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Treatment Planning

Many factors come into play when treating multiple myeloma. Before recommending a treatment approach, your doctor will consider different aspects of your disease and any prior treatments you have received as well as your age and overall health. Because multiple myeloma is characterized by remission and relapse over time, your doctor may also think about how your treatment today will fit into a longer-term treatment strategy.3,5

As a patient, it can be helpful to understand that different treatments can have different impacts on your life and your disease—both now and over time. Ideally, your doctor will ask you about your personal goals, your current lifestyle, and any questions or concerns you have about potential treatments.

It may be up to you, however, to proactively talk to your doctor about these topics. This can help your doctor better understand which treatment approaches will best meet your needs.

Following a Diagnosis

Induction Therapy

This is the first phase of treatment, with the goal of reducing the number of multiple myeloma cells and M proteins in the bone marrow. Induction therapy may include chemotherapy, targeted therapy and corticosteroids.12

Stem Cell Transplant

Following induction therapy, eligible patients may receive a stem cell transplant, during which they receive healthy blood-forming cells to replace those killed during induction therapy.5

Maintenance Therapy

Patients who undergo an induction therapy and/or a stem cell transplant often continue with a combination of therapies to keep them in remission as long as possible.5

Different Types of Therapies for Multiple Myeloma

Multiple myeloma is very rarely treated with a single therapy. Instead, physicians often use different combinations of the following classes of medications to attack the disease in different ways.11

Proteasome Inhibitors

Proteasomes are structures within cells that break down and recycle proteins that are no longer needed. Proteasome inhibitors interfere with this process, creating a build-up of waste and ultimately causing multiple myeloma cells to die.11,13

Immunomodulatory Agents (IMiDs)

IMiDs work in multiple ways to treat multiple myeloma.11 They are designed to boost the body’s immune response by stimulating natural killer cells and activating T cells, reducing the growth of myeloma cells. IMiDs also can kill multiple myeloma cells.13,14

Monoclonal Antibodies

Monoclonal antibodies are a broad class of drugs designed to bind to a specific target mostly found on a myeloma cell’s surface, ultimately leading to the cell’s death.11

Chemotherapy

Chemotherapy drugs have been used to treat patients with multiple myeloma for many years.3 There are many types of chemotherapy drugs and the way doctors use these agents has evolved over the past several years.

Corticosteroids

Corticosteroids have both anti-inflammatory and anti-myeloma effects, particularly when given in large doses.5

Following a Relapse

Multiple myeloma is characterized by recurring cycles of relapse and remission.10 For this reason, treatment is often ongoing throughout the course of the disease.

When a relapse does occur, treatment options will depend on a variety of factors, including age and overall health, characteristics of the relapsed disease, previous treatments and treatment goals.5

Your oncologist will tailor a combination of treatment options with hopes of getting you back into remission.

Read about one treatment for patients with relapsed multiple myeloma.

Considering Other Complications

Over the course of the disease, you may be at an increased risk for some physical effects of multiple myeloma.

Be sure to talk to your doctor about common problems you might want to consider as part of your treatment plan.

- Serious Bone Problems: Multiple myeloma can weaken bones, which can lead to breaks (fractures), pressure on the spinal cord, the need for surgery to prevent or repair a fracture, and the need for radiation to the bone.15

- Anemia: When there is a decreased number of red blood cells in the body, it's called anemia.16 This can lead to fatigue, shortness of breath, headaches, chest pain, and pale skin.17

- Renal Impairment: Approximately 60 percent of multiple myeloma patients have or will develop impairment in kidney function over the course of the disease.18

- Infections: Multiple myeloma can impair the body's immune system, leading to infections.4 In addition, patients who have an infection may take longer to recover.19 It's important to talk to your healthcare team upon the first signs of feeling sick.

Read about a prescription medicine to prevent serious bone problems in patients with multiple myeloma.

Working With Your Oncologist

In order to get the right care, it’s critical for you to have an open and honest dialogue with your oncologist.

A conversation with your oncologist can fly by and it may feel like you need to make decisions on your treatment quickly. Keep these tips in mind before your next visit.

  • Be prepared to discuss treatment options and goals with your oncologist.
  • Be open and honest about your health, including how you’re handling side effects, emotional issues or if you’re confused by what the doctor is saying.
  • Understand your next steps, whether they be treatment-related or otherwise.
  • Request assistance for any additional issues you’re facing. Your doctor can help you build your support team.