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Newly Diagnosed With Multiple Myeloma? Making a Treatment Plan With Your Doctor

Newly Diagnosed With Multiple Myeloma? Making a Treatment Plan With Your Doctor

This article is for people who have been newly diagnosed with multiple myeloma and their care partners, or anyone who wants to learn more about multiple myeloma. The goal of this activity is to help patients and care partners talk to and work with their doctor about their treatment plan for multiple myeloma.

You will learn about:

  • What multiple myeloma is, and symptoms and complications (additional problems) that may happen

  • Treating newly diagnosed multiple myeloma and types of treatment

  • Making a treatment plan with your doctor and working with your healthcare team

  • Questions to ask your doctor

All medicines listed in this activity may not be approved by the US Food and Drug Administration (FDA) for newly diagnosed multiple myeloma but are recommended by the National Comprehensive Cancer Network (NCCN).

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What Is Multiple Myeloma?

Myeloma is a type of cancer that starts in plasma cells in your bone marrow, the tissue inside bones where most blood cells are made. Plasma cells are white blood cells that make antibodies to help you fight off infections.

In myeloma, cancerous plasma cells (myeloma cells) grow out of control and can build up in your bone marrow crowding out your normal cells. When myeloma cells spread throughout the bone marrow, it's called multiple myeloma. It's not known exactly what causes multiple myeloma.

Symptoms and Complications

With multiple myeloma, the presence of myeloma cells and the crowding out of normal cells can lead to symptoms and complications (additional problems) such as:

  • Low blood counts that may cause weakness, fatigue (tiredness), bleeding, bruising, or infections

  • High calcium levels in your blood that may cause extreme thirst, constipation, belly pain, or confusion

  • Bone problems, such as pain or fractures (breaks)

  • Kidney damage or failure (where your kidneys stop working) that may cause weakness, shortness of breath, itching, or leg swelling

Treating Newly Diagnosed Multiple Myeloma

There is no cure for multiple myeloma, but there are several treatments that can help manage it. The goals of treatment are to decrease the number of myeloma cells, control cancer growth, reduce your symptoms, and improve your quality of life.

There's no one treatment for newly diagnosed multiple myeloma that's for everyone. For many people, a combination of 3 medicines -- sometimes called triplet therapy -- may be recommended. For others, 4 medicines may be recommended.

Types of Treatment

Types of treatment your doctor may recommend can include:

  • Medicines such as:

    o  Chemotherapy (or "chemo") to kill cancer cells

    o  Targeted therapy to destroy cancer cells or stop their growth

    o  Immunotherapy to help your immune system find and kill cancer cells

    o  Steroids to decrease swelling and kill cancer cells

  • Radiation therapy to help treat pain 

  • Stem cell transplant to replace damaged or destroyed stem cells (cells that turn into blood cells) in your bone marrow

  • Surgery to fix fractures and stabilize bones

  • Joining a clinical trial

  • Supportive care to improve your quality of life

Making a Treatment Plan

You and your doctor will make a treatment plan together that best fits your individual needs and considers your symptoms, overall health, and personal preferences.

There are many treatments for multiple myeloma, so be sure to ask about all of your options. Before treatment, ask about the goals of each treatment, what you can expect during treatment, and what side effects may happen.

Taking treatment as directed is important. Don't skip doses, stop, or change treatment without talking to your doctor first, as this could affect how well your body responds.

Managing Side Effects

All treatments may have side effects. Some can go away on their own over time, but others may last longer. Together, you and your doctor can discuss ways to manage any that may happen.

Before treatment, ask about which side effects can happen with each treatment you're taking and when you should contact your doctor or seek emergency medical care because of side effects.

During treatment, be sure to tell your doctor about side effects and how they affect your daily life. Tracking and recording them in a journal or diary can help.

Working With Your Healthcare Team

With multiple myeloma, it's common to work with different types of doctors and healthcare team members to create your overall treatment plan. This can include physician assistants, nurses, nurse practitioners, pharmacists, social workers, counselors, and dietitians, among others.

Before treatment, ask about when, where, and how you'll be getting each treatment, as well as which doctor or team member you'll be seeing for each one.

Getting to know and having open communication with your healthcare team can help you get the care that's right for you.

Tiffany talks about her personal journey with multiple myeloma and working with her healthcare team.

Questions to Ask Your Doctor

Questions you can ask your doctor about multiple myeloma can include:

  • What treatments are available and what are the treatment goals?

  • How, when, where, and for how long will I take treatment?

  • What are the possible side effects and how can we manage them?

  • How will we know if treatment is working?

  • Are there any lifestyle changes I should make?

  • How can I make sure I have the best quality of life possible?

  • What should I do if I feel stressed or depressed?

  • Is there a clinical trial I can join?

  • Where can I find more information and resources?

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Authors and Disclosures

Clinician Reviewer

Karen Badal, MD, MPH

Senior Medical Education Director, Medscape, LLC.

Disclosure: Karen Badal, MD, MPH, has disclosed no relevant financial relationships.


Anita A. Galdieri, PharmD, RPh

Associate Director, Content Development, Medscape, LLC.

Disclosure: Anita. A. Galdieri, PharmD, RPh, has disclosed no relevant financial relationships.


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