Hodgkin's lymphoma is a rapidly growing cancer of the lymphatic system. It is relatively treatable and prognosis is generally good, even in advanced stages of the disease. The most commonly prescribed treatment are chemotherapy and radiation therapy. This article will address the particulars of radiation therapy for Hodgkin's lymphoma, including method of administration and common side effects.
Method of Treatment
Radiation therapy for Hodgkin's lymphoma (sometimes called radiotherapy) works by targeting high-energy radioactive waves at the cancerous tumors, which kills the cancer cells. There are two different approaches to this, each with special considerations.
In the first approach, called involved field radiation, the patient's body is placed inside or beneath a large machine, which focuses the rays on the specific lymph nodes identified as harboring cancerous cells. Thus, this form of radiotherapy is considered a "local therapy", and is typically administered after several rounds of chemotherapy.
In contrast, extended field radiation is administered only when chemotherapy has not been, and targets adjacent lymph nodes in addition to the cancerous ones. It was once thought that this would preemptively kill any cancer cells that had made it to the adjacent nodes, but studies have shown no real increase in survival rates using extended field radiation. This, along with more serious side effects, have led clinicians to increasingly favor involved field radiation.
Over the course of several treatments, the tumors shrink. A typical course of treatment will involve doses of radiation five days a week for several weeks.
Complications and Side Effects
While often a life-saving procedure, radiotherapy is not without its risks. Chief among these is the immunosuppressive qualities of radiation. Even local radiation can cause a systemically weakened immune system, especially in patients who have already received chemotherapy. To prevent life-threatening infections from developing, patients should receive vaccinations against the influenza virus, and pneumonia and meningitis bacteria.
Another complication is infertility among those who receive radiation in the pelvic area. Typically, men's sperm will recover within five years; infertility in women may be permanent.
Heart disease and stroke risk increase for patients who receive radiotherapy. Lower doses of radiation have been associated with less of a risk increase.
Another cause for concern is the potential to develop secondary cancers at the site of radiation treatment. The type of cancer and its associated risk depend on the area targeted. Women who receive radiation treatments to the chest area, for example, are more prone to develop breast cancer at a later time. Additionally, smoking after treatment greatly increase the odds of developing lung cancer, and is highly discouraged.
Secondary side effects of radiation therapy for Hodgkin's lymphoma include the following:
- Nausea and vomiting
- Diarrhea and other intestinal problems
- Sore throat or trouble swallowing
- Dry or irritated skin over the point of treatment
Many of these side effects can be successfully managed, and few are permanent. Most clear up within several weeks or months after finishing treatment. Anyone treated with radiation therapy, regardless of outcome, will likely require lifetime monitoring to ensure the cancer has been successfully eradicated.