If you have multiple myeloma, remember that you often have a lot of choices in how to treat it. You and your doctor will work together to create a cancer treatment plan that’s right for you.
The goal of multiple myeloma treatment is to shrink your tumors, stop the cancer from spreading, keep your bones strong, and help you feel better and live longer. To do this, you might get medication, a stem cell transplant, radiation, a type of blood filtering called plasmapheresis, and surgery.
The treatment plan you and your doctor choose will depend on:
- Your age
- How much your cancer has spread in your body, called the stage of your disease
- Lab test results
- Symptoms you have, like fatigue or pain
- Your lifestyle and general health
Which Drugs Treat Multiple Myeloma?
Using medication to treat cancer is called chemotherapy. You might take just one medicine or a mix of them. Some come in pills, while others are shots into your vein or muscle.
Chemotherapy drugs for multiple myeloma kill cancer cells or keep them from spreading. They include:
- Bendamustine (Treanda)
- Cyclophosphamide (Cytoxan)
- Doxorubicin (Adriamycin)
- Etoposide (VP-16)
- Liposomal doxorubicin (Doxil)
- Melphalan (Alkeran, Evomela)
- Vincristine (Oncovin)
Your doctor may suggest that you take other drugs to fight your multiple myeloma along with your chemotherapy.
Some drugs help your immune system fight cancer cells in your blood. They include:
- Daratumumab (Darzalex
- Elotuzumab (Empliciti)
- Lenalidomide (Revlimid)
- Pomalidomide (Pomalyst)
- Thalidomide (Thalomid)
These drugs may cause birth defects if you take them while you’re pregnant, so talk to your doctor about using birth control.
Newer drugs keep cancer cells from growing out of control. They include:
- Bortezomib (Velcade)
- Carfilzomib (Kyprolis)
- Ixazomib (Ninlaro)
- Panobinostat (Farydak).
Your doctor may also prescribe steroid drugs like dexamethasone or prednisone. Sometimes you’ll get them along with your chemotherapy so you have less nausea and vomiting during treatment.
Multiple myeloma can make your bones weaker and more likely to break. Your doctor may give you drugs to help strengthen your bones, including pamidronate (Aredia) and zoledronic acid (Zometa), which are bisphosphonates or denosumab (Xgeva) which is a monoclonal antibody..
Stem Cell Transplant
Myeloma damages your bone marrow where cells, called stem cells, make new blood. A stem cell transplant can help your body make new, healthy blood cells. You can get new stem cells from a healthy donor. In the standard treatment, your doctor collects some of your own stem cells from your blood and gives them back to you.
Before a transplant, you'll get high-dose chemotherapy to kill any cancer in your bone marrow. It could last for several days. You also may receive radiation therapy. Then the doctor will put stem cells back into your blood through an IV. (If you're using your own stem cells, the doctor will collect them from you before you start chemo.) You may not feel much pain, and you'll be awake while it's happening.
It can take up to 2 weeks after the transplant for your bone marrow to start making new blood cells. You may need to stay in the hospital during this time. You'll also have a higher risk of infection, so your doctor might give you antibiotics to keep you from getting sick.
Using your own stem cells for a transplant can make myeloma go away for a while, sometimes several years, but it won't cure the disease.
Your doctor may try other treatments to fight your multiple myeloma.
- Radiation, along with drugs, can kill cancer cells or treat bones that the disease has damaged.
- You might have surgery to remove tumors or treat bones or muscles damaged by multiple myeloma.
- Plasmapheresis is a way to remove myeloma from the liquid part of your blood, called plasma. It won’t get rid of your disease, but it may relieve your symptoms for a short time. You’ll probably also get chemotherapy or treatment with another drug at the same time.
Will I Have Side Effects?
Side effects are possible, though not everyone has the same ones. The treatments may not affect you as much as another person. Some, like blood clots, may be serious but are rare.
The side effects you might have from multiple myeloma treatment include:
- Too few red blood cells (called anemia)
- Bleeding problems
- Blood clots
- Nerve pain, tingling, or numbness
Talk to your doctor about how your treatment makes you feel. There may be ways to reduce your side effects, including lowering your drug dosage, changing medications, taking aspirin to fight blood clots, changing your diet to help with constipation or diarrhea, or giving you other medicines to ease nausea or fatigue.
What Else Can I Do?
Stick with your multiple myeloma treatment plan. Your medications will work better against your cancer if you take them as prescribed. If you take pills at home, follow the instructions carefully.
Don’t be afraid to talk to your doctor or nurse if you don’t understand how to take your medicine. Don’t stop taking it if you have side effects. Instead, call your doctor’s office and talk about your options.