Radiotherapy uses high dose x-rays to destroy cancer cells. Because cancer cells are dividing quickly they are particularly susceptible to damage from radiotherapy. Early stage Hodgkin lymphoma used to be treated with radiotherapy alone but these days it more commonly follows a course of chemotherapy. Radiotherapy may also be used after chemotherapy to treat advanced Hodgkin lymphoma. Radiotherapy may be used on its own or in combination with chemotherapy to treat high grade non-Hodgkin lymphoma and some people with low grade non-Hodgkin lymphoma. It may also be used to treat relapsed disease.

Radiotherapy is targeted directly at where tumours are in the body. The area to be treated will be mapped out in advance using a machine called a simulator, often using a CT scan. Marks may be made on the skin to help line up the x-ray machine for the treatment. People we spoke to had radiotherapy to the head, neck, shoulder, chest, armpit, eye, eyelid, spine or groin. Most people had to lie flat during treatment, others said they had to lie with their arm up at an angle so the x-rays could target their armpit. One man had total body irradiation (TBI) as part of preparation for a stem cell transplant. 

People who have radiotherapy to the head and/or neck may have a plastic mould or mask made to hold their head in position during treatment, which can be unpleasant but it does not last long. One man said the staff tried to talk to him after putting the mask in place but this was pointless as he couldn't speak through it. Lead shielding may also be placed between the patient and the x-ray machine to protect other areas of the body from the radiation. 

The treatment is given in the hospital radiotherapy department, usually as daily sessions from Monday to Friday, with a rest at the weekend. The length of treatment depends on the type and stage of the lymphoma and ranges from one day to eight weeks. Each treatment only takes a few minutes to give. One man had to make a long journey each day to spend only a short time at the hospital. Another advised people who do not like early mornings to avoid getting booked into the 9 a.m. slot, as he had, because they would have to come at the same time every day. During the short time that the radiotherapy is given the staff leave the room but they can still see you and talk with you. One woman found this 'freaky'. A man took his grandchildren into the waiting room one day to watch the red light go on and to try to imagine what was happening on the other side of the wall. One man said he enjoyed radiotherapy because he could lie around doing nothing during his treatment. Another took part in a trial comparing two different regimens of radiotherapy (see 'Treatment decisions').

Radiotherapy targets dividing cells, and healthy cells in the treatment field that are dividing quickly, such as the skin and lining of the mouth and gut, are also damaged. This is what causes the unwanted or side effects of treatment. A common unwanted effect of radiotherapy is tiredness but its intensity varies between different people. One person said they felt a bit tired but it was difficult to decide how much of it was due to the radiotherapy and how much to the illness itself. Another said, 'the treatment made me much more ill than the actual illness itself'; he felt weak and took three months off work. One person said the tiredness was worse towards the end of the treatment period and she needed a nap in the afternoons, another that he 'slumped on the sofa' for months afterwards. Some thought the tiredness was more do to with the daily travelling to and from hospital rather than the treatment itself.

People who had radiotherapy to the neck and chest often developed a dry mouth or a painful swollen throat. Some said this made swallowing difficult for a while and they could eat only soft food. Some were given anaesthetic lozenges or mouthwash to soothe the pain. One man's voice went husky. A man who had radiotherapy to his head also developed oral thrush (a fungal infection) and damage to his senses of taste and smell. People whose treatment field included areas of their bowel often felt nausea, but vomiting was prevented by taking anti-sickness tablets. 

In some people the treated areas of skin became red and sore, as in sunburn, and they were given creams or powders to moisturise and soothe it. People who had radiotherapy to parts of their head and neck lost their hair in those areas. One woman believed her hair had thinned after radiotherapy to her eye. She also had to protect her eye from sunlight afterwards, otherwise it watered a lot. 

Last reviewed February 2016.
Last updated February 2016.

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