Local radiotherapy
Local radiotherapy may be used both as an anti-myeloma treatment and as a supportive treatment for painful or structurally damaging lytic lesions. It is the treatment of choice for spinal cord compression and should be started as soon as possible, ideally within 24 hours of diagnosis.
Radiotherapy is also useful following stabilisation of long bone fractures and can provide effective and quick-acting pain control in areas of localised myeloma bone disease.
Pain relief can usually be achieved with doses of 30Gy in 10 – 15 fractions. However, radiotherapy can sometimes increase pain initially and it can take a few weeks before patients feel the benefits of radiotherapy treatment.
Nurses should ensure patients are aware of the potential side-effects of radiotherapy treatment. These may vary from patient to patient and may depend on the site being treated:
- Fatigue
- Loss of appetite
- Mucositis, sore mouth
- Diarrhoea
- Bone marrow suppression
- Skin reactions
- Cystitis
- Hair loss
Extra care is needed for patients who are in pain. It is often helpful for nurses to encourage patients to take pain medication before starting radiotherapy treatment and to brief the radiographer beforehand.