Radiation therapy is a treatment option used to alleviate symptoms of myeloma-related bone disease and to treat solitary plasmacytomas (tumors formed from abnormal plasma cells).

Radiation therapy (RT) is a common type of cancer treatment that works by using high-energy waves or particles to damage DNA in cancer cells. The treatment prevents these cells from growing and dividing, which causes them to die.

It’s estimated that up to 50% of people with cancer receive RT as a part of their treatment plan. In some situations, RT is used in the treatment of multiple myeloma.

How multiple myeloma affects your bones

Multiple myeloma happens when plasma cells in the bone marrow become abnormal, growing and dividing uncontrollably.

The effects of multiple myeloma can damage your bones, leading to pain and an increased risk of breaking. When bones in your spine are affected, the myeloma can lead to compression of your spinal cord and surrounding nerves, which can cause:

Discover more about multiple myeloma.

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Doctors use RT to alleviate symptoms of multiple myeloma and prevent the complications that may occur from bone disease.

Treatments that focus on easing symptoms and improving quality of life are called “palliative care.”

Solitary plasmacytoma

RT is also commonly used to treat solitary plasmacytomas. Solitary plasmacytomas occur when abnormal plasma cells form a tumor, often in a bone.

Unlike multiple myeloma, in which many tumors are present, people with solitary plasmacytomas have only a single tumor. It’s estimated that 65% to 84% of solitary plasmacytomas in bone progress to multiple myeloma in 10 years.

Can radiation cause multiple myeloma?

Previous radiation exposure is a risk factor for multiple myeloma because radiation can damage DNA in cells, leading to changes that promote cancer.

Some medical procedures, such as X-rays, CT scans, and PET scans do use radiation. The risk of cancer from these tests is very small. Additionally, their benefits outweigh their risks.

Having RT may boost your risk of developing a second cancer later. However, a 2021 review notes that older research shows only a small amount of second cancers, about 8%, are related to RT.

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The RT used for multiple myeloma is called “external beam radiation therapy (RT),” which uses a machine to direct the radiation at the location to be treated. This is a local treatment, which means that it’s aimed only at a specific area of your body.

Where do I receive radiation therapy?

External beam RT is given at a hospital or cancer treatment center. The therapy is typically an outpatient procedure, which means that you return home between treatments.

How often do I receive radiation therapy?

RT is given in a series of fractions as opposed to one dose, which helps to limit the damage to healthy cells that are close to the treatment site.

Many people receive external beam RT once each day five days per week, typically Monday through Friday. The break for the weekend allows time for healthy cells to recover.

How long does radiation therapy last?

The total treatment time can be between 5 and 8 weeks, depending on your individual situation.

What happens during a treatment session?

Depending on the area being treated, you may be asked to undress or put on a hospital gown. The areas of your body not receiving treatment will be shielded to protect them from radiation.

The process of receiving external beam RT is painless. You’ll be asked to lie down on a treatment table or to sit in a special chair and remain very still.

The doctor will go to an adjacent room to operate the machine that delivers the radiation, but you can still communicate with them through the intercom.

While delivering the radiation itself only takes a few minutes, your appointment may last up to 30 minutes or an hour. This is because it can take some time to make sure that you’re in the proper position.

The main benefits of RT for multiple myeloma include:

  • relief of symptoms related to bone disease
  • prevention of serious complications that can happen due to spinal compression
  • management of solitary plasmacytomas

RT does come with some potential side effects, such as:

Often, these side effects go away after you finish RT. A doctor can give you a better idea of what to expect with your specific RT regimen.

RT leads to positive outcomes as a type of palliative care for multiple myeloma. For example, a small 2020 study found that, compared with those who didn’t receive RT, having RT was associated with five times lower symptom scores.

A 2016 study of 238 people with multiple myeloma affecting their spine found that 97% of people responded to RT. Of 69 individuals who were previously unable to walk, 64% regained the ability to walk. Local control rates of multiple myeloma spine lesions were 82% after 3 years.

A 2019 study of 88 people with multiple myeloma affecting their spine found that people reported some pain relief after RT 83% of the time. Significant pain relief after RT was reported 34% of the time.

Out of the 35 people who had what the 2019 study referred to as “neurological impairments,” RT improved these symptoms 83% of the time. These neurological impairments included weakness, numbness and tingling, and trouble walking.

Solitary plasmacytoma

A 2018 review notes that RT can provide local control of solitary plasmacytomas in 85% to 90% of cases, but it’s still possible for solitary plasmacytomas to recur or for multiple myeloma to develop in the future.

The recurrence is echoed by the findings of a 2020 study of RT for solitary plasmacytomas in 42 people. The 10-year local control rate after RT was 88%, but many participants developed multiple myeloma within 10 years.

In addition to RT, other potential treatments for multiple myeloma include:

RT is one of several treatments used for multiple myeloma. It’s typically used as palliative care for myeloma-related bone disease with the goal of easing symptoms and preventing complications. RT can also be used to treat solitary plasmacytomas.

If RT is recommended as a part of your multiple myeloma treatment plan, you’ll receive it via external beam RT. The specifics of your RT therapy, such as the radiation dose and number of sessions, will depend on your specific situation.

RT can have several benefits for multiple myeloma, but it’s also linked to a variety of side effects. If RT is recommended as a part of your multiple myeloma treatment plan, you may want to have an open conversation with a doctor about its benefits and drawbacks.