Multiple myeloma is a type of cancer. Specifically, it is a cancer of the plasma cells, which are white blood cells inside the bone marrow. A person's plasma cells are critical to the immune system. Multiple myeloma occurs when the plasma cells grow out of control and become cancerous.
Although it is not entirely clear what causes this form of cancer, multiple myeloma treatment includes various therapy options. Type of treatment recommended largely depends on the individual's circumstances and stage of cancer.
After a diagnosis and possible stage classification, an oncologist will create a treatment plan based on the patient's form of cancer, the aggressive nature of the cancer, and other health-related factors. Stage I generally refers to a less aggressive form of the disease, whereas Stage III is more aggressive.
Options for treatment include drug therapy, radiation, surgery, supportive treatments, or some combination of these. If your multiple myeloma is slow-spreading, your doctor may propose a "watch and wait" approach that involves monitoring before treatment.
There are numerous drugs oncologists may prescribe as part of multiple myeloma treatment. Chemotherapy uses drugs to destroy cancer cells. Patients can take medications for chemotherapy by mouth or through the vein or muscle.
Other drugs oncologists use are steroids like dexamethasone and prednisone. In addition to being a part of the treatment, they can also help control nausea. Doctors may also use proteasome inhibitors. Proteasome inhibitors stop enzyme complexes from breaking down proteins that control cell division. Monoclonal antibodies can help the body's immune system fight infections. Many doctors may prescribe multiple treatments as a part of drug therapy.
Radiation is one of the most common cancer treatments. With high-energy rays, radiation therapy targets and kills cancer cells. The goal is to focus on the cancer while doing as little damage to surrounding healthy tissue as possible.
Oncologists may also suggest radiation to treat damaged bones that do not respond to chemotherapy. When myeloma weakens the bones in the back, the bones may collapse and put pressure on the spinal nerves and spinal cord. To prevent paralysis, patients need radiation therapy and surgery.
Some oncologists may choose to remove single plasmacytomas with surgery. While not a common approach, surgery may become necessary if a patient faces paralysis, numbness, or muscle weakness due to spinal compression. During surgery, the physician attaches metal plates or rods to support the bones and help prevent and treat any fractures.
As part of multiple myeloma treatment, stem cell transplants include chemotherapy that kills the patient's bone marrow cells. This makes space for non-cancerous cells. Following the procedure, the patient receives healthy blood-forming stem cells. In an autologous transplant, the doctor uses the patient's own stem cells, whereas in an allogeneic transplant, the patient receives stem cells from a donor.
This treatment helps the patient's body fight against cancer cells and alters the genes inside immune cells to attack cancer. During the treatment, physicians remove T-cells from the patient's blood and change them in a lab to have receptors that attach to proteins on cancer cells. In this way, the patient's own cells are in effect re-programmed to attack the cancer. This is a newer treatment that has a great deal of potential and is being studied for its use against more types of cancer.
Patients with multiple myeloma may have low levels of normal antibodies or low red blood cell counts. To fight against infections, patients may need antibodies from donors to raise the levels and prevent secondary infections. Likewise, the patient may require blood transfusions or drugs that can improve the blood cell count.
There are also supportive treatments that are designed to relieve symptoms of multiple myeloma or side effects of other treatments for the cancer. For example, a patient receiving chemotherapy may experience nausea as a side effect and receive a supportive treatment to reduce stomach discomfort. Palliative care is also designed to keep patients with advanced stages of cancer more comfortable and pain-free.
There are various multiple myeloma treatment options available for patients. When an oncologist creates a treatment plan, it depends heavily on the patient. It is important to realize that the stage and aggressiveness of your cancer will play a role in determining treatment, as will your personal desires and lifestyle.
Those with cancer require information and support throughout the course of treatment, from the diagnosis and beyond. Contact our office to hear from an experienced, compassionate oncologist.
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