This article first appeared on the Multiple Myeloma Research Foundation website and is reprinted here with their permission.
Over the years, the Multiple Myeloma Research Foundation (MMRF) has collected questions from patients like you, who are just starting treatment. Here you will find answers to the most frequently asked questions.
1. What are my treatment options?
Due to advances in myeloma research, there are many treatment options available today. Treatments range from standard-dose chemotherapy, steroids, newer targeted agents (such as Revlimid, Thalomid and Velcade) as well as high-dose chemotherapy and stem cell transplantation. Some of these medications are taken orally, while others are given intravenously (by needle). Although each of these treatment approaches may be used alone, combinations of two or more anti-myeloma medications are commonly used. In addition to standard treatments, clinical trials that study new treatments and combinations are an option for many patients. It is important to keep in mind that in treatment there is no one standard therapy for multiple myeloma. You and your doctor will decide on the best treatment approach for you.
Use the links below to find out more about specific treatments.
- Revlimid® (lenalidomide)
- Velcade® (bortezomib) for Injection
- Thalomid® (thalidomide)
- High-Dose Chemotherapy and Stem Cell Transplantation
- Radiation Therapy
- Growth Factors
- Learn more about clinical trials.
Information regarding treatments for the disease is constantly changing, and the MMRF will provide updated information as new discoveries take place. The MMRF advises patients and caregivers to work with their physicians to determine the most appropriate treatment course and answer specific questions relating to treatment.
2. Is high-dose chemotherapy and stem cell transplantation right for me?
In general, patients in overall good physical condition are eligible for high-dose chemotherapy and stem cell transplantation. In some cases, this treatment may even be possible in patients who have reduced kidney function or kidney failure.
Once your doctor determines that you are healthy enough to undergo high-dose chemotherapy and stem cell transplant, there are several considerations you will need to factor into your decision. While there have been many advances to make this treatment safer and more tolerable, reactions to stem cell transplant vary—some patients find the procedure physically demanding while others tolerate it quite well. Further, depending on your circumstances, high-dose chemotherapy and stem cell transplantation can take an emotional and financial toll on you and your family.
In addition, you will need to weigh whether to you wish to undergo this procedure in the early stages of your treatment or reserve this option for later in the disease course. Studies have shown that there is no difference in survival in patients who choose to undergo high-dose chemotherapy and stem cell transplantation early versus patients those who delay transplant until they relapse. However, patients who achieve disease remission following transplant may have a better quality of life.
We encourage you to discuss the pros and cons of high-dose chemotherapy and stem cell transplantation with your doctor in your case.
Learn more about high-dose chemotherapy and stem cell transplantation.
3. How do I know if a clinical trial is right for me?
Many people with multiple myeloma participate in clinical trials. There are many clinical trials for patients at all stages of the disease. In some types of clinical trials, patients may be the first to benefit from a new treatment. In other types, patients may receive either the new treatment or the current standard of care for treating the disease. For many people with multiple myeloma, a clinical trial may be the best treatment option available. Find a clinical trial that may be right for you or call 1-866-603-MMCT (6628) to speak with a Clinical Trial Specialist.
4. What are the possible side effects from myeloma treatment and how do I manage them?
Like all medical treatments, myeloma treatments have side effects. For example, a small percentage of patients may develop blood clots can occur as a result of treatment with Revlimid or Thalomid in combination with steroids if they are not treated prophylactically with anti-clotting agents. In addition, nerve problems (neuropathy) are associated with both Velcade and Thalomid. While side effects are specific to each type of treatment, some of the issues that may arise as a result of treatment are:
- Blood clots
- Nerve problems (neuropathy)
- Easy bruising
- Problems with bleeding
- Gastrointestinal problems (e.g., diarrhea, constipation, nausea)
There are a wide range of treatments and strategies available to manage side effects. If side effects are severe, your doctor may reduce the dose of your myeloma medicines or temporarily stop treatment.
Remember to bring up any concerns you have about your treatment and side effects with your doctor. Call your doctor immediately if any side effects become severe.
Click here to learn more about how to manage symptoms and side effects of the disease and its treatments.
5. Where can I find help paying for treatment?
The cost of treating multiple myeloma can be high and may include unexpected out-of-pocket expenses. People with multiple myeloma may want to seek financial help soon after being diagnosed. Most hospitals and clinics have social workers who can help patients and their families manage financial concerns and provide access to community resources. Your doctor or oncology nurse may also be able to provide a referral to resources available in your community. Or, view our list of resources to assist with treatment costs.
Please take a moment and consider donating to the Multiple Myeloma Research Foundation (MMRF). Follow this link and donate what you can.