Chemotherapy is treatment with cancer-fighting drugs. Because these medicines go in your bloodstream and can reach all parts of your body, they’re a good choice to destroy myeloma cells. They can be injected into a vein or taken as pills.
It can be given after a transplant to reduce the chance that cancer cells will come back. Or it may be used to lessen pain and control symptoms if you have an advanced stage.
Often, combining two treatments is most effective.
Your doctor will choose your treatment based on things like your:
- Lab test results
Many people get chemotherapy in cycles. If your doctor decides this is right for you, you’ll get medicine for several days in a row. Then your body will recover for weeks before you have another treatment.
Your doctor will monitor your progress through blood tests, and he’ll adjust your medicine based on the results.
Both can be taken by IV, but in pill form, they may cause fewer side effects.
Make sure you take it on an empty stomach. This will make sure the right amount gets into your bloodstream.
Other chemotherapy drugs used to treat multiple myeloma include:
- Bendamustine (Treanda)
- Doxorubicin (Adriamycin)
- Etoposide (Etopophos, Toposar)
- Panobinostat (Farydak)
- Vincristine (Oncovin)
Another medicine, liposomal doxorubicin (Doxil), can be given by IV to patients with myeloma, but it’s not as common.
Other Drugs Given With Chemotherapy
Some medicines help chemotherapy drugs work better. For instance:
Immunomodulating agents (IMiDs) like lenalidomide (Revlimid), pomalidomide (Pomalyst) and thalidomide (Thalomid) help your immune system fight the cancer. They’re given in capsules. After chemotherapy, your doctor may still want you to take low doses of these to keep new tumors from growing.
Proteasome inhibitors trigger the death of myeloma cells by loading them up with defective proteins. Bortezomib (Velcade) is one that’s often used. It can be injected into a vein or under the skin. Other proteasome inhibitors include Carfilzomib (Kyprolis), which is administered by IV, and ixazomib (Ninlaro), which is given in pill form.
One or several of these medicines likely will be added to your treatment. For instance, if a stem cell transplant isn’t right for you, your doctor may suggest a combination of bortezomib, lenalidomide, and dexamethasone (you may hear this combination called VRd.)
You can also ask your doctor about joining a clinical trial. This will allow you to try a new and possibly more effective drug that’s still being tested.
Chemotherapy Before a Stem Cell Transplant
A stem cell transplant is a common treatment for multiple myeloma. Before you have one, you’ll be given a high dose of a chemotherapy drug to kill as many cancer cells as possible. Or your doctor might give you a combination of some of the other medicines mentioned above.
You’ll then get a transplant of blood-making stem cells. These healthy cells replace the ones that have been damaged by the chemo therapy.
Chemotherapy drugs can also damage healthy cells and cause side effects. Some of the most common side effects include:
These often get better or go away once your treatment ends. Still, it’s important to tell your doctor about any side effects you’re having so she can help you manage them.