Radiotherapy treatment

Radiotherapy uses radiation, usually x-rays, to destroy cancer cells.

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

Before your first treatment, your therapy radiographers Open a glossary item 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.

Photo of a linear accelerator

During the treatment

You need to lie very still. 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, nausea and hair loss in the area being treated.

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 for most of the time for a while. But this does wear off. 

The skin in the area being treated may become red and sore. It may take 4 to 6 weeks for this to get better.

Using lotions, powders or creams on the 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

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 the therapy radiographers Open a glossary item 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 7am till 9pm.

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.

The radiotherapy staff may be able to arrange transport if you have no other way to get to the hospital. Your radiotherapy doctor would have to agree. This is because it is only for people that would struggle using public transport and have no access to a car. 

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.

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

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