Multiple Myeloma


Quick, pain-free radiation treatment options offer relief to patients with multiple myeloma.

Multiple Myeloma Overview

Blood cells originate from bone marrow (the soft tissue in the center of the bone) and the spleen. The stem cells develop into red and white blood cells and platelets. Plasma cells are white blood cells that produce antibodies that are part of your immune system.

Multiple myeloma, also called plasma cell myeloma, is cancer of the plasma cells in bone marrow. As the cancer grows it may affect the solid part of the bone as well as the marrow. Over 22,000 Americans will be diagnosed with this disease in 2012.

It is unclear what may cause multiple myeloma. Family history, age, and race increase risk. The disease is highest among African Americans and lowest among Asian Americans. It is rare in people under the age of 35 and most common over 65 years old. Symptoms include fatigue and shortness of breath from anemia, fevers and, as the cancer progresses, bone pain and broken bones. The cancer grows so slowly it may take several years before symptoms even appear.

Multiple Myeloma Treatment Options

Because the tumors are located in the bone, surgery is not a viable multiple myeloma treatment option. However, depending on the stage of the disease, your Medical Oncologist may recommend a bone marrow (stem cell) transplant, chemotherapy, targeted therapy, radiation therapy or a combination of treatments.

Chemotherapy

Chemotherapy can effectively slow the progress of multiple myeloma by destroying the cancerous cells. Multiple myeloma can significantly weaken bones and cause them to break. Biophosphonates help to prevent further bone damage.

Targeted Therapy

Targeted multiple myeloma therapy uses drugs to interfere with cellular activity that the cancer depends on to survive and grow. Proteasome inhibitors stop cells from breaking down critical proteins that control plasma cell growth.

Bone Marrow or Stem Cell Transplant

In a bone marrow transplant, diseased marrow is removed and replaced with healthy, cancer-free marrow. There are two basic types of bone marrow transplants: Autologous transplants remove the patient’s own stem cells. In a process called leukapheresis, blood and/or marrow are removed from the patient and the blood-forming stem cells are separated out. The blood is then returned to the patient and the stem cells are frozen. The patient then undergoes chemotherapy to destroy almost all of the cells in the bone marrow including the cancerous cells. The stem cells are then intravenously returned to the patient. Allogeneic transplants follow the same process but use donor stem cells instead of the patient’s own. The donor may be a relative but could also be someone unrelated with the same or similar tissue type as the patient. Patients may undergo one or two stem cell transplants six to 12 months apart.

Multiple Myeloma Radiation Therapy

Radiation therapy for multiple myeloma may be used to shrink and/or destroy tumors and to alleviate pain in areas of bone that have not responded to chemotherapy. An External Beam Radiation Therapy (EBRT) delivery device is used to precisely target the tumor site with a high-energy x-ray beam. Treatments are painless and require no sedation.

Radiation Therapy for Multiple Myeloma

3D-Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT)

3D-Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy (IMRT) are two forms of External Beam Radiation Therapy. During 3D-Conformal treatments, a device called a “multi-leaf collimator” will shape the individual radiation beams to “conform” to the shape of your tumor according to the data and instructions it receives from the system computer. IMRT uses thousands of radiation “beamlets” from many different angles to deliver a single dose of radiation. The intensity of the “beamlets” can change during the treatment session to modulate the dose, so that the tumor receives a very precise high dose of radiation, while minimizing damage to surrounding, normal tissue.

Before each session, a Radiation Therapist will carefully position you on the treatment table using a body immobilizer for precise body placement. Image guidance will be used to confirm the location of the tumor before the therapy begins. During your treatment sessions, the radiation delivery system will revolve around you, delivering the radiation according to the plan set by your Radiation Oncologist. Each treatment session lasts from 10 to 30 minutes. These multiple myeloma radiation therapy sessions are pain-free and require no sedation so you can return to your normal activities right away.

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