Primary health care doctors will usually refer people with myeloma to a hematologist or medical oncologist. Many such doctors are referred to as hematologist-oncologists.
- Although medical treatments are fairly standardized, different doctors have different philosophies and practices in caring for their patients.
- A person may want to consult with more than one specialist before selecting the hematologist-oncologist.
- Family members, friends, and health care professionals are good resources to get referrals. Many communities, medical societies, and cancer centers offer telephone or Internet referral services.
During a consultation with a hematologist-oncologist, the person will have an opportunity to ask questions and to discuss the treatments available.
- The doctor will present each type of treatment, give the pros and cons, and make recommendations based on published treatment guidelines and the doctor's experience.
- Treatment for myeloma depends on the stage. Factors such as age, overall health, and recurrence of myeloma are included in the treatment decision-making process.
- The decision of which treatment to pursue is made between the person's hematologist-oncologist (with input from other members of the care team) and family members, but the decision ultimately rests with the patient.
- For optimal treatment results, a person should be certain to understand exactly what will be done and why, and what to expect from the treatments that have been decided upon.
Like all cancers, myeloma is most likely manageable when it is diagnosed early and treated promptly.
- A treatment plan is individualized for a specific situation.
- The first decision to be made is whether or not to offer the patient a stem cell transplant at any point in the future. This influences the types of medications to be prescribed for treatment at the outset.
- The most widely used therapies are various types of chemotherapy, immune modulating or immunomodulatory drugs, cortisone derivatives such as prednisone or dexamethasone (corticosteroids), and/or radiation therapy.
- Newer medications that are active against myeloma may be offered, either as single therapy or together with chemotherapy.
- Supportive care is given to treat complications and symptoms. Some potential supportive care medications include growth factors for anemia and medications to treat bone disease.
- High dose chemotherapy followed by a stem cell infusion - called a stem cell transplant is often offered as a best way to control multiple myeloma for as long as possible. It is often offered after completion of initial, or induction, treatment.
Clarence Sarkodee-Adoo, MD
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