Treatment Options
It’s important to learn about your treatment options so you and your doctor can make an educated decision.
Being diagnosed with multiple myeloma can be scary. Understanding your treatment options may help you feel more in control and help you communicate with your oncologist.
Multiple myeloma is an incurable condition, but a tremendous amount of progress has been made in research of treatments for the disease. Physicians now have more options to treat multiple myeloma than ever before.
Goals of Treatment
You and your healthcare provider will decide what your goals for treatment are. Generally, the aim of treatment for multiple myeloma is to decrease as many cancerous plasma cells as possible in the body.
A person with multiple myeloma is considered in remission when the M-protein level is greatly reduced, or becomes so low that it cannot be measured, and other symptoms of illness disappear. Though this is not the same as a complete cure, some people have stayed in remission for many years.
Determining a Course of Therapy
Your oncologist will discuss your treatment options with you to determine the best course of therapy for you. The type of treatment you receive is based on a number of considerations. These include your age and general health; your disease stage; your symptoms; your treatment goals; and your test results, including renal function and blood tests.
Keep in mind that seeking a second opinion may provide more information and help you feel more confident about your treatment plan.
Treatment Plan Options
Watchful Waiting
Patients who are in the early stages of multiple myeloma may not need to undergo treatment immediately. Your physician may schedule you for regular visits to monitor for any changes in your condition. Treatment may be necessary once a patient begins to experience symptoms.
Active Treatments
Drug Therapy
There are several different types of drugs that are approved to help fight symptomatic multiple myeloma, and these drugs are given alone or in combination with one another. There are a number of different combinations that a patient may receive, and each type of drug works to fight cancer cells in a different way; however, they may all affect healthy cells as well:
- Chemotherapy kills fast-growing myeloma cells
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Targeted therapies are usually directed against molecules involved in the process leading to multiple myeloma. Examples include:
- Steroids that have antitumor effects
Stem Cell Transplantation
Stem cell transplantation can be used to treat patients with multiple myeloma. Stem cell transplants allow patients to receive higher doses of chemotherapy or radiation. The higher doses of drugs destroy both myeloma cells and, as a side effect, healthy cells in the bone marrow. To replace the healthy cells that were destroyed during treatment, the doctor will give the patient a stem cell transplant.
In a stem cell transplant, blood-forming cells (stem cells) are removed from the patient’s or the donor’s blood or bone marrow. The stem cells are frozen while the patient receives high-dose treatment and then reinfused into the patient’s bloodstream. The new blood cells replace the ones that were destroyed by treatment.
Certain factors affect whether or not a patient is eligible to have a stem cell transplant, including age and other diseases and conditions the patient may have. VELCADE has not been studied in transplant-eligible patients.
Supportive Therapies
Supportive therapies are treatments used to help manage symptoms of the disease.
Radiation Therapy
Radiation therapy uses focused high-energy beams to penetrate the tissues of the body to reach and destroy cancerous cells. Radiation treatment is often given to areas of the bone damaged by myeloma that are causing severe pain.
Surgery
Surgery is not used to treat multiple myeloma but rather to manage complications from the disease. In some cases, patients may elect to have metal rods or plates attached to weight-bearing bones that are or will become fractured due to damage. These rods or plates help support the bones.
Supportive Care
Other drugs may also be given to slow down the process of bone deterioration that can result in bone weakness and fractures. A class of drug called bisphosphonates helps strengthen bones in patients with multiple myeloma.
Clinical Trials
Clinical trials involve studies of new or experimental treatments that are administered to patients with specific diseases. They help doctors test whether investigational therapies work. These studies are one of the steps in the development of new treatments to determine if they are safe and effective.
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A type of white blood cell that produces antibodies
An antibody found in unusually large amounts in the blood or urine of people with multiple myeloma and other types of plasma cell tumors. Also called monoclonal protein.
Use of chemical agents (drugs) in the treatment or control of disease such as cancer
A drug or an agent that blocks the action of the proteasome, a large protein complex that helps destroy other proteins in the cell when they are no longer needed
Medical procedure that involves transplantation of hematopoietic stem cells (immature blood-forming cells). Patients are given high-dose cancer treatment that will destroy the cells in the patient’s bone marrow. The stem cells can be used to help “rescue” the bone marrow from this intensive treatment. In an autologous transplant some of the patient’s stem cells are taken and stored before they have the high-dose treatment. After the high-dose treatment, the patient’s stem cells are given back to them through an intravenous line (like a blood transfusion). When the stem cells come from another person, it is called an allogeneic transplantation
Soft, sponge-like area in the center of large bones that contains hematopoietic stem cells for production of white blood cells, red blood cells, and platelets
The use of high-energy X-rays and similar rays (such as electrons) to treat disease. This can be given either as external radiotherapy from the outside of the body using X-rays or from within the body as internal radiotherapy. Radiotherapy works by destroying the cancer cells in the treated area. Although normal cells can also be damaged by the radiotherapy, they can usually repair themselves. Radiotherapy treatment can cure some cancers and can also reduce the chance of a cancer coming back after surgery. It may be used to reduce cancer symptoms.
Scientifically controlled study of the safety and effectiveness of a medication (such as a drug or vaccine) using consenting human subjects
Drugs that interfere with the formation of new blood vessels; can be used to treat certain types of cancer
Drugs that interfere with and influence immune system activity; can be used to treat disease including autoimmune disease and some cancers
Steroids are naturally occurring in the body and have a variety of functions. They can also be used as medication to treat certain conditions. Three main categories of steroids are sex hormones for sexual maturation, corticosteroids for metabolism, immune function and regulation of salts and fluids in the body, and anabolic steroids for muscle and bone growth