How Multiple Myeloma Is Treated
Your doctor will choose from a variety of treatment options depending on factors such as your overall health, the stage of your multiple myeloma, and how many treatments you have already received. Drugs can disrupt the growth of cancer cells, kill the cancer itself, or help your immune system attack the cancer. They may be used in combination with each other, with other drugs, or with other therapies.
It is important to discuss all the potential benefits and risks associated with the treatment options you are considering with your healthcare team.
Commonly used multiple myeloma treatments
Monoclonal antibodies kill cancer cells directly and help the immune system attack them
Immunomodulatory agents can send signals to the immune system to destroy cancerous cells
Proteasome inhibitors interfere with actions inside cancer cells that help them grow and spread
Steroids help decrease inflammation and swelling
Chemotherapy either kills cancer cells or stops them from spreading
Conditioning and stem cell transplants* destroy cells in the blood, including cancerous cells, replacing them with healthy stem cells (cells that have not yet finished developing)
Bone support medication such as bisphosphonates help improve bone strength and prevent loss of bone mass
*Not everyone is eligible for stem cell transplant.
Combining treatments
Often treatments are combined because they fight the cancer and/or symptoms in different ways. It’s common to be on a combination of 2 or more drugs. Four drugs at the same time is called a quadruplet (quad) regimen. Taking 3 medicines at the same time is called a triplet regimen. Two drugs at the same time is called a doublet regimen.
Your doctor will decide what is the right regimen for you based on staging as well as the effectiveness and safety of each medicine. Some examples of how these medicines can be combined for your individual treatment regimen include:
QUAD REGIMEN
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TRIPLET REGIMEN
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DOUBLET REGIMEN
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= Monoclonal antibody = Proteasome inhibitor = Corticosteriod = Immunomodulatory agent
Talking with your healthcare team
When it’s time to choose a treatment for multiple myeloma, you can play an active role in the treatment decision. Your doctor and healthcare team are here to answer questions, make recommendations, and provide guidance when choosing a treatment plan.
The key to shared decision making is having open discussions with your healthcare team. Here’s how you can start:
- Express your desire to be involved in treatment decisions
- Ask questions to understand your options
- Let the doctor know your goals, values, and preferences
- Ask for time if you need it (and if it’s appropriate)
- Arrive at a treatment decision together
It is important to discuss all the potential benefits and risks associated with the treatment options you are considering. Here is a list of questions you may want to ask your healthcare team:
- What different treatment options are available?
- Will I need to be on multiple treatments at one time?
- What do you recommend and why?
- How quickly do we need to make a decision?
- Are there transportation assistance options if I am unable to get to and from treatment?
- What are the potential side effects of the treatments you recommend?