Radiotherapy for myeloma

Radiotherapy uses high energy waves similar to x-rays to kill cancer cells. You might have radiotherapy for myeloma to help symptoms caused by bone damage.

When might you have radiotherapy for myeloma?

Myeloma can damage areas of bone. This can weaken the bones, and cause pain. Sometimes the bone can break (fracture).

Radiotherapy aims to destroy myeloma cells in the bone. This can help to reduce pain and slow down the bone damage.

Myeloma can damage the bones that protect the spine (vertebrae). Damage to the vertebrae can cause them to press on your spinal cord. Pressure on the spinal cord stops the nerves working normally. This is called spinal cord compression.

Read more about spinal cord compression

Radiotherapy is a treatment for spinal cord compression. By destroying myeloma cells, it can help reduce pain and improve other symptoms.

Sometimes you need to have surgery to keep the bone stable before you can have radiotherapy. This means having an operation. The surgeon puts a metal pin into the bone to strengthen it and hold it together. They do this if there is a strong risk of the bone breaking before radiotherapy has had time to work. 

More rarely, you might have radiotherapy as part of a stem cell transplant. In this case you have radiotherapy to your whole body. This is called total body irradiation (TBI).

Planning your treatment

The radiotherapy team plan your radiotherapy before you start treatment. This means working out the dose of radiotherapy you need and exactly where you need it.

Your planning appointment takes from 15 minutes to 2 hours.

You usually have a planning CT scan in the radiotherapy department.

The scan shows the cancer and the area around it. You might have other types of scans or x-rays to help your treatment team plan your radiotherapy. The plan they create is just for you.

Read more about radiotherapy planning

The radiotherapy room

Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.

Before your first treatment, your ​radiographers​ will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.

During the treatment

You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment. This is to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.

Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.

You won't be radioactive

This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.

Travelling to radiotherapy appointments

You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.

You can ask your radiographers for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7 am till 9 pm.

Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.

Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport. Or who have any other illnesses or disabilities. You might need to arrange hospital transport yourself.

Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this and hospital transport.

Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.

Side effects

The most common side effects of radiotherapy during and just after treatment are:

• reddening of the skin in the treatment area

• tiredness

• loss of hair in the treatment area

Find out more about the possible side effects of radiotherapy and what can help

Radiotherapy for total body irradiation (TBI)

Rarely, you might have total body irridation (TBI) before an allogeneic stem cell transplant. You have radiotherapy twice a day for 3 or 4 days, or as a single treatment.

The radiographers help you to lie or stand in the correct position. Then you have treatment for 10 to 15 minutes on both sides of your body.

Total body irradiation is part of having intensive treatment for myeloma. So the side effects of this type of radiotherapy are likely to be more severe.

Common side effects include:

• sickness

• tiredness

• diarrhoea

• low blood cell levels

• complete head and body hair loss

Read about intensive treatment for myeloma