Multiple Myeloma: Radiation Therapy
What is radiation therapy?
Radiation uses high-energy radiation from X-rays or particles to kill cancer cells.
When might radiation be used?
Radiation can be part of the treatment for some people with multiple myeloma. There are several reasons your healthcare provider may recommend this treatment:
To help relieve bone pain that isn’t responding to other treatments. These include chemotherapy.
To treat a single plasma cell tumor. This is called a solitary plasmacytoma.
As part of the treatment for a stem cell transplant, you may receive radiation to your whole body. This is called total body irradiation or TBI.
Radiation is not the main treatment for multiple myeloma. But sometimes it can be helpful in the situations above.
To plan your treatment strategy, meet with your healthcare team. Your team might include a hematologist, radiation oncologist, and medical oncologist.
What happens during radiation
The most common way to receive radiation for this cancer is from a machine outside your body. This machine gives off invisible X-ray beams. This is called external radiation. A doctor who specializes in cancer and radiation is called a radiation oncologist. This doctor works with you to decide the kind of radiation you need. He or she also decides the dose and how long you’ll need the treatment.
You can usually receive external radiation therapy on an outpatient basis in a hospital or a clinic. How often and how long you get this treatment depends on why it’s being given.
Preparing for radiation
Before your first treatment, you’ll have a session to check exactly where on your body the radiation beams need to be directed. The process is called simulation. This session may take up to two hours. During this session, you may have imaging tests, such as computed tomography (CT) scans or magnetic resonance imaging (MRI) scans. This can help your healthcare provider know the exact location of your tumor(s) to better aim the radiation. Also at this session, you may have body molds made. These can help keep you from moving during the treatment. Then, you’ll lie still on a table while a radiation therapist uses a machine to define your treatment field. The field is the exact area on your body where the radiation will be aimed. Sometimes it’s called your port. The therapist may mark your skin with tiny dots of semi-permanent ink so that the radiation will be aimed at the exact same place each time.
On the days you get radiation
On the days you get radiation treatment, you’ll lie on a table while the machine is placed over you. You may have to wear a hospital gown. It’s like getting an X-ray, only longer. It usually takes about 15 to 30 minutes to do. You should, though, plan on being there for about an hour.
At the start of the treatment session, a radiation therapist may place blocks or special shields to protect parts of your body that don’t need to be exposed to radiation. The therapist then lines up the machine so that radiation is directed to the spot that was marked during the simulation. When you’re ready, the therapist leaves the room and turns the machine on. You may hear whirring or clicking noises, similar to the sounds of a vacuum cleaner, while the radiation is being given. During the session, you’ll be able to talk to the therapist over an intercom. You can’t feel radiation, so the process will be painless. Also, you will not be radioactive afterward.
What to expect after radiation therapy
Because radiation affects normal cells as well as cancer cells, you may have some side effects. The side effects from radiation are often limited to the area being treated. Some people have few or no side effects. If you do have them, your healthcare provider may change your treatments or stop treatment until the side effects are cleared up. Be sure to tell your healthcare provider about any side effects you have.
Potential side effects
More common side effects of radiation include:
Skin irritation or changes in areas of your skin that get radiation
Nausea or diarrhea. This can happen from radiation aimed at your stomach or pelvis.
Low blood cell counts
If you have any of these side effects, talk with your healthcare provider about how to deal with them. Also ask how to know when they become serious. Usually these effects go away a few weeks after you stop getting treatment.
March 21, 2017
Alteri, Rick, MD,Gersten, Todd, MD