Wendy Hu, MD
Kathryn L Hale, MS, PA-C
Clarence Sarkodee-Adoo, MD
Mary L Windle, PharmD
IN THIS ARTICLE
Standard first-line (primary) therapy for myeloma involves corticosteroid therapy, with or without chemotherapy. Supportive care is frequently given in conjunction with treatment. However, current investigations may eventually change the approach to first-line treatment of myeloma to nonchemotherapeutic approaches. Sometimes radiation therapy is added for people with significant bone damage.
Chemotherapy is the use of powerful drugs to kill cancer cells. Chemotherapy is a systemic therapy, meaning that it circulates through the bloodstream and affects almost all parts of the body. Ideally, chemotherapy can find and kill cancer cells throughout the body.
Unfortunately, chemotherapy also affects healthy cells, which accounts for its well-known side effects.
New therapies and novel ways to administer known therapies are continually under investigation for the treatment of multiple myeloma. These novel therapies come about as a result of favorable performance in earlier, monitored, national multi-institutional studies. Usually, a clinical trial is offered to patients in order to extend and confirm the earlier results of such studies. In order to receive such new therapies, a patient would have to agree to treatment by enrolling in a clinical trial.
Ideally, the treating hematologist/oncologist will belong to a clinical trial network that provides up-to-date therapy and instant analysis of ongoing data. Patient enrollment in any clinical trial involves agreeing to a particular treatment plan that is exquisitely detailed by the physician and other members of the treatment team. A written protocol is provided to the patient and includes a fully detailed/informed written consent document.
The protocol, and its associated consent form, details the medications, all known side effects, and alternatives to treatment should there be failures in therapy or patient refusal to participate. As noted, the patient is fully apprised of the potential benefits and risks associated with such treatment, and consent is obtained in the presence of the treating physician and very likely other members of the treatment team.
Alternatively, a hematologist-oncologist may refer a patient to another institution to receive investigational treatment or intensive treatment, which may be otherwise unavailable at the current institution, such as stem cell transplantation.
Radiation therapy uses high-energy rays to kill cancer cells. It is considered a local therapy, meaning that it should be used to target areas of the body involved by myeloma. A radiation oncologist plans and supervises therapy.
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