Doctor Discussion Guide: Progressive Multiple Myeloma Treatment Options
You may feel angry, scared, or confused by this diagnosis. These emotions are normal. But having progressive multiple myeloma doesnâ€™t mean that you canâ€™t achieve remission again.
Although there isnâ€™t a cure for this type of cancer, itâ€™s possible to live with multiple myeloma and control your symptoms. For this to happen, you should have regular discussions with your doctor. You should come to your appointments with your own set of questions to help make sure you and your doctor cover all the key topics regarding your care.
Hereâ€™s what you should ask your doctor about progressive multiple myeloma treatment options.
1. What do you recommend as a next step?
Your doctor can help you determine which treatment may have the best outcome for you.
They may suggest targeted therapy drugs or biological therapy drugs. Targeted therapy attacks specific molecules involved in cancer growth. These drugs include bortezomib (Velcade), carfilzomib (Kyprolis), and ixazomib (Ninlaro).
Biological therapy strengthens the immune system, which can help your body fight cancer cells. Drugs in this category include thalidomide (Thalomid), lenalidomide (Revlimid), and pomalidomide (Pomalyst). Your doctor may recommend one of these drugs on its own if you stop responding to a prior therapy. They may also have you take these drugs in combination with another therapy.
Other options for progressive multiple myeloma may include chemotherapy or radiation to kill cancer cells. Your doctor may also recommend a bone marrow transplant to replace your diseased bone marrow with healthy bone marrow.
Sometimes doctors recommend maintenance therapy to help control symptoms once you achieve remission. This involves taking a low-dose targeted therapy drug or corticosteroid to prevent the myeloma from coming back.
If your condition hasnâ€™t responded to any treatment, the next step may be palliative care or hospice care. Palliative care treats your symptoms and not the cancer. Hospice care focuses on helping you live your last days in as much comfort as possible.
2. Am I eligible for clinical trials?
When traditional therapy doesnâ€™t slow the progression of multiple myeloma, ask your doctor about clinical trials. Researchers conduct trials to see if promising new experimental drugs can effectively treat certain conditions.
There are no guarantees for success in clinical trials. But if an experimental drug is successful, this may help extend your life. Your doctor can refer you to a clinical trial specialist to see if youâ€™re eligible to participate in studies related to multiple myeloma.
3. What is the goal of treatment?
Itâ€™s important to understand the goal of a specific treatment. Is your doctor recommending a particular treatment to help kill cancer cells and bring on remission? Or is the goal of treatment to help manage symptoms and improve the quality of your life?
4. What are the side effects of treatment?
Before committing to any treatment, ask your doctor about potential side effects. For example, side effects of chemotherapy may include hair loss, fatigue, nausea, and vomiting. Also remember to ask your doctors about medications that can help relieve some of the symptoms of these treatment- related side effects.
Your doctor may say youâ€™re a candidate for a bone marrow transplant. If so, make sure you know the risks. These include the risk of an infection during the first few months after the transplant. You may also need to stay in the hospital for a while after the procedure.
Other side effects of treatment include blood clots, anemia, fatigue, and gastrointestinal problems.
5. How will treatment affect my daily life?
Itâ€™s important to know how your body may respond to a specific treatment.
Your doctor may recommend aggressive therapy to stop the progression of the disease. Side effects can make it difficult to work or care for your family. You may have to take time off from work, change your activity level, or rely on help from a relative.
Side effects donâ€™t occur in everyone. But if you know what to expect before beginning treatment, you can prepare yourself for this possibility.
6. What is my prognosis with treatment?
Your doctor canâ€™t guarantee that a specific treatment will improve your condition. But based on your health, they may be able to estimate the success rate. Knowing your prognosis can help you decide if a particular treatment is worth it. Itâ€™s also beneficial to get a second opinion. Another doctor may suggest a different course of action. They may also provide new insight on how to treat the disease.
7. Can I get financial help for treatment?
The out-of-pocket costs of treating multiple myeloma can be expensive. If you have difficulty covering the cost of treatment, discuss these financial concerns with your doctor. Your doctor may refer you to a social worker or a caseworker. These individuals can provide information on applying for financial help to cover some of your costs.
Thereâ€™s no cure for multiple myeloma, but you can achieve remission and live a long life. For the best possible outcome, youâ€™ll need to work with your doctor to determine the most appropriate treatment. The right treatment for you may not involve treating the cancer. Instead, it could be to improve your quality of life and help you manage symptoms.
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