Lymphoma - Hodgkin: Late Effects of Treatment

Approved by the Cancer.Net Editorial Board, 07/2020

ON THIS PAGE: You will find out more about the physical and emotional side effects that can occur long after treatment for Hodgkin lymphoma has ended and how these late effects can be prevented and/or managed. Use the menu to see other pages.

People who received treatment for Hodgkin lymphoma have an increased risk of developing other diseases or conditions later in life. This is because both chemotherapy and radiation therapy can cause permanent damage. Treatments have improved in the last 30 years, and now people 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. Infertility is the inability to have a child. 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. Bone marrow/stem cell transplantation usually causes infertility in men. It is unusual, but not impossible, for women to become pregnant after a transplant.

    People 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 (after certain types of chemotherapy, like BEACOPP, 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. People 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 problems and lung damage. Radiation therapy to the chest area also can cause lung damage and increase the risk of heart disease. It is very important that people who received radiation therapy to the chest limit other risk factors that may lead to heart damage by not smoking, by 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 can cause problems with the thyroid gland, most commonly hypothyroidism. Hypothyroidism is when the body produces too little thyroid hormone, which regulates metabolism. This problem can be checked using a blood test and managed by regularly taking a thyroid hormone supplement pill.

  • Emotional issues. Survivors of Hodgkin lymphoma have a higher risk of depression and other emotional concernsmost commonly in the year after treatment ends. Patients and caregivers should talk with the health care team if they see symptoms of depression.

Learn more about possible late effects of cancer treatment.

The next section in this guide is Follow-up CareIt explains the importance of checkups after cancer treatment is finished. Use the menu to choose a different section to read in this guide.