Treatment for myeloma is highly individual and depends on several factors, such as the type and stage of myeloma, your symptoms and your general health. The aim is to try to get the myeloma under control rather than to cure the cancer.
Learn more about:
- Treatment options
- Combining drug therapies
- Proteasome inhibitors
- Stem cell transplant
- Supportive treatment
People who have been diagnosed with monoclonal gammopathy of undetermined significance (MGUS) or smouldering myeloma usually do not need treatment straightaway. Most people with MGUS never develop active myeloma. In most cases of smouldering myeloma, having treatment early does not offer any clear benefit.
If tests show you have MGUS or smouldering myeloma, you will need check-ups every 3–12 months. This is called active monitoring. Your doctor will start treatment if you develop symptoms or other significant signs of myeloma.
Treatment to control the myeloma
This is often called induction or first-line treatment. It includes a combination of different drugs. A stem cell transplant may be suggested for some people. Active treatment may be followed by periods of stable disease (plateau phase or remission) when no treatment is needed.
Treatment for the symptoms and side effects caused by myeloma
This helps manage issues associated with myeloma, such as bone disease, pain, tiredness, kidney damage, hypercalcaemia, frequent infections and fatigue.
Treatment to prevent the disease returning
This is called maintenance or consolidation therapy and involves a longer, lower-dose course of an immunomodulator such as thalidomide, steroids and/or other drugs. It is often used after a stem cell transplant and sometimes after other first-line treatment.
Treatment when the disease comes back (disease progression, also called relapse or recurrence)
You may be offered a different type of chemotherapy, a stem cell transplant, steroids or other drugs to regain control of the disease. In some cases, you may receive a treatment that has previously worked well for you.
Most people with myeloma will be treated with a combination of two, three or more different drugs. The combinations may include traditional chemotherapy drugs and steroids, as well as newer therapies that are known as immunomodulators and proteasome inhibitors.
Combinations of drugs are used because each type of drug works differently to kill myeloma cells, and the combined effect helps treat as much disease as possible.
The choice of combination will depend on the type of myeloma, your age and your kidney function. Your haematologist will select the most suitable combination and discuss this with you. To learn more about the different drug combinations for myeloma, visit Myeloma Australia or eviq.org.au.
Dr Jane Estell, Senior Staff Specialist, Haematology Department, Concord Cancer Centre, and Senior Clinical Lecturer, The University of Sydney; Brenda Clasquin, 13 11 20 Consultant, Cancer Council NSW; Jacqui Keogh, Senior Myeloma Support Nurse, Myeloma Australia; Dr Silvia Ling, Haematologist, Liverpool Hospital and Sydney Adventist Hospital; and John Miller, Consumer.
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