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About radiotherapy for non Hodgkin lymphoma

Men and women discussing non Hodgkin's lymphoma

This page tells you about radiotherapy for non Hodgkin lymphoma. You can find the following information

 

A quick guide to what's on this page

About radiotherapy for non Hodgkin lymphoma

Radiotherapy uses high energy rays to kill cancer cells. Radiotherapy is often used as a local treatment. You have it when there are lymphoma cells in one or two areas of lymph nodes in one part of the body (stage 1 or 2). 

You may have radiotherapy with chemotherapy for high grade NHL or if there is a lot of lymphoma. Or you may have radiotherapy after chemotherapy to help stop the lymphoma from coming back. 

You usually have radiotherapy treatment once a day from Monday to Friday, with a rest over the weekend. The length of the treatment will depend on the type and size of your lymphoma. Each treatment only takes a few minutes. You can't feel it and it doesn't make you radioactive. So there is no risk to your family or other people when you return home. 

Planning your treatment

On your first visit, you lie under a large specialised CT scanning machine. Your treatment team uses the machine to work out exactly where to give the treatment. The doctor will make marks on your skin that the radiographer uses to line up the radiotherapy machine when you have your treatment.

Side effects

Radiotherapy has 2 main short term side effects. It can cause red, sore skin in the area being treated. And it may make you very tired. If you are having radiotherapy to your brain, as part of a bone marrow transplant or stem cell transplant, you may feel very, very tired. Other radiotherapy side effects vary, depending on the part of the body being treated.
 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating NHL section.

 

 

Radiotherapy for NHL

Radiotherapy uses high energy rays to kill cancer cells. Radiotherapy is often used as a local treatment. You have it when there are lymphoma cells in one or two areas of lymph nodes in one part of the body (stage 1 or 2). 

You may have radiotherapy with chemotherapy for high grade NHL or if there is a lot of lymphoma. Or you may have it after chemotherapy to help stop the lymphoma from coming back.

 

Total Body Irradiation (TBI)

If you are having a stem cell or bone marrow transplant, you may have TBI followed by a course of high dose chemotherapy. TBI is when you have whole body is given radiotherapy to kill off remaining bone marrow cells. Afterwards you are given either your own or a donor's bone marrow or stem cells, through a drip.

You can read more about TBI on this page and there is more information about stem cell and bone marrow transplants on this page.

 

When and where you have radiotherapy

You have radiotherapy treatment in the hospital radiotherapy department. Usually, you have treatment once a day from Monday to Friday, with a rest over the weekend. The length of the treatment will depend on the type and size of your lymphoma.

 

Planning your radiotherapy

Before you begin your treatment, the radiotherapy team carefully plan your external beam radiotherapy. This means working out how much radiation you need to treat the lymphoma and exactly where you need it. 

Your planning appointment may take from 15 minutes up to a couple of hours. You will have a planning CT scan. The scan shows the area of the lymphoma and the structures around it.

CT scanner

You lie on the scanner couch with the treatment area exposed. The radiographers will put some markers on your skin. You need to lie very still. Once you are in position the radiographers will move the couch up and through the scanner. The scanner is a doughnut shape. 

The radiographers leave the room and the scan starts. It takes up to 5 minutes. You won't feel anything. The radiographers watch from the next door room.

Before the planning appointment you may also have other scans, such as MRI scans or PET scans. Your treatment team can feed the other scans into the planning scanner.

Ink marks

Once the treatment team has planned your radiotherapy, they may put ink marks on your skin to make sure they treat exactly the same area every day. They may also make pin point sized tattoo marks in these areas.

Moulds or masks

If you are having treatment to your head or neck, you may need to have a mould (shell) made to keep you perfectly still while you have treatment. You may also have a mould if you have to keep an arm or leg perfectly still. The moulds are made in the mould room.

After your planning session

You may have to wait a few days or up to 2 weeks before you start treatment. During this time the physicists and your radiotherapy doctor decide the final details of your plan. 

Your doctor will plan the areas that need treatment and outline areas to limit the dose to or avoid completely. They call this contouring. Then the physicists and staff called dosimetrists plan the treatment very precisely using advanced computers.

 

Having your radiotherapy

Radiotherapy machines are very big. The machine may be fixed in one position or able to rotate around your body to give treatment from different directions. Before your first treatment your radiographers will explain what you will see and hear. The treatment rooms usually have docks for you to plug in music players so you can listen to your own music. 

You can't feel the radiotherapy when you have the treatment. It takes anything from 15 to 30 minutes. It is important to lie in the same position each time, so the radiographers may take a little while to get you ready.

A photo of a linear accelerator, which gives radiotherapy

Once you are in the right position the staff leave you alone in the room for the treatment. They watch you carefully on a closed circuit television screen.

Our page about having external radiotherapy has a video about having radiotherapy that you may want to watch.

External radiotherapy does not make you radioactive. It is safe to be with other people, including children, throughout your treatment.

 

Side effects

Radiotherapy has two main short term side effects. It can cause red, sore skin in the area being treated. And it may make you very tired.

The tiredness usually comes on as you go through your course of treatment. It may last for a few weeks after your treatment has finished. Tiredness is an effect of the radiation. And as you have to travel to the hospital daily for the treatment, this builds up after a few weeks. You may find that you need to take a rest during the day from time to time.

If family commitments are going to make it difficult for you to rest, it is worth planning ahead. You will probably need more help as your treatment goes on.

If you are having radiotherapy to your brain, as part of a bone marrow or stem cell transplant, you may become very, very tired. Doctors call this somnolence syndrome. Some people are affected more than others. At its worst, you may be asleep practically all the time for a while but this does wear off.

Other radiotherapy side effects vary, depending on the part of the body being treated, which include diarrhoea and nausea.

 

More information about radiotherapy

Find out about

Radiotherapy

Staging NHL

Radiotherapy skin markings

Radiotherapy moulds and masks

Radiotherapy side effects 

NHL organisations page

NHL reading list

For general information and support

Contact the Cancer Research UK nurses on freephone 0808 800 4040 (Open 9am - 5pm, Monday to Friday)

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Updated: 15 September 2014