Radiotherapy uses high-energy x-rays to kill cancer cells and shrink cancers. Radiotherapy is usually given in small doses also known as fractions each week day Monday to Friday over a few weeks in the radiotherapy department of a hospital.
Before radiotherapy begins, the radiotherapist doctor who specialises in treating people with radiotherapy will carefully calculate the correct dose of radiation therapy for you. The areas of your body that need to be treated will be marked with tiny ink dots on your skin using a special pen.
When you are having radiotherapy you usually lie on a table underneath the radiotherapy machine which delivers the planned dose of radiation. Important structures like your heart and lungs are shielded as much as possible to ensure that they are not affected by the treatment given. Radiotherapy is painless. In fact you do not see or feel anything during the actual treatment. You will however need to stay perfectly still for a few minutes while the treatment is taking place. You might like to bring along some music to help you relax.
Chemotherapy literally means therapy with chemicals. Many chemotherapy drugs are also called cytotoxics cell toxic because they kill cells, especially ones that multiply quickly like cancer cells. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function.
These drugs are called immune checkpoint inhibitors or PD-1 inhibitors. When these drugs are used alone in people with Hodgkin lymphoma who have had a recurrence after previous treatments, the scans of about 2 of every 3 patients show improvement for an average of 9 months, although it is unlikely that the lymphoma is cured.
There are side effects from these immunotherapy treatments, but they are generally mild. It is important to talk with your doctor about all immunotherapy side effects. There is some concern that allogeneic bone marrow transplantation may be more dangerous in people who have received 1 of these drugs.
Doctors do not yet know if it is safe to combine PD-1 inhibitors with other treatments for Hodgkin lymphoma or if these drugs would be useful in treating Hodgkin lymphoma that has not recurred.
Different types of immunotherapy can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes. Talk with your doctor about possible side effects for the immunotherapy recommended for you. Learn more about the basics of immunotherapy.
Radiation therapy is the use of high-energy x-rays or protons to destroy cancer cells. A radiation oncologist is a doctor who specializes in giving radiation therapy to treat cancer. Radiation therapy for Hodgkin lymphoma is always external-beam radiation therapy, which is radiation given from a machine outside the body.
A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set number of days or weeks. Whenever possible, radiation therapy is directed only at the affected lymph node areas. This helps reduce the risk of damaging healthy tissues.
Newer radiation therapy techniques may also be available. These include:. Intensity modulated radiotherapy IMRT , which varies the strength and direction of the radiation beams so less healthy tissue is affected.
Controlling breathing during treatment, such as having the patient hold their breath, may enable smaller areas to be effectively treated. Proton therapy, which uses protons rather than x-rays to treat the cancer, may be recommended for certain people.
The immediate side effects from radiation therapy depend on the area of the body that is being treated. All people treated with radiation therapy may experience fatigue or mild skin reactions.
Radiation therapy to the mediastinum may cause a cough, nausea, or pain with swallowing. Most side effects go away soon after treatment is finished. Although the risk for long-term side effects has decreased with improvements in treatment, radiation therapy may still cause long-term side effects, also called late effects. This may include damage to the thyroid gland if radiation therapy is given to the neck, secondary cancers, and vascular damage, including damage to blood vessels and valves in the heart if radiation therapy is given to the chest.
To reduce the risk of long-term side effects, clinical trials are being done to find out the best doses and smallest possible area to receive the radiation therapy. A stem cell transplantation is a medical procedure in which specialized cells, called hematopoietic stem cells, are collected from the the blood circulating through the body, called peripheral blood, so they may develop into healthy bone marrow.
Hematopoietic stem cells are blood-forming cells found both in the bloodstream and in the bone marrow. Sometimes, the stem cells are collected from bone marrow, so the procedure may also be called a bone marrow transplantation. Transplantation is not used as a first treatment for Hodgkin lymphoma, but it may be recommended for people who have lymphoma remaining after chemotherapy or if the lymphoma returns following treatment. Before recommending transplantation, doctors will talk with the patient about the risks of this treatment.
There are 2 types of stem cell transplantation, depending on the source of the replacement blood stem cells. Autologous AUTO transplant. The stem cells are collected when the patient is in remission after treatment. The stem cells are then frozen. An AUTO transplant allows more intense chemotherapy doses to be given so leftover lymphoma cells are destroyed. Returning the saved stem cells to the body by intravenous infusion then allows the bone marrow and blood cells to recover from the intensive, high-dose chemotherapy.
Allogeneic ALLO transplant. It is important to talk with the doctor about the potential risks and benefits of both types of transplants to determine the best choice for an individual. Side effects depend on the type of transplant, your general health, and other factors. Learn more about the basics of bone marrow transplants. Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects.
Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs.
Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment. Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies.
You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy. Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan.
You should also talk about the possible side effects of the specific treatment plan and palliative care options. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Diagnosis Bone marrow exam Open pop-up dialog box Close. Bone marrow exam In a bone marrow aspiration, a doctor or nurse uses a thin needle to remove a small amount of liquid bone marrow, usually from a spot in the back of your hipbone pelvis.
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Show references Hoffman R, et al. Hodgkin lymphoma: Clinical manifestations, staging, and therapy. In: Hematology: Basic Principles and Practice. Philadelphia, Pa. Accessed Oct. The lymphoma guide: Information for patients and caregivers.
Accessed July 18, Adult Hodgkin lymphoma treatment PDQ. National Cancer Institute. Distress management. Fort Washington, Pa. Hodgkin lymphoma. Maurer MJ, et al. Event-free survival at 24 months is a robust end point for disease-related outcome in diffuse large B-cell lymphoma treated with immunochemotherapy.
Journal of Clinical Oncology. Riggin EA. Allscripts EPSi. Mayo Clinic, Rochester, Minn. If regular chemotherapy is unsuccessful or Hodgkin lymphoma returns after treatment, you may have a course of chemotherapy at a higher dose. However, this intensive chemotherapy destroys your bone marrow, leading to the problems mentioned above.
You'll need a stem cell or bone marrow transplant to replace the damaged bone marrow. Radiotherapy is most often used to treat early-stage Hodgkin lymphoma, where the cancer is only in 1 part of the body. Treatment is normally given in short daily sessions, Monday to Friday, over several weeks.
You shouldn't have to stay in hospital between appointments. Radiotherapy itself is painless, but it can have some significant side effects. These can vary and will be directly related to the part of your body being treated. For example, treatment to your throat can lead to a sore throat, while treatment to the head can lead to hair loss. Most side effects are temporary, but there's a risk of long-term problems, including infertility and permanently darkened skin in the treatment area.
Steroid medication is sometimes used in combination with chemotherapy as a more intensive treatment for advanced cases of Hodgkin lymphoma, or if initial treatment hasn't worked. If you're diagnosed with a rare type of Hodgkin lymphoma called lymphocyte-predominant Hodgkin lymphoma, you may have chemotherapy in combination with a medication called rituximab. Rituximab is a type of biological therapy called a monoclonal antibody. It attaches itself to the surface of cancerous cells and stimulates the immune system to attack and kill the cell.
You may be given additional medication to prevent or reduce side effects. Any side effects should improve over time as your body gets used to the medication.
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