Myeloma
Storyboard Description
The use of radiotherapy in pain management for osteolytic fractures resulting from multiple myeloma.
Storyboard Text
- 2nd September 2019
- DOCTOR B ONCOLOGIST
- Mr Jones 35 year old male Recent diagnosis of multiple myeloma from presentation of increased pain osteolytic fracture of right humerus found will require palliative radiotherapy and chemotherapy post
- Mr. Jones
- The doctors say I need radiotherapy, but why?
- -OSTEOLYIC FRACTURES AND BONE PAIN IS COMMON IN PATIENTS WITH MM LARGE LESIONS ARE ASSOCIATED WITH PAIN AND THE RISK OF FRACTURE RADIOTHERAPY IS ASSOCIATED WITH RAPID PAIN RELIEF
- SO THE RADIOTHERAPY WITH HELP WITH MY PAIN?
- Radiotherapy produces complete or partial pain relief for 75-95% of patients, with one study showing 85% irradiation of pain in patients Radiotherapy also has minimal side effects
- Thats good, i'd do anything to help with the pain; but how do i get radiotherapy?
- radiotherapy is delivered with linear accelarators, a high energy x-ray They target disease sites, cause DNA damage which leads to cell death palliative radiotherapy is focused on symptom control, so is delivered at lower total doses
- Radiotherapy can be used for pain management in any patient with bone metastases for pain management Metasteses in long bones have risk of fracturing, if this risk is high surgical stabilisation may be carried out before radiotherapy
- Okay, thankyou for educating me. I am happy to try radiotherapy
- 4 weeks later
- It's so good to be home. The radiotherapy really helped with my pain. I started chemotherapy last week...
- The most common indication of radiotherpay in mm patients is pain palliation, pathological fractures and neurological complications
- Not all patients will require radiotherapy managment, its found 7% of mm patients will require it in the first 12 months of diagnosis however for patients with fractures, lesions and increased pain, radiotherapy is recommended for analgesic releief
- References: Matuschek et al 2015, 'Effects of radiotherapy in the treatment of multiple myeloma: a retrospective anaylsis of a single institution', Radiation oncology 10:71 Spencer K 2018 'palliative radiotherapy' The BMJ Talamo et al 2015 'Current role of radiation therapy for multiple myeloma', Front Oncol. 5:40
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