Myeloma

Planning treatment

Myeloma

Planning treatment

Your specialist works with a multidisciplinary team (MDT) to recommend the best treatment options for you. The specialist will explain these to you, and together you will agree on a treatment plan.

Our Canrefer website has information about MDTs in NSW.

It is a good idea to take someone with you to appointments to support you and help you remember what is discussed.

What you need to know

Myeloma treatment options

The best treatment for your myeloma depends on several things:

  • the type and stage of myeloma you have
  • whether you have symptoms
  • your age
  • your general health – including kidney and heart function
  • your own choices and preferences
  • what treatment you have had before.
  • Whether there are any clinical trials available.

Your specialist will explain the options to you.

Some cancer treatments can affect fertility.

​If having children in the future is important to you, talk to your doctor about this BEFORE you start treatment. 

Types of treatment for myeloma

The main types of treatment for myeloma are:

  • chemotherapy
  • corticosteroids (steroids)
  • targeted therapy
  • immunotherapy
  • stem cell transplant
  • radiation therapy (radiotherapy)
  • supportive measures.

Many people have a combination of these treatments.

Some people also have palliative care to manage symptoms, or take part in clinical trials which test new cancer care options.

Supportive treatments for myeloma

Most people with myeloma will have supportive treatments. These help to manage the damage caused by myeloma and the complications of the main treatments given.

Supportive treatments for myeloma can include:

  • bisphosphonates – drugs to strengthen and protect the bones
  • antibiotic, anti-viral and anti-fungal medications – to reduce the chance of getting a severe infection
  • analgesics – to reduce the pain caused by bone disease and peripheral neuropathy
  • blood infusions – this can include red blood cells,  platelets or immunoglobulins blood thinners – to reduce the chance of getting blood clots
  • medication to reduce nerve pain that can be caused by peripheral neuropathy
  • plasmapheresis – to remove myeloma proteins from the blood.

Active surveillance for myeloma

Not everyone with myeloma requires treatment straightaway.

People who have smouldering myeloma don’t have symptoms at diagnosis. They can be monitored regularly for symptoms of myeloma or any changes in their blood tests.

People whose myeloma is in remission after treatment may be monitored regularly for signs or symptoms of recurrence.

This is known as active surveillance or watchful waiting.

Purpose of treatment for myeloma

The purpose of a treatment is known as the treatment intent.

Depending on your situation, this can be:

  • to achieve a remission – where myeloma protein is absent and immunoglobulin levels return to normal range
  • control – to control the myeloma and stop it causing complications
  • supportive – to minimise the effects of myeloma and its treatment
  • palliative – to manage symptoms caused by the cancer and focus on quality of life.

What to ask or talk about

Understanding your treatment options

Your specialist should explain:

  • what they think is the best treatment for you
  • how helpful they expect it to be
  • where you can have your treatment
  • any side effects you may get
  • whether there is a clinical trial you could take part in
  • any costs involved with treatment.

This will help you to make an informed decision about what treatment to have.

Making treatment decisions

Some key points to remember when making treatment decisions:

  • Make sure you have all the information you need to make your decision, including what costs will be involved.
  • Ask the specialist to explain more clearly if you don’t understand the choices.
  • Don’t be rushed into decisions.
  • Take time to think about your choices and discuss them with your doctors and your family or friends.
  • If you are not happy with the choices you are offered, you can ask to see another specialist for a second opinion.​

Checklists

Use our checklists to find helpful tips or questions to ask.

Next steps

Treatment plan

Once you and your specialist have agreed on your treatment, a treatment plan will be made. 

The treatment plan gives details of:

  • the different treatments you will have
  • the order you will have them in
  • where you will have each treatment
  • what each treatment will involve
  • how long the treatment will take. 

Starting treatment

Before you start treatment, make sure you know:

  • the date and time of your first treatment
  • where you need to go
  • if you need any tests beforehand
  • whether there is anything you should do to prepare
  • when you next need to see your specialist.

Where to get help

There are people you can talk to for more information or support.

My notes: