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Defining Your Treatment Goals

For most cancer patients, the ultimate goal of treatment is to be cured. However, for an incurable disease like multiple myeloma, it’s important to define your priorities and what you’d most like to achieve with treatment. These are called treatment goals.

Treatment goals may change through the course of your multiple myeloma journey, however they’re an important factor in choosing the right treatment regimen.

Many factors may come into play when developing treatment goals and decisions. However, some example treatment goals may include attending your grandchild’s wedding or continuing your favorite outdoor activity.

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.5

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.5 Proteasome inhibitors interfere with this process, creating a build-up of waste and ultimately causing multiple myeloma cells to die.11,12

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.12,13

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 and kill the cell.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.14

- Anemia: When there is a decreased number of red blood cells in the body, it's called anemia.5 This can lead to fatigue, shortness of breath, headaches, chest pain, and pale skin.15

- Renal Impairment: Approximately 60 percent of multiple myeloma patients have or will develop renal impairment over the course of the disease.16

- Infections: Multiple myeloma can impede the body's immune system, leading to infections.4 In addition, patients who have an infection may take longer to recover.17 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 it be treatment-related or otherwise.
  • Request assistance for any additional issues you’re facing. An oncologist can help you build your support team.