Northern Centre for Cancer Care

Radiotherapy to the para-aortic lymph nodes for children

This page has been written to give you general information and answer some of the questions you may have about the side effects of radiotherapy.

We hope you will find this helpful.


We give radiation treatment (radiotherapy) in addition to surgery and or chemotherapy because the disease may come back if we do not. The paraaortic nodes may be involved by Hodgkin’s Lymphoma or by spread of sarcomas or other tumours from neighbouring organs. The treatment has to be planned with great care and it is successful for many, but unfortunately not all patients.

The total radiation dose has to be spread out over quite a long time to make the individual treatments safe. We give treatment every day for about three to four weeks (usually excluding weekends and bank holidays). At each session, the patient spends about ten minutes in the treatment room but most of this time is spent getting him/her into the right position.

Radiotherapy does not hurt, the machine does not touch the patient and it is rather like having an ordinary x-ray. We have to treat the whole area accurately, which means that the patient must lie very still. We decide whether the patient lies on their front or their back depending on the best way of giving the treatment. Lying still can be very difficult for some children, particularly young ones, so occasionally we have to use a general anaesthetic. A buzzing noise may be heard when the machine is working.


There are always side effects. We can relieve most of them but sometimes not completely. Some of the side effects happen immediately, some of them happen soon after we finish treatment and some take a longer time to show.

Immediate side-effects

  • Nausea and vomiting may occur with this treatment but these can usually be well controlled with anti-sickness drugs.
  • Diarrhoea may occur but it can usually be controlled with tablets and avoiding certain foods such as fruits, some spicy foods and certain vegetables.

Side-effects after treatment

  • A course of radiotherapy often makes patients tired. This is most noticeable near the end of the treatment and just afterwards.

Long-term side-effects

  • These are the hardest to predict and unfortunately, when they do happen, they are permanent.
  • The radiation may affect the growth of the backbones in the radiation area. As only a small part of the spine is treated it is unlikely to have a significant effect on final height.
  • The testicles are usually away from the treated area and in most cases will be unaffected by the radiotherapy. In girls the ovaries may be near the treatment area. Infertility and the need for hormone replacement therapy may occur. Options for overcoming infertility can be discussed at the appropriate time
  • The radiation dose we give is low and we would not expect any long-term bowel problems. However sometimes after surgery and radiotherapy the tissue surrounding the bowel can stick together (adhesions) and this can sometimes cause symptoms requiring surgery.
  • We are finding that, very rarely, children who have had treatment for one tumour can develop another type of tumour some years later.

During follow-up we will be looking out for all of these problems.

More information

Useful contacts

  • Northern Centre for Cancer Care Information Centre, tel: 0191 2138611. Opening hours Monday to Friday from 9.00am to 4.30pm
  • Macmillan Cancer Relief, Head Office tel: 020 7840 7840, freephone 0808 800 1234

Leaflet to download

You can also download the information on this page as a PDF leaflet:

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