Late effects of treatment for lymphoma

Some people have side effects during their lymphoma treatment and for a few weeks after. Usually, these effects reduce and eventually disappear.

But some people may have side effects that continue for months after treatment. These are often called long-term effects. Other people may have side effects that develop months or years after treatment. These are often called late effects.

Not everyone has long-term or late effects. And many side effects get better over time. This can depend on different factors, such as the type of treatment. Your specialist doctor or nurse can give you more information.

We have more information on treating Hodgkin lymphoma (HL) and treating non-Hodgkin lymphoma (NHL).

Your immune system protects you against infection. Lymphoma and treatment for it can affect how your immune system works. this can make you less able to fight infections.

It is important to report any signs of an infection to your lymphoma team or GP. Having it treated straight away can prevent serious complications.

Your specialist doctor may advise you to have vaccinations to protect you against infections such as flu or pneumonia. They usually also recommend that you have a coronavirus vaccination.

These are inactivated vaccinations that can help reduce the risk of infection. People with weak immune systems can have these, as they are not live vaccinations. Ask them for advice about when you should have vaccinations.

Some vaccines have small amounts of a live virus or bacteria in them. They are called live vaccines. You should not have live vaccines:

• If you have had Hodgkin lymphoma
• for 6 to 12 months after treatment for NHL, or until your immune system has recovered.

Ask your specialist doctor or nurse whether a vaccination is safe for you to have before having it.

Pneumonia is a severe type of chest infection. Certain treatments can lower the number of lymphocytes (white blood cells that fight infection). This can last for several months. It can make you more likely to develop a type of pneumonia called PJP or PCP.

If you are at risk, your doctor will ask you to take tablets such as to help prevent infection. These may be co-trimoxazole (Septrin®). You may need to take them for several months. They reduce your risk of infection until the number of lymphocytes in your blood returns to normal.

People usually reach menopause between the ages of 45 and 55. But after treatment for lymphoma, you may have an earlier menopause. Your doctor or nurse can tell you if this is likely.

We have more information about menopausal symptoms.

Chemotherapy and radiotherapy can lead to a slightly increased risk of developing a second cancer later in life. But treatments are designed to limit these risks as much as possible.

Women under the age of 30 who have had radiotherapy to the chest area have a higher risk of breast cancer. They should have screening for breast cancer at an earlier age than usual. Screening usually involves a physical check-up and an x-ray (mammogram) or MRI scan of each breast. Your doctor or nurse will explain what to expect.

The chemotherapy drug bleomycin can cause changes to the lungs that may affect your breathing. These changes may happen during treatment. They usually get better months or years after treatment ends. Sometimes bleomycin causes permanent damage to the lungs. This is more likely if:

• you also had radiotherapy to the chest area
• you are over 60
• you have other lung problems.

If you smoke, quitting will improve your lung health and reduce your risk of breathing problems.

High doses of oxygen can make breathing problems worse in people who have had bleomycin. If you need oxygen treatment or an operation, always tell your doctor or nurse that you have had bleomycin.