Lymphoma - Hodgkin: Late Effects of Treatment

Approved by the Cancer.Net Editorial Board, 06/2014

ON THIS PAGE: You will find out more about the physical and emotional side effects that can occur long after treatment for this type of cancer has ended and how these late effects can be prevented and/or managed. To see other pages, use the menu on the side of your screen.

People who received treatment for Hodgkin lymphoma have an increased risk of developing other diseases or conditions later in life because both chemotherapy and radiation therapy can cause permanent damage. Treatments have improved in the last 30 years, and now patients are less likely to experience late effects; however, there is still some risk. Therefore, it is important that patients see their doctors regularly for follow-up care and watch for any new side effects.

  • Radiation therapy to the pelvic area can lead to infertility in women or men unless the ovaries or testicles are shielded from the radiation during treatment. Also, teenagers and adults who received chemotherapy may be at higher risk for low sperm counts (for men) or damage to the ovaries (for women).

    Men who received combination chemotherapy may be at risk for infertility after treatment. The risk appears to be associated with drugs known as alkylating agents, which are used much less often in current chemotherapy regimens for Hodgkin lymphoma. Although the risk of infertility for men is low after chemotherapy for Hodgkin lymphoma, it is still possible, and men who are considering having a family should consider sperm storage before starting chemotherapy. Men who have had a stem cell transplant are almost always infertile after this treatment.

    Women who received chemotherapy for Hodgkin lymphoma have an increased risk of infertility or early menopause. Again, this is mostly related to alkylating drugs and is less common with modern chemotherapy treatments. It is unusual, but not impossible, for women to become pregnant after stem cell transplantation.

    Learn more about fertility concerns and preservation for men and women.

  • Some survivors of Hodgkin lymphoma have a higher risk of developing a secondary cancer, especially acute myeloid leukemia (following certain types of chemotherapy or radiation therapy), non-Hodgkin lymphoma, lung cancer, or breast cancer. The risk of a secondary cancer is likely to decrease in the future because the treatments used now have fewer risks. Patients can lower their risk of developing a secondary cancer by limiting or avoiding other risk factors, such as smoking.
  • Radiation therapy to the chest area can cause lung damage, increase the risk of heart disease, and increase the risk of lung cancer and breast cancer. It is important that men and women who received radiation to the chest limit other risk factors that may lead to heart damage, such as smoking, obesity, and high cholesterol. It is important that women who received radiation therapy to the chest begin regular breast cancer screening at an early age.
  • Patients who received anthracyclines (doxorubicin) or bleomycin during chemotherapy have a higher risk of both heart and lung damage.
  • Radiation therapy to the neck area specifically or as part of total body irradiation (TBI) before a stem cell transplant can cause thyroid problems, most commonly hypothyroidism. Hypothyroidism is when the body produces too little thyroid hormone, which regulates metabolism. This problem can be managed by taking a thyroid hormone supplement pill.
  • Survivors of Hodgkin lymphoma may also have a higher risk of depression or other emotional concerns.

Learn more about possible late effects of cancer treatment.

The next section helps explain medical tests and check-ups needed after finishing cancer treatment. Use the menu on the side of your screen to select After Treatment, or you can select another section, to continue reading this guide.