25 NCCN Guidelines for Patients ® : Multiple Myeloma, 2019 3 Myeloma treatments Radiation therapy | Surgery This chapter describes the main treatments for multiple myeloma and its symptoms. Knowing what a treatment is will help you understand your treatment options listed in the Treatment guide in Part 4. There is more than one treatment for myeloma. Not every person with myeloma will receive every treatment listed in this chapter. Radiation therapy Radiation therapy is a type of local therapy. Local therapy treats cancer cells in one small, specific area of the body only. In myeloma, radiation therapy is most commonly used to treat an area of bone damage that is painful or a plasmacytoma that is causing pain. Radiation therapy can be used as the only treatment for solitary plasmacytomas. A solitary plasmacytoma is a single mass of myeloma cells. Radiation therapy uses high-energy rays to treat cancer. The rays damage the genes in cells. This either kills the cancer cells or stops new cancer cells from being made. EBRT ( e xternal b eam r adiation t herapy) is the most common type of radiation therapy used to treat solitary plasmacytomas. For EBRT, a machine outside the body delivers radiation to the cancer site. Side effects of radiation therapy A side effect is an unhealthy or unpleasant physical or emotional condition caused by treatment. Side effects of radiation therapy may not occur in the first few visits. Over time, you may have nausea, diarrhea, and fatigue. You may lose your appetite and may even lose weight during treatment. Other common side effects are changes in your skin and hair loss in the treated area. Surgery Surgery is an operation to remove or repair a body part. It is a type of local therapy. Surgery can be used to remove a solitary plasmacytoma located outside of the bone if it is causing symptoms and can’t be treated with radiation alone. Radiation therapy may be given before or after the surgery. Surgery may also be used to fix fractures in bones caused by myeloma. Side effects of surgery You may experience weakness, tiredness, and pain after the surgery. Other common side effects are swelling, surgical scars, and, less frequently, infections.