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Non-Hodgkin Lymphoma: External Radiation Therapy

What is radiation therapy?

Radiation therapy uses strong X-rays or other beams of energy to kill cancer cells or stop them from growing. There are different types of radiation therapy. For non-Hodgkin lymphoma, radiation is most often aimed at the cancer from a large machine that doesn't touch your body. This is called external radiation therapy or external beam radiation.

When is external radiation therapy used for non-Hodgkin lymphoma?

Your doctor may advise external radiation in these cases:

  • As the main treatment for certain types of lymphoma that are found early (stage I or II). Radiation works well for some lymphomas.

  • As the main treatment if you have a type of lymphoma that responds well to radiation and is only in a few places that are close to each other.

  • As part of the treatment for non-Hodgkin lymphoma that's growing fast, especially if you have a large or bulky tumor. (You might get chemotherapy along with the radiation.)

  • To help ease symptoms such as pain, by shrinking tumors that are pressing on organs and nerves.

  • As part of your treatment if you are getting a stem cell transplant. In this case, radiation is given to most of your body over a short period of time. This is known as total body irradiation.

Some people with lymphoma only in the skin might have electron beam radiation therapy. This treatment only affects your skin. It doesn’t go deeper into your body. This helps limit the side effects.

How is external radiation therapy given?

For this treatment, a doctor called a radiation oncologist creates your treatment plan. The plan shows what kind of radiation you’ll get and how long the treatment will last. This doctor can also prepare you for how you may feel during and after the treatment.

Radiation treatment is often done as an outpatient in a hospital or a clinic. That means you don't need to stay overnight in the hospital.

Preparing for radiation treatments with simulation

To get ready for your treatment, you will have a session called a simulation. This session helps decide which position you'll need to be in for your radiation treatments. Your doctor will want to make sure that the radiation is focused on the exact same spot each time. This first appointment may take up to 2 hours. Here's what you can expect during simulation:

  • You may have imaging scans, such as CT scans. These scans let your doctor see inside your body. They help show the exact location of the lymphoma. Your doctor then knows exactly where to aim the radiation.

  • You'll lie still on a table. A radiation therapist will use a machine to define your treatment field. This field is the exact spot on your body where the radiation will be aimed. You may have more than one treatment field if you have lymphoma in more than one place.

  • You will get into position. A mold or cast may be made to hold you in the exact same position for each treatment. Then the radiation therapist will mark the area of your body where the radiation will go. Your skin will be marked with a tiny ink dot, or a tattoo. This won't wash off right away in the shower.

  • If you're having total body irradiation, you may have to stand in a special machine. Or you may lie down on your stomach or your back.

  • You may have heavy protective shields put over organs such as your lungs, heart, and kidneys. This helps to protect them from the radiation.

During a radiation treatment session

The treatment is a lot like getting an X-ray. You stay in the radiation room for about 20 to 30 minutes. Most of this time is used to get you ready. The treatment will take just a few minutes. It doesn't hurt.

You’ll lie on a table while the machine is placed over you. The radiation therapist will line up lights on the machine with the marks on your skin. The radiation therapist will leave the room to turn on the machine. You will be able to talk with and hear each other over an intercom. You may hear whirring or clicking noises as the machine moves.

You will likely need radiation treatment every day for 5 days in a row for several weeks. You will not be radioactive during this time.

Possible short-term side effects

Radiation therapy affects normal cells as well as cancer cells. This can lead to side effects. The side effects of radiation depend on the part of your body being treated and other factors. You may feel better during your radiation treatment if you get plenty of rest and eat well. Most side effects get better over time once treatment is over.

Common side effects include:

  • Skin in the treated area that’s dry, irritated, and sensitive

  • Hair loss in the area being treated

  • Tiredness

  • Feeling weak

  • Worsening of chemotherapy side effects

Radiation to your chest or neck can cause:

  • Dry mouth

  • Mouth sores

  • Painful swallowing or burning in your throat

Radiation of your stomach can cause:

  • Nausea and vomiting

  • Loose stool or diarrhea

Total body radiation can cause:

  • Low blood cell counts

  • A higher risk for infection, from low white blood cell counts and from damaged skin and mucous membranes

Call your healthcare provider if you have signs of infection, such as fever or pain. Ask what other symptoms you should watch for and should call your healthcare provider about.

Possible long-term side effects

Radiation can also sometimes cause damage that may not show up until months or even years after treatment. Depending on where the radiation was aimed, this can include:

  • Lung or heart damage, from radiation to your chest

  • Damage to the thyroid gland, from radiation that reaches your neck

  • Headaches or memory loss, from radiation to your head

  • An increased risk for another cancer in the treated area

Online Medical Reviewer: Kimberly Stump-Sutliff RN MSN AOCNS
Online Medical Reviewer: Lu Cunningham RN BSN
Online Medical Reviewer: Richard LoCicero MD
Date Last Reviewed: 12/1/2019
© 2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.