Radiotherapy treatment

Radiotherapy uses radiation, usually x-rays, to destroy cancer cells.

Why you might have radiotherapy for myeloma

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

Radiotherapy aims to kill cancer cells in the bone. This can help to reduce pain and slow down the bone damage. This includes the bones of the spine. These bones protect the spine. Damage to the spinal bones can press on your spinal cord and cause pain and other changes.

Spinal cord compression is an emergency. Contact your doctor straight away if you have any symptoms of spinal cord compression.

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.

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 able to rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.

Before your first treatment, your therapy radiographers Open a glossary item 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.

Photo of a linear accelerator

During the treatment

You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment 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 the therapy radiographers Open a glossary item 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 7am till 9pm.

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.

The radiotherapy staff may be able to arrange transport if you have no other way to get to the hospital. Your radiotherapy doctor would have to agree. This is because it is only for people that would struggle using public transport and have no access to a car. 

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.

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

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
Call the Cancer Research UK nurses on freephone 0808 800 4040 if you have questions about radiotherapy for myeloma. Lines are open 9am to 5pm, Monday to Friday.
Last reviewed: 
30 Apr 2020
Next review due: 
30 Apr 2023
  • Cancer and its management (6th edition)
    Tobias J and Hochhauser D
    Blackwell Publishing Ltd, 2010

  • Long-term follow-up of patients with multiple myeloma treated with total body irradiation-Melphalan conditioning

    R Munker and others 

    European Journal of Haematology 2017 99(1):56-59

  • Principles and practice of oncology (9th edition)
    De Vita, V.T., Hellman, S. and Rosenberg S.A.
    Lippincott, Williams and Wilkins, 2011

  • Pan-London Haemato-Oncology Clinical Guidelines Plasma Cell Disorders
    September 2018

     

  • Local radiotherapy for palliation in multiple myeloma patients with symptomatic bone lesions

    J Lee 

    Radiation Oncology Journal 2016 34(1):59-63

  • The combination of ionizing radiation and proteasomal inhibition by bortezomib enhances the expression of NKG2D ligands in multiple myeloma cells

    Y Lee and others 

    Journal of Radiation Research 2018 59(3):245-252

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