Many types of cancer grow so slowly that doctors recommend not treating them until they start to cause problems. This approach is called watchful waiting. It’s what doctors usually suggest for people with multiple myeloma in its earliest phase, known as asymptomatic or smoldering multiple myeloma. In this stage, the cancer is there, but you aren’t having any symptoms.
It may be hard to know that you’re sick and to do nothing about it. But for most people, treatment doesn’t seem to help when multiple myeloma has no symptoms. And it opens you up to the risks and side effects that go along with cancer treatments.
What Happens During Watchful Waiting?
If your doctor recommends this approach, you’ll have regular checkups -- every 3 to 6 months. Your doctor will be looking for signs your cancer is getting worse.
Tests you might get include:
- Complete blood count (CBC)
- Blood chemistry tests
- Quantitative immunoglobulin (Ig) test
- Protein electrophoresis
- Serum free light chain test
- X-rays (once per year)
It’s important to keep track of how you’re feeling and let your doctor know if you’re having symptoms like fatigue or bone pain. You may get treatment to strengthen your bones if your doctor sees signs they’re becoming thin.
When to Treat Multiple Myeloma
If you’re diagnosed with multiple myeloma in an active stage, you’ll start treatment right away.
Most people with smoldering multiple myeloma start treatment only when their condition becomes active. You and your doctor will know you’ve reached that point when test results show at least one other symptom, such as:
Some people live with multiple myeloma for many years without any symptoms. But for other people, the disease gets worse quickly. Scientists are trying to figure out how to tell whose cancer will get worse faster and whether early treatment can slow it down.
They’ve already found some things that make you more likely to get sick sooner, including:
- Anemia that’s getting worse
- Certain genetic changes in the cancer cells
- Specific defective antibodies
- High levels of defective antibodies and low levels of healthy ones
If your doctor thinks it seems likely you’ll start having symptoms within 2 years, you might want to think about starting treatment. Researchers are testing drugs that slow the growth of tumors and others that fight inflammation to see whether they can keep you healthy longer.