When might radiation be used?
Radiation is seldom the main treatment for multiple myeloma, but it might be part of the treatment for some people. Your healthcare provider may suggest radiation to:
Help relieve bone pain that isn’t responding to other treatments.
Help prevent a fracture
Help prevent spinal cord damage when bones of the spine (called vertebra) collapse. (This is a medical emergency.)
Treat a single plasma cell tumor, called a solitary plasmacytoma. In this case, it may be the main treatment.
You'll meet with your healthcare team to plan radiation. The team might include a hematologist, radiation oncologist, and medical oncologist.
What happens during radiation?
The most common way to get radiation for myeloma is from a large X-ray machine that focuses invisible beams of energy on the tumor. This is called external beam 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, as well as the dose and how long you’ll need the treatment.
External beam radiation therapy is given on an outpatient basis at a hospital or a clinic. This means you go home the same day. How often and how long you get radiation depends on why it’s being given. It's often given as daily treatments 5 days a week for a few weeks.
Preparing for radiation
Before your first treatment, you’ll have a session to find exactly where the radiation beams need to be focused. The process is called simulation. It may take up to 2 hours. During this session, imaging tests, like a CT scan, MRI, or PET scan, are done. This is to help your healthcare provider know exactly where the tumor is in order to aim the radiation. Body molds or casts may also be made at this visit. These help put you in the same position for each treatment and help keep you from moving during treatment.
You’ll lie still on a table while a radiation therapist uses a machine to define your treatment field or port. The field is the exact spot on your body where the radiation will be aimed. The therapist may mark your skin with tiny dots of semi-permanent ink or tiny tattoos 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 and the machine will rotate around you. You may have to wear a hospital gown. It’s a lot like getting an X-ray, only it may take a little longer. It usually takes about 15 to 30 minutes to do. But you should plan on being there for about an hour.
At the start of the treatment session, a radiation therapist may use blocks or special shields to protect parts of your body from radiation exposure. The therapist then lines up the machine so that radiation goes to the right place. You may see lights from the machine that line up with the spots that were marked during simulation.
When you’re ready, the therapist leaves the room and turns the machine on. You may hear whirring or clicking noises, much like the sounds of a vacuum cleaner, while the radiation is being given. During treatment, you’ll be able to hear and talk to the therapist over an intercom. And the therapist can see you. You can’t feel the radiation, and it doesn't hurt. 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 tend to be limited to the area being treated. And they tend to get worse as treatment goes on. If you do have them, your healthcare provider may change your treatments or stop treatment until the side effects get better. Be sure to tell your healthcare provider about any side effects you have.
Potential side effects
Common side effects of radiation include:
Skin irritation or changes in your skin that gets radiation. This is often like a bad sunburn, and your skin may blister and peel.
Nausea or diarrhea. This can happen if radiation is 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 and when you need to call your provider. Know how to get help after office hours and on weekends and holidays.
Side effects usually go away over time after you stop getting treatment.