Page 71

Why Radiotherapy Is Used For Multiple Myeloma?

What is multiple myeloma?

Multiple myeloma is a malignant tumour of a type of white blood cell (the plasma cell).

Blood cells of all types are made in the bone marrow, which in adults occupies the central position of bones such as the vertebrae, ribs, pelvis and skull.

Multiple myeloma is a cancer of plasma cells that, as a result, make excessive amounts of antibody (termed paraprotein or 'M' band). In common with all cancers, the plasma cells in myeloma are identical ('clonal'), because they originate from a single abnormal cell that starts to multiply out of control. The protein produced is, therefore, also identical ('monoclonal' meaning the product of a single clone).

The main treatments for Multiple Myeloma

Chemotherapy is nearly always the main treatment for myeloma. Radiotherapy and biological therapy are also used. If you are fit enough, your specialist may suggest intensive treatment using high dose chemotherapy with bone marrow or stem cell transplant.

The aim of your treatment is to try to get the disease under control. When there is no sign of active disease in your body, the cancer is said to be in remission.

What radiotherapy is?

Radiotherapy means using radiation to treat cancer. The radiation used is similar to that used for X-rays.

Why radiotherapy is used for Multiple Myeloma

Myeloma can cause a lot of damage to bones. Radiotherapy can treat areas where there is localised bone damage or pain. The myeloma destroys area of bone until it is full of holes, like a piece of lace. Obviously, this weakens the bone. Sometimes it causes it to break (fracture). Radiotherapy kills off the cancer cells in the bone and shrinks the cancer. This reduces the pressure caused by the cancer growth in the bone and helps to reduce bone pain.

Sometimes, a bone needs to be pinned to keep it stable and stop it from fracturing. This is done during an operation. The surgeon puts a metal pin into the bone to strengthen it and hold it together. This is done if there is a strong risk of the bone breaking before radiotherapy has had time to work. If you have an operation to fix a bone, you might still need to have radiotherapy afterwards to kill off the cancer and strengthen the bone.

If you have pain because of very widespread myeloma in your bones, or other treatments for myeloma are no longer controlling your myeloma, your doctor might suggest hemi body irradiation. This means that half your body is treated with radiotherapy at a time - the top half and the bottom half. The treatment is given in 2 halves because having your whole body treated has too many side effects. The damage to your bone marrow would be so severe that you would not be able to make enough blood cells and would be at serious risk of infection. Hemi body irradiation can make you feel sick and tired. Usually, your radiotherapist will prescribe anti-sickness tablets for you to take before each treatment. It is important to take these. They will make a big difference to how the treatment makes you feel.