Treatment and Prevention
Because it is not known what causes multiple myeloma, it is not possible to prevent this disease. However, you have a number of options for the treatment of multiple myeloma.
Multiple myeloma often develops slowly and may not always have signs or symptoms. For people with multiple myeloma who are not experiencing symptoms, they may not need to start treatment right away. However, they will need regular visits to their doctor to monitor the progression of the disease.
You may need treatment for the disease if:
- you develop symptoms
- there is an increase in the level of M protein in your blood or urine
- there is an increase in calcium in your blood
- your bones show signs of weakening
- you have problems with kidney function
The different types of treatment include:
- chemotherapy (e.g., melphalan*, cyclophosphamide, doxorubicin)
- novel therapies (e.g., lenalidomide, bortezomib, thalidomide)
- stem cell transplantation
- radiation therapy
- bisphosphonates (e.g., pamidronate, zoledronic acid)
Chemotherapy and newer therapies are common treatments for multiple myeloma. These medications directly damage and kill the abnormal myeloma cells. These medications are specifically designed to quickly attack multiplying cells, but they can also damage normal cells. To reduce the damaging effects and adverse events of these medications, your doctor will carefully determine the type and dose of the medication as well as the duration of treatment.
A person with multiple myeloma can take the medication by mouth or through intravenous injection. The medication must be taken over a period of time, often months. If the level of M proteins stabilizes, you may be able to stop chemotherapy treatment.
Stem cell transplantation involves a combination of chemotherapy to wipe out the diseased cells and the transfusion of a special type of cells called stem cells. Stem cells from you or a donor are transfused into your body to replace damaged bone marrow.
Radiation therapy uses high-energy X-rays that penetrate the body to destroy myeloma cells. The radiation targets a specific area, often where a tumor has developed. The treatment may be repeated for 4 or 5 days a week over several weeks. It may also be used to relieve bone pain.
Bisphosphonates are medications given by vein that reduce the likelihood of bones breaking from the myeloma. They may also lessen bone pain.
To treat the anemia that is often associated with multiple myeloma, a group of medications called erythropoietin stimulating agents may be prescribed. They cause the bone marrow to produce more red blood cells.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Todd Gersten, MD, Hematology/Oncology, Palm Beach Cancer Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network.