Because you still have more to ask

You may still have more questions. Print or download the discussion guides below to help you and your caregiver when talking with your healthcare team. These guides list some of the most common questions that people with multiple myeloma or mantle cell lymphoma have for every phase of treatment. Be sure to bring up any other questions that you may have with your healthcare provider.

Getting Started: What to Expect

When starting treatment, you may have many questions for your healthcare team. It may be helpful to understand how your treatment works, how and when it’s given, and what to expect. These questions may help guide your discussions with your doctor or nurse. Each office visit is a chance for you and your loved ones to learn more.


Tests

  • What are the typical tests I will need?
  • How often do I need them?
  • What tests/results should I keep track of?
  • Can you explain the results of my blood and urine tests?
    (Don't hesitate to ask about any other tests that you're curious about.)

Treatment

  • What treatment options are available to me?
  • Can you help me understand the differences in available treatments?
  • What are the different treatment schedules for each?
  • How effective is the treatment you’re recommending?
  • How long will I receive treatment and how will it be given?
  • What are the potential side effects of the treatment?
  • How will I know if the multiple myeloma/mantle cell lymphoma is responding to treatment?
  • What does it mean if I achieve remission?
  • These are the medications and supplements I am currently taking. Do any of these affect
    my treatment, and, if so, how?

Physical & daily life

  • Will I be nauseous?
  • Will I have diarrhea?
  • Will I be exhausted?
  • Can I eat all kinds of foods?
  • I've had chickenpox. Is there anything I can do to lessen the chance of getting shingles?

Side effects

  • What are the side effects associated with these treatments?
  • Are there signs or symptoms I should look out for?
  • I have heard of peripheral neuropathy—can you explain what it is?
  • What should I do if I experience any side effects?

Paying for treatment

  • Can you tell me about the cost of the various treatment options?
  • What organizations or resources are available to help me pay for treatment?
  • Can I still get treatment if I don’t have insurance?

Adjusting to Treatment: Staying on Track

At this point, you have probably settled into the routine of treatment. You may have new questions or different concerns than when you started treatment. Each visit continues to be a chance to learn more and have your questions answered.

General questions

  • Which tests are important at this point?
  • Is there assistance to get back and forth from my medical appointments?
  • Will I need home healthcare?

Treatment

  • What happens if/when I begin responding to treatment? And how can I tell?
  • If the multiple myeloma/mantle cell lymphoma has responded to treatment, do I continue with the same therapy?
  • What happens after I complete my treatment?
  • What happens if/when the multiple myeloma/mantle cell lymphoma comes back (relapses)?
  • How will I know if the multiple myeloma/mantle cell lymphoma is getting worse?

Side effects

  • What side effects should I look out for at this point?
  • Should I expect any new or worsening symptoms at this point in my treatment?

Relapse: If Multiple Myeloma/Mantle Cell Lymphoma Returns

It is important to know about other treatment options and what to expect next. Keep an open dialogue with your healthcare team so you can set and manage goals for what’s to come.

General questions

  • What treatment options are available to me?
  • How effective is the treatment you’re recommending?
  • How long will I receive treatment and how will it be given?
  • What signs might show that the multiple myeloma/mantle cell lymphoma is responding?
  • Can you tell me about the cost of the various treatment options?

Side effects

  • I experienced side effects with the last treatment. Will they be similar?
  • What side effects have been reported with this treatment?
  • How can I recognize the signs and symptoms of these side effects?
  • What should I do if I experience any side effects?
  • How can I help prevent any side effects from treatment?

 

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Please see below for Important Safety Information.

Indications and Important Safety Information for VELCADE® (bortezomib)

What is VELCADE used for?

VELCADE (bortezomib) is approved for the treatment of people with multiple myeloma (a cancer of the plasma cells). VELCADE is also approved for the treatment of people with mantle cell lymphoma (a cancer of the lymph nodes).

How is VELCADE administered?

VELCADE is prescribed by a doctor experienced in the use of medications to treat cancer. It is administered by a healthcare professional as an injection into your vein (intravenously, or IV) or under your skin (subcutaneously). VELCADE must not be administered into your spinal fluid (intrathecally).

Who should not receive VELCADE?

Before you receive treatment with VELCADE, tell your doctor about all of your medical conditions. You should not receive VELCADE if you are allergic to bortezomib, boron, or mannitol.

What are the possible side effects of VELCADE?

VELCADE (bortezomib) can cause serious side effects, including:

  • Peripheral neuropathy. VELCADE can cause damage to the nerves, a condition called peripheral neuropathy. You may feel muscle weakness, tingling, burning, pain, and loss of feeling in your hands and feet, any of which can be severe. Tell your doctor if you notice any of these symptoms. Your doctor may change the dose and/or schedule of VELCADE or stop it altogether. If you have peripheral neuropathy before starting VELCADE, your doctor could consider giving you VELCADE subcutaneously.
  • Low blood pressure. VELCADE can cause a drop in blood pressure. Tell your doctor if you have low blood pressure, feel dizzy, or feel as though you might faint. If you are taking drugs that lower blood pressure, your medications might need to be adjusted. If you are not drinking enough liquids, your doctor may need to administer IV fluids.
  • Heart problems. Treatment with VELCADE can cause or worsen heart rhythm problems and heart failure. Your doctor may closely monitor you if you have, or are at risk for, heart disease. Tell your doctor if you experience chest pressure or pain, palpitations, swelling of your ankles or feet, or shortness of breath.
  • Lung problems. There have been reports of lung disorders in people receiving VELCADE. Some of these events have been fatal. Tell your doctor if you experience any cough, shortness of breath, wheezing, or difficulty breathing.
  • Liver problems. If you have liver problems, it can be harder for your body to get rid of VELCADE. VELCADE has caused sudden liver failure in people who were taking many medications or had other serious medical conditions. Symptoms of liver problems include a yellow discoloration of the eyes and skin (jaundice) and changes in liver enzymes measured in blood tests. Your doctor will closely monitor you if you have liver disease.
  • Posterior reversible encephalopathy syndrome (PRES). There have been reports of a rare, reversible condition involving the brain, called PRES, in people treated with VELCADE. People with PRES can have seizures, high blood pressure, headaches, tiredness, confusion, blindness, or other vision problems. Treatment with VELCADE should be stopped in cases of PRES.
  • Gastrointestinal problems. VELCADE (bortezomib) treatment can cause nausea, vomiting, diarrhea, and constipation. If your symptoms are severe, your doctor may recommend IV fluids and/or medications.
  • Neutropenia (low levels of neutrophils, a type of white blood cell). VELCADE can cause low levels of white blood cells (infection-fighting cells). If your white blood cells become low, you can be at higher risk for infections. Tell your doctor if you develop a fever or believe you have an infection.
  • Thrombocytopenia (low levels of platelets). VELCADE can cause low levels of platelets (clot-forming cells). If platelets become very low, there is an increased risk of bleeding. Your doctor may recommend a platelet transfusion or other supportive care.
    You will have regular blood tests to check your cell counts during your treatment with VELCADE. If the number of these cells is very low, your doctor may change the dose and/or schedule of VELCADE.
  • Tumor lysis syndrome (TLS). TLS is a syndrome that causes a chemical imbalance in the blood that could lead to heart and/or kidney problems. TLS can occur with cancer treatments, and your doctor will be monitoring your blood and urine for any signs of this syndrome. If you develop TLS, your doctor will take appropriate steps to treat it.

More than 1 in 5 people (20%) receiving VELCADE have experienced the following side effects in one or more clinical trials: neutropenia, thrombocytopenia, peripheral neuropathy, fatigue, nausea, diarrhea, leukopenia (low levels of white blood cells), anemia, constipation, neuralgia (nerve pain), vomiting, lymphopenia (low levels of a certain type of white blood cells), rash, pyrexia (fever), and anorexia.

What other information should you discuss with your doctor?

Women should avoid becoming pregnant or breast-feeding while being treated with VELCADE (bortezomib). Tell your doctor immediately if you think you are pregnant. Discuss with your doctor when it is safe to restart breast-feeding after finishing your treatment.

You should also tell your doctor if you:

  • Have kidney disease. If you are on dialysis, your doctor will administer VELCADE after the dialysis procedure.
  • Are taking medication for diabetes. VELCADE can affect your blood glucose levels. Your doctor may require close monitoring of your blood glucose levels and change the dose of your diabetes medicine while you are being treated with VELCADE.
  • Have liver disease.
  • Are using any other medications, including prescription and nonprescription medications, herbal or dietary supplements, or holistic treatments. St. John’s wort should be avoided.
  • Develop a rash of any type or have skin pain while receiving VELCADE.

The side effects of VELCADE may impair your ability to drive or operate machinery.

These are not all of the possible side effects with VELCADE. It is important to always contact your doctor if you experience any side effects while on VELCADE. If you have any questions about VELCADE, contact your doctor. Additional information is available on the website at VELCADE.com.

Please read the full Prescribing Information for VELCADE.


© 2016 Millennium Pharmaceuticals, Inc.
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