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Treatment Options for Hodgkin's and Non-Hodgkin's Lymphoma

Treatment options depend on the type of lymphoma, its stage and your overall health.  Treatment may include chemotherapy or radiation therapy, either alone or in combination.  It may help to talk to several cancer specialists before deciding on the best course of treatment for you, your cancer and your lifestyle.

  • A radiation oncologist is a doctor who specializes in destroying cancer cells with high energy X-rays or other types of radiation.
  • A medical oncologist is a doctor who is an expert at prescribing special drugs (chemotherapy) to treat cancer.  Some medical oncologists are also hematologists, meaning they have experience treating blood problems.

Understanding Radiation Therapy

Radiation therapy, also called radiotherapy, is the careful use of radiation to safely and effectively kill cancer cells while avoiding nearby healthy tissue.

  • Radiation oncologists use radiation therapy to cure cancer, to control cancer growth or to relieve symptoms, such as pain.
  • Radiation therapy works within cancer cells by damaging their ability to multiply.  When these cells are destroyed by the radiation, the body naturally eliminates them.
  • Healthy tissues can also be affected by radiation, but they are usually able to repair themselves in a way cancer cells cannot.

External Beam Radiation Therapy

External beam radiation therapy is a series of outpatient treatments to accurately deliver radiation to the cancer cells.

  • Radiation oncologists deliver external beam radiation therapy to the lymphoma from a machine called a linear accelerator.
  • Each treatment is painless and is similar to getting an X-ray.  Treatments last less than 30 minutes each, every day except for Saturday and Sunday, for three to four weeks.
  • Involved field radiation is when your doctor delivers radiation only to the parts of your body known to have cancer.  It is often combined with chemotherapy.  Radiation above the diaphragm to the neck, chest and/or underarms is called mantle field radiation.  Treatment below the diaphragm to the abdomen, spleen and/or pelvis is called inverted-Y field radiation.
  • Your radiation oncologist may deliver radiation to all the lymph nodes in the body to destroy cancer cells that may have spread to other lymph nodes.  This is called total nodal irradiation.
  • Your radiation oncologist may also deliver radiation to the entire body.  This is called total body irradiation.  It is often done before chemotherapy and a stem cell or bone marrow transplant to eliminate any remaining cancer cells and create space for the new stem cells.

Potential Side Effects

The side effects you may experience will depend on the part of the body being treated, the dose of radiation given and if you also receive chemotherapy.  Ask your doctor before treatment begins about possible side effects, and how best to manage them.

  • You may experience very few or no side effects and can continue your normal routine during treatment.
  • You may experience mild skin irritation, hair loss, sore throat, upset stomach, loose bowel movements, nausea and/or fatigue.  Most side effects will go away after treatment ends.

Tell your doctor or nurse if you experience any discomfort.  They may be able to prescribe medication or change your diet to help.

Biologic Therapy for Non-Hodgkin's Lymphoma

Also called immunotherapy, biologic therapy works with your immune system to fight cancer.  Biologic therapy is like chemotherapy.  The difference is that chemotherapy attacks the cancer directly and biologic therapy helps your immune system better fight the disease.

  • Monoclonal antibodies work by targeting certain molecules in the body and attaching themselves to those molecules.  This causes some lymphoma cells to die and makes others more likely to be destroyed by radiation and chemotherapy.
  • Radiolabeled antibodies are monoclonal antibodies with radioactive particles attached.  These antibodies are designed to attach themselves directly to the cancer cell and damage it with small amounts of radiation without injuring nearby healthy tissue.  Presently, radiolabeled antibodies are being used to treat non-Hodgkins lymphoma that has come back after treatment.