Lymphoma - Hodgkin: Late Effects of Treatment

Approved by the Cancer.Net Editorial Board, 10/2015

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 lymphoma 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.

  • Infertility. Radiation therapy to the pelvic area can cause infertility unless the ovaries or testicles are shielded 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).The risk of infertility is low after ABVD chemotherapy for Hodgkin lymphoma but is much higher after BEACOPP. Stem cell transplantation usually causes infertility in men. It is unusual, but not impossible, for women to become pregnant after a stem cell transplant.

    Patients who are considering having a family should discuss fertility preservation with their doctor before starting treatment. Learn more about fertility concerns and preservation for men and women.

  • Second cancers. 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. It is also important that women who received radiation therapy to the chest begin regular breast cancer screening at age 40 or 8 years after treatment, whichever comes first.

  • Lung and heart damage. Patients who received anthracyclines (doxorubicin) or bleomycin during chemotherapy have a higher risk of both heart and lung damage. Radiation therapy to the chest area also can cause lung damage and increase the risk of heart disease. It is important that men and women who received radiation to the chest limit other risk factors that may lead to heart damage, by not smoking, getting regular exercise, by monitoring and maintaining healthy blood pressure and cholesterol levels, and by making healthy food choices.

  • Thyroid problems. 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. 

  • Emotional issues. Survivors of Hodgkin lymphoma have a higher risk of depression and other emotional concerns.

Learn more about possible late effects of cancer treatment.

The next section in this guide is Follow-Up Care, and it explains the importance of check-ups after cancer treatment is finished. Or, use the menu on the side of your screen to choose another section to continue reading this guide.