Wendy Hu, MD
Clarence Sarkodee-Adoo, MD
Mary L Windle, PharmD
Jay B. Zatzkin, MD
IN THIS ARTICLE
Myeloma Medical Treatment
Standard first-line (primary) therapy for myeloma involves combinations of corticosteroid therapy and immunomodulatory agents, with or without chemotherapy drugs. Supportive care medication is frequently given in conjunction with such treatment. 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 can result in side effects.
A person taking thalidomide or lenalidomide must observe strict precautions about the risk of these agents to a person who may become pregnant as they can cause severe birth defects.
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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