Surviving Lymphoma: Late Effects

Artificial Tears etc.

Lymphoma, in it's many forms, can cause little damage to the body before and during treatment or it can take a terrible toll in terms of organ function and stamina.  Exactly what lymphoma does to the body varies according to the individual - the effects listed may or may not apply to you.  

Chemotherapy Effects

Different chemotherapy drugs can cause different effects.  The most common are:

• "Chemo Brain" - a term used by cancer survivors to explain memory loss and intermittent recollection.
• Peripheral Neuropathy - a numbing of the hand, feet, and other extremities.  This often occurs with patients being treated with vinblastine (Hodgkin's) or vincristine (some type of Non-Hodgkin's) chemotherapy.   The numbing may go away after treatment although it may take time. 
• Heart problems from damage from adriamycin (A in ABVD)
• Lung problems from damage from bleomycin (B in ABVD)
• Heavy prednisone exposure may cause avascular necrosis - where part of the bone actually may die and degenerate.

Radiation Effects

With modern treatments, true complications from radiotherapy are rare.  Older generators were less precise in their delivery of radiation, raising the chances of problems.  Any effects vary according to the field of radiation exposure.

• Some long term effects include lung fibrosis, gastrointestinal problems, neurological problems, cardiac (heart) problems, osteoporosis, and thyroid function problems. 
• Radiation to the mouth area can destroy salivary function.
• Radiation can lead to increased risk for developing other types of cancer, especially near radiation ports.  Young women are more at risk for breast cancer, for example, if radiation was given to the chest.

Other Effects

Some effects are much harder to point a finger at.  These include:

• Fatigue - fighting the cancer and replenishing cells takes a great deal of energy.  It takes time but much of the energy comes back, albeit slowly.
• Pain - some pain may linger after cancer treatment

Dealing with Late Effects

Knowing about late effects is the first step.  Coping is the rest of the journey.  Knowledge is again of great help - knowing your treatment and the effects you are experiencing or likely to experience. 

Doctors are now beginning to listen to patients - with cancer becoming more of a condition which one survives for many years, the science of coping with late effects is becoming known in the medical journals.  If your medical team does not listen to your concerns show them your own research.  If there are still problems you should seek a second opinion.

Finally, late effects may make life difficult, from minor annoyance to daily threat.  Being informed and choosing the proper support systems are keys to taking control of your new life.

Further Reading

Non-Hodgkin's Lymphomas, Peter M. Mauch (Editor), James O. Armitage (Editor), et al., 2004.

• Section V: Late Effects
  • Chapter 33: Second Cancers
  • Chapter 34: Late Effects of Treatment after Lymphoma
  • Chapter 35: Assessing Quality of Life in Patients with Lymphoma

Reference and Information Links

• Secondary Cancer Information
• Peripheral Neuropathy and Avascular Necrosis
• A list of saliva substitutes
• Fatigue data sheet from NCI
• Fatigue Causes and Cures from Li's Pages
• Cancer pain information for Adults and Children from University of Iowa
• A very good article on late effects in long term high-grade NHL patients (updated link)

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This page is a work in progress - if you have more complete information, references, or other information please contact the author. The author is not in the medical field and does not warrant the correctness of the material on this page or the sites linked - please take online information and consult with your own medical team to make informed decisions.

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Updated December 27, 2004