Other treatments used during and after first line therapy
Radiotherapy
This is often used to treat bony deposits. Radiotherapy treatments will be given either as a one off (a single fraction) or daily (10 to 15 fractions) over 1- 2 weeks. Myeloma may cause many areas of bony damage; radiotherapy is an effective treatment for persistent bone pain or pathological fractures due to myeloma. It is given after orthopaedic surgery to stabilise the affected bone. An occasional severe side effect of radiotherapy to the spine or pelvis is severe bone marrow suppression (risk of infections) and anaemia (need for transfusion). A person who has had this side effect may have severe fatigue for many months afterwards.
Surgery
Orthopaedic surgery may be used to treat or prevent pathological fracture often in combination with radiotherapy to the affected area.
This is a treatment given in hospital over 1-2 days, it filters excess myeloma protein from the blood; this can reduce symptoms of dizziness. It can be repeated when the proteins build up again. There are no enduring side effects of this treatment.
Renal replacement therapy
3-12% of people with myeloma will require dialysis either temporarily or permanently. Haemodialysis or Peritoneal dialysis may be used. The need for dialysis may give rise to needs
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Amended February 2009
