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If you have multiple myeloma, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for multiple myeloma, your healthcare team will consider:
Multiple myeloma can’t be cured. The goal of treatment is to reduce symptoms, slow the progression, or advancement, of the disease and put the disease into remission. Remission for multiple myeloma is when most or all signs and symptoms of the disease disappear.
You may be offered the following treatments for multiple myeloma.
During watchful waiting, the healthcare team watches for any signs and symptoms that mean the cancer is progressing from smouldering or indolent multiple myeloma to active multiple myeloma. During watchful waiting you will see your doctor and have tests every 3–6 months. You will begin treatment if there are signs that the disease is progressing to active multiple myeloma.
Targeted therapy uses drugs to target specific molecules (such as proteins) on the surface of cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. Targeted therapy is a main treatment for multiple myeloma. Targeted therapy drugs may be combined with chemotherapy drugs or supportive therapy drugs.
Chemotherapy may be given in combination with targeted therapy drugs or with supportive care drugs such as corticosteroids.
A stem cell transplant is a main treatment for people with multiple myeloma. A stem cell transplant may also be used to treat people whose cancer comes back after their first treatment (called a relapse, or recurrence) or if other treatments are no longer working (called refractory treatment).
Radiation therapy may be used as the main treatment for a solitary plasmacytoma of the bone or extramedullary plasmacytoma. It may also be used to prevent bone fractures (breaks) and control symptoms of advanced multiple myeloma, like bone pain.
Surgery is sometimes used to treat spinal cord compression or to treat or prevent bone fractures. Surgery may also be used to treat an extramedullary plasmacytoma. If surgery is used, it is usually done after radiation therapy.
Supportive therapy helps to prevent or control multiple myeloma and other health problems caused by treatment. Supportive therapy for multiple myeloma includes:
Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits after treatment has finished. These visits allow your healthcare team to monitor your progress (watch for changes) and response to treatment. Multiple myeloma often comes back or doesn’t completely go away. Follow-up is very important to see if the disease is starting to relapse. For most people, multiple myeloma treatment may stop for a while, but in most cases the disease comes back and you will need to have another treatment.
Some clinical trials in Canada are open to people with multiple myeloma. Clinical trials look at new and better ways to prevent, find and treat cancer. Find out more about clinical trials.
You will have tests at some point after your treatment that will help tell the doctors how well the treatment worked. This is called response to treatment. The International Myeloma Working Group categorizes the response to treatment into the following categories.
A stringent complete response (sCR) is defined by the following:
A complete response (CR) is defined by any one of the following:
A very good partial response (VGPR) is defined by either of the following:
A partial response (PR) is defined as:
Progressive disease (PD) is defined by one or more of the following:
Stable disease (SD) means that the person does not meet the criteria for any of the categories above.
To make the decisions that are right for you, ask your healthcare team questions about treatment.