Multiple Myeloma: Treatment Options

How is it treated?

Multiple Myeloma may be treated in many ways. A patient and his/her Oncologist will decide which treatment is appropriate for that patient's particular situation depending on the stage of the cancer, age, and general health of that patient.

• Chemotherapy is a systemic, or whole body, treatment, the goal of which is to kill any remaining Cancer cells in the body and to keep the Cancer from spreading to other organs. The drugs are typically given in cycles of a few days of treatment and then 3-4 weeks to rest, for a period of weeks or months determined by the oncologist. Chemotherapy may be accompanied by Radiation Therapy. There are two ways chemotherapy can be administered, depending on patient health and the drugs being used:
  
  • Pill form: Chemotherapy pills are available for some drugs and allow the patient to remain at home for the entire treatment.
    
  
  
• Intravenous: The most common method of chemotherapy, intravenous injections are usually given on an outpatient basis at the hospital or treatment center. Patients who are in very poor health or have severe side effects may need to remain in the hospital for a few days.
  
  
• A Peripheral Stem Cell Transplant (PBSC) is a process in which the patient is connected to a cell separation machine and blood is drawn from one arm. This blood circulates through a machine in order to remove the stem cells (immature cells that develop into blood cells). The blood is then returned to the opposite arm and the stem cells are treated with drugs to kill cancer cells and then frozen until they are transplanted back into the patient. This procedure usually takes 2-6 hours for one or more days. Also, a PBSC may require a donor. The donor will be given a growth factor to help move the blood stem cells from the marrow into circulating blood. The blood will be collected from the donor, through apheresis, and transplanted into the patient. The PBSC's often engraft sooner than a typical bone marrow transplant.
  
  
• Radiation Therapy, also called Radiotherapy, uses high-energy rays, directed by a large machine toward the specific location of the cancer, to destroy cancer cells. A patient may go to a clinic or hospital 5 days a week for several weeks to receive radiation therapy.
  
  
• Biological Therapy, also called Immunotherapy, is a treatment that uses the body's immune system to fight the cancer or to lessen the side effects that can be caused by some cancer treatments. It uses materials in the body to strengthen, direct, or restore the body's natural defenses against disease.
  
  
• Plasmapheresis removes blood from a vein, and separates the blood cells (which are returned into another vein) from the blood plasma (liquid part of the blood). It is then discarded and replaced with a salt solution and blood proteins from donors. This procedure is usually done when the blood gets too thick and needs to be filtered. Although plasmapheresis can relieve some symptoms, it does not kill the Myeloma cells.
  
  
• Clinical Trials are research studies conducted in order to determine the effectiveness and side effects of new treatments. There are always new experimental treatments being tested that often have promising results. The effectiveness and side effects of clinical trials are not always known, but they can sometimes offer hope of survival. Consult your physician or the Rhode Island Cancer Council to find out what clinical trials are going on near you and if you are eligible.
  

Surgery For Multiple Myeloma

Although surgery is occasionally used to remove single Myelomas, it is very rarely used in treating Multiple Myeloma. As noted previously, when there is pressure on the spinal cord, severe muscle weakness, or numbness, emergency surgery may be necessary. Non-emergency surgery to attach metal rods or plates may be used to help support weight-bearing bones in the spine or legs and may be necessary to prevent fractures of these bones.

Possible Side Effects From Surgery

Generally, surgery is used to treat particular clusters of Multiple Myeloma so it does not cure the patient of cancer. The side effects of surgery for Multiple Myeloma may include:

• Pain
  
• Weakness
  

These side effects are temporary and may be relieved by medication.

Possible Side Effects from Treatments

*Most side effects are temporary and can often be relieved with medication.*

• Peripheral Stem Cell Transplant: The side effects of a Peripheral Stem Cell Transplant may be either temporary or permanent. Some of these side effects may be quite severe and even dangerous:
  
  • Increased risk of infection, bleeding, and other side effects of chemotherapy
    
  • The transplant itself is painless, but patients may experience lightheadedness, coldness, numbness around the lips, or cramping in the hands during the actual procedure.
    
  • If the transplant was from a donor then the recipient has a greater chance of chronic graft-versus-host disease (GVHD). This is a condition where the transplanted T-cells attack the recipients body. This condition can be mild or serious.
    
  
  
• Chemotherapy: Symptoms vary with the drugs being used and among individuals; however, the following are some common side effects:
  
  • Nausea/vomiting
    
  • Hair loss
    
  • Fatigue
    
  • Increased risk of infection
    
  • Fever
    
  • Easy bruising/ bleeding
    
  • Tingling in the fingers and toes
    
  • Ringing in the ears/ difficulty hearing
    
  
  Most of these symptoms are temporary and should cease shortly after treatment is stopped.
  
  
• Radiation Therapy: As with chemotherapy, Radiation Therapy side effects are different for everyone, and are usually specific to the areas exposed to the rays. Some commonly reported side effects for patients are:
  
  • Fatigue
    
  • Skin irritation in the area treated
    
  • Permanent bronzing of the skin of the treated area
    
  • Nausea/vomiting
    
  
  The side effects of radiation therapies are usually temporary, and symptoms should disappear once treatment stops.
  
  
• Plasmapheresis: This treatment does not kill cancer cells, though it relieves some of the symptoms of Multiple Myeloma. Common side effects of plasmapheresis include:
  
  • Drop in blood pressure, which may cause light-headedness or fainting, dizziness, blurred vision, chills, sweating or abdominal cramps
    
  • Bleeding
    
  • Tingling around the mouth or in the limbs
    
  • Metallic taste in the mouth
    
  
  
  

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  See also:

  Other Multiple Myeloma Information: Multiple Myeloma: The Facts Multiple Myeloma: Treatment Options Cancer Info: Multiple Myeloma Glossary of Cancer Terms Hematology Oncologists Hematology Physicians Multiple Myeloma Support Groups Cancer Forum

  
  

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