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Multiple myeloma

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From MayoClinic.com


Generally, if you have multiple myeloma and aren't experiencing symptoms, you don't need treatment. However, your doctors will likely monitor your condition at three- to six-month variable intervals, checking for signs — such as increasing levels of M protein in your blood or urine — that the disease is progressing. If it is, you may need treatment to help prevent symptoms.

If you're experiencing symptoms, treatment can help relieve pain, control complications of the disease, stabilize your condition and slow the progress of the disease.

Though there's no cure for multiple myeloma, if you have good treatment results you can usually return to near-normal activity. The appropriate treatment depends on your needs, medical status and general health. Standard treatment options include:

  • Chemotherapy. Chemotherapy is the most common treatment for this disease. It involves using medicine — taken orally as a pill or given through an intravenous (IV) injection — to kill myeloma cells. Chemotherapy is often given in cycles over a period of months, followed by a rest period. Often chemotherapy is discontinued during what is called a plateau phase or remission, during which your M protein level remains stable. You may need chemotherapy again if the M protein level begins to rise.

  • Stem cell transplantation. This treatment involves using high-dose chemotherapy along with transfusion of previously collected immature blood cells (stem cells) to replace diseased or damaged marrow. The stem cells can come from you or from a donor, and they may be from either blood or bone marrow.

  • Radiation therapy. This treatment uses high-energy penetrating waves to damage myeloma cells and stop their growth. Radiation therapy may be used to target myeloma cells in a specific area — for instance, to more quickly shrink a tumor that's causing pain or destroying a bone. Radiation is usually given four to five times a week for a period of weeks.

  • Other available treatments are being studied to determine their place in treatment of multiple myeloma. Your doctor can discuss with you whether these treatments are appropriate for you. Some of these include:

  • Bortezomib (Velcade). Velcade is the newest treatment for resistant forms of multiple myeloma. It's the first drug in a new class of medications called proteasome inhibitors. It works by blocking the action of proteasomes, which causes cancer cells to die. The drug was approved in 2003 under the Food and Drug Administration's accelerated-approval process as a third-line treatment for multiple myeloma. Because the drug was fast-tracked for approval, it will continue to be studied.

  • Thalidomide. Thalidomide, a drug originally used to treat morning sickness in the 1950s was removed from the market after it was found to cause severe birth defects. The drug may, however, be an effective treatment for stopping the growth and spread of myeloma cells. Because thalidomide can have serious side effects such as nerve damage and dizziness, researchers are trying to develop a treatment that acts like thalidomide on myeloma cells without the side effects.

  • New therapies. Many new treatments are being tested. Your doctor may be aware of clinical trials available to you.

Because multiple myeloma can cause a number of complications, you may also need treatment for those specific conditions. One example is pain medication or wearing a back brace to help relieve the back pain you might experience with multiple myeloma. People with severe kidney damage may need dialysis. Also, antibiotics may be necessary to help treat infections or to help reduce your risk of them.


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