Multiple Myeloma Treatment

How is Multiple Myeloma Diagnosed?

A physician will use blood tests, urine tests, imaging tests and biopsy to make a diagnosis. Further tests will be needed if your doctor finds signs of myeloma when you don’t have symptoms. Your doctor can monitor the progression of the disease using the following tests:

• Blood and urine tests – Blood and urine tests are used to check for M proteins. These proteins are caused by multiple myeloma. Blood tests can also be used to assess, kidney function, blood cell counts, calcium levels, uric acid levels and the percentage of plasma cells in the bone marrow.
• Imaging tests – X-rays, MRI scans or CT scans can be used to determine whether bones have been damaged by multiple myeloma.
• Biopsy – During a biopsy, your surgeon removes a small sample of bone marrow with a long needle and it will be checked for abnormalities. Various tests can determine whether you have myeloma or some other condition. If myeloma is found, the tests can show how far it’s progressed. This is known as staging cancer.

What are the Multiple Myeloma Stages?

Myeloma that is not causing active symptoms is called the “smoldering stage,” or Durie-Salmon stage 1. This means that there are myeloma cells present in your body, but they are not progressing or causing any damage to your bones or kidneys. They may also be undetectable in your blood.

• Stage 1 – In this stage, a small number of myeloma cells in your blood and urine will be present. Your hemoglobin levels are slightly below normal and your bone X-rays may look normal.
• Stage 2 – In this stage, a moderate number of myeloma cells will be present. Hemoglobin levels are usually much lower than normal. Monoclonal immunoglobulin may be increased, and blood calcium levels may also be high. X-rays may show several areas of bone damage.
• Stage 3 – In the final stage of multiple myeloma, a high number of myeloma cells are found. Your hemoglobin level is usually below 8.5 grams per deciliter, and calcium blood levels are high. There are many areas of bone destruction which are caused by cancer.

What are the Treatment Options for Multiple Myeloma?

There are many ways for treating multiple myeloma; the specific approach taken will depend on the stage of the disease, what symptoms are present, whether kidney damage has occurred, and whether any other health problems exist. Treatment approaches will include the following:

• Biologic therapy to increase the immune system’s ability to fight cancer
• Chemotherapy: to attack cancer cells
• Immunotherapy: Immunomodulators(drugs) to reduce the production of abnormal proteins by cancer cells
• Participation in a clinical trial testing assuring new treatments for multiple myeloma
• Radiotherapy: Using radiation to destroy cancer cells and helps to control pain and reduce the risk.
• Bone Marrow Transplant: Also known as stem cell transplant is done to provide healthy stem cells that can make new blood cells
• Steroids to slow growth of cancer cells and enhance other therapies
• Targeted therapy helps to limit the production of new cancer cells

What is the Outcome for Multiple Myeloma?

Multiple Myeloma can be asymptomatic and will progress slow for some people. Poor kidney function and faster-growing cancer cells will indicate a poor outlook. After Multiple Myeloma treatment, you will need regular follow-up testing and you will be advised to drink lots of fluids to enable your kidneys to function properly. Because of your weak immune system, you will also have to take extra precautions to avoid infections.