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What You Need to Know about  Hodgkin's Lymphoma

Side Effects of Treatment

Treatments for Hodgkin's disease are very powerful. It is hard to limit the effects of therapy so that only cancer cells are destroyed. Because treatment also damages healthy cells and tissues, it often causes side effects.

The side effects of cancer treatment depend mainly on the type and extent of the therapy. Side effects may not be the same for everyone, and they may even change from one treatment to the next. Doctors and nurses can explain the possible side effects of treatment. They can also lessen or control many of the side effects that may occur during and after treatment.

Radiation Therapy

The side effects of radiation depend on the treatment dose and the part of the body that is treated. During radiation therapy, people are likely to become extremely tired, especially in the later weeks of treatment. Rest is important, but doctors usually advise patients to try to stay as active as they can.

It is common to lose hair in the treated area and for the skin to become red, dry, tender, and itchy. There may also be permanent darkening or "bronzing" of the skin in the treated area.

When the chest and neck are treated, patients may have a dry, sore throat and some trouble swallowing. Sometimes, they have shortness of breath or a dry cough. Radiation therapy to the abdomen may cause nausea, vomiting, diarrhea, or urinary discomfort. Often, changes in diet or medicine can ease these problems.

Radiation therapy also may cause a decrease in the number of white blood cells, cells that help protect the body against infection, or platelets, cells that help the blood to clot. If that happens, patients need to be careful to avoid possible sources of infection or injury. The doctor monitors a patient's blood count very carefully during radiation treatment. If necessary, treatment may have to be postponed to let the blood counts return to normal.

Although the side effects of radiation therapy can be difficult, they can usually be treated or controlled. It may also help to know that, in most cases, side effects are not permanent. However, patients may want to discuss with their doctor the possible long-term effects of radiation treatment on fertility (the ability to produce children) and the increased chance of second cancers after treatment is over. (The "Followup Care" section includes more information about the chance for second cancers.) Loss of fertility may be temporary or permanent, depending on if the testes or ovaries received radiation and the patient's age. For men, sperm banking before treatment may be a choice. Women's menstrual periods may stop, and they may have hot flashes and vaginal dryness. Menstrual periods are more likely to return for younger women. The National Cancer Institute booklet Radiation Therapy and You has helpful information about radiation therapy and managing its side effects.

Chemotherapy

The side effects of chemotherapy depend mainly on the specific drugs and the doses the patient receives. As with other types of treatment, side effects may vary from person to person.

Anticancer drugs generally affect cells that divide rapidly. In addition to cancer cells, these include blood cells, which fight infection, help the blood to clot, and carry oxygen to all parts of the body. When blood cells are affected, the patient is more likely to get infections, may bruise or bleed easily, and may feel unusually weak and tired.

Cells in hair roots also divide rapidly; therefore, chemotherapy may lead to hair loss. Hair loss is a major concern for many patients. Some anticancer drugs only cause the hair to thin out, while others may result in the loss of all body hair. People may cope with hair loss better if they decide how to handle hair loss before starting treatment.

Cells that line the digestive tract also divide rapidly, and are often damaged by chemotherapy. As a result, side effects may include poor appetite, nausea and vomiting, and/or mouth and lip sores.

Most side effects go away gradually during the recovery periods between treatments or after treatment is over. Sometimes, however, chemotherapy results in a permanent loss of fertility. The National Cancer Institute booklet Chemotherapy and You has helpful information about chemotherapy and coping with side effects.

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