you have radiotherapy

You have radiotherapy treatment in the hospital radiotherapy department. 

The full dose of radiotherapy is usually divided into a number of smaller doses called fractions. This allows the healthy cells to recover between treatments. You usually have one fraction a day, from Monday to Friday. 

These daily treatments make up a radiotherapy course. The length of your radiotherapy course depends on your situation. It might last a few weeks.  

You can also have radiotherapy to help with symptoms or slow down the growth of your lymphoma. This is called palliative radiotherapy. You might just have one dose of palliative radiotherapy although sometimes the course is longer.

The radiotherapy room

Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.

Before your first treatment, your ​radiographers​ will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.

Before each treatment session

The radiographers help you to get onto the treatment couch. You might need to raise your arms over your head.

The radiographers line up the radiotherapy machine using the marks on your body. Once you are in the right position, they leave the room.

During the treatment

You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment. This is to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.

Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.

You won't be radioactive

This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.

Side effects

Radiotherapy for NHL can cause red, sore skin in the treatment area. And it can make you very tired. Other radiotherapy side effects vary, depending on the part of the body being treated. They include:

• diarrhoea

• feeling sick (nausea)

• hair loss in the treatment area 

Side effects tend to start a few days after the radiotherapy begins. They gradually get worse during treatment. They can continue to get worse after your treatment ends. But they usually begin to improve 1 or 2 weeks after your treatment ends.

Video about general side effects of radiotherapy

This video shows people affected by cancer talking about the general side effects of radiotherapy. The video is around 7 and a half minutes long.

We have a detailed section on radiotherapy side effects

Travelling to radiotherapy appointments

You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.

You can ask your radiographers for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7 am till 9 pm.

Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.

Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport. Or who have any other illnesses or disabilities. You might need to arrange hospital transport yourself.

Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this and hospital transport.

Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.