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Radiotherapy treatment

Find out about how you have radiotherapy for non-Hodgkin lymphoma (NHL).

What it is

Radiotherapy uses high energy x-rays to treat cancer cells.

Radiotherapy to one area of the body

You might have radiotherapy for stage 1 or 2 NHL. In this situation, you have radiotherapy to one area of the body. 

You might have radiotherapy to one area of your body:

  • with chemotherapy (chemoradiotherapy) for high grade non-Hodgkin lymphoma 
  • if there are big areas of lymphoma (bulky disease) 
  • after chemotherapy to help stop lymphoma coming back 

Total body irradiation

You might have total body irradiation (TBI) followed by high dose chemotherapy if you are having a stem cell or bone marrow transplant.

In TBI your 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.

When you have radiotherapy

You have radiotherapy treatment in the hospital radiotherapy department.  The length of the treatment will depend on the type and size of your lymphoma.

The radiotherapy room

Radiotherapy machines are very big. They rotate around you to give you your treatment. The machine doesn't touch you at any point.

Before you start your course of treatment your therapy radiographers explain what you will see and hear. In some departments the treatment rooms have docks for you to plug in your music player. So you can listen to your own music.

Photo of a linear accelerator

During the treatment

You need to lie very still on your back. Your radiographers might take images (x-rays or scans) before your treatment 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 non-Hodgkin lymphoma has two main short term side effects. It can cause red, sore skin in the area being treated. And it can make you very tired.

Radiotherapy side effects vary, depending on the part of the body being treated. They include diarrhoea and nausea.

You might feel tired during your treatment. It tends to get worse as the treatment goes on. You might also feel weak and lack energy. Rest when you need to.

Tiredness can carry on for some weeks after the treatment has ended but it usually improves gradually.

Various things can help you to reduce tiredness and cope with it, such as exercise. Some research has shown that taking gentle exercise can give you more energy. It's important to balance exercise with resting.

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

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

The area being treated may become red and sore.

Using lotions, powders or creams on your treatment area might make things worse. It is important to get advice from the radiotherapy department before you use something to soothe your skin.

Radiotherapy can inflame the lining of your bowel. This can cause diarrhoea. You may also have:

  • griping or cramping pain
  • an increase in wind
  • feeling you need to go to the toilet urgently
  • some mucus or blood in your poo (stool)

It’s important to drink plenty if you have diarrhoea, so you don't become dehydrated. Your doctor might prescribe tablets to help slow down your bowel if you need them. This should help to reduce the number of times you have diarrhoea.  Changing your diet might also help lessen the number of times you need to go, such as a low fibre diet. Ask your nurse or doctor about this.

Ask your nurse or radiographer for soothing creams to apply around your back passage (anus). The skin in that area can get very sore and might break if you have severe diarrhoea.

Diarrhoea should gradually get better a few weeks after your treatment has finished. Let your doctor or nurse know if it continues.

You might feel sick during the first few days after your radiotherapy treatment. Tell your doctor or nurse if you do feel sick. They can give you anti sickness medicine.

Travelling to radiotherapy appointments

Tell the radiotherapy department if you prefer treatment at a particular time of day. They can try to arrange this.

Car parking can be difficult at hospitals. It’s worth asking the radiotherapy unit staff:

  • if they can give you a hospital parking permit
  • about discounted parking rates
  • where you can get help with travel fares
  • for tips on free places to park nearby

If you have no other way to get to the hospital, the radiotherapy staff might be able to arrange hospital transport for you. But it might not always be at convenient times. To see if you're eligible they usually work it out based on your earnings or income.

Some hospitals have their own drivers or can arrange ambulances. Some charities offer hospital transport.

Information and help