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Multiple Myeloma

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by Alan R

(Plasma-Cell Myeloma)

 

Treatment

After cancer is found, staging tests are done to find out if the cancer has spread. Treatment is sometimes able to slow the progress of multiple myeloma. Complete remission is rare. Treatment is also important to control symptoms. Treatment depends on your symptoms and the stage of your cancer. Options include:

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body. The drugs kill mostly cancer cells. Some healthy cells may be killed in the process.
Chemotherapy drugs are used in combination and may also be given with other types of medicines, like immunomodulating agents.

Immunomodulating Agents

Immunomodulating agents work by changing the way the myeloma cells live. This makes it difficult for them to survive, reproduce, and produce proteins that cause symptoms. These medicines are often paired with a corticosteroid.

Corticosteroids

Corticosteroids may be combined with other medications or given alone. Corticosteroids can also help to treat the symptoms of chemotherapy, like nausea and vomiting.

Proteasome Inhibitor

A proteasome inhibitor is also available to treat multiple myeloma. Proteasomes are a type of protein complex that breaks down proteins. It inhibits proteasomes, which causes more proteins to be in the cells. Because of these extra proteins, the cells eventually do not grow anymore.

Bisphosphonates

Bisphosphonates are given to slow the process of bone loss.

Biologic Therapies

Biologic therapies repair, encourage, or raise the body’s response to cancer by affecting the immune system. Interferon is one biologic agent used to treat multiple myeloma. Interferon may be used with chemotherapy to help prolong remission, slowing the speed at which myeloma cells grow.

Radiation Therapy

Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. External beam radiation therapy may be given to relieve bone pain. It is not considered a cure.

Surgery

Surgery is done to remove a tumor that causes pain or other disabling symptoms when radiation therapy is not considered a good option. Surgery is not a cure.

Peripheral Stem Cell Transplant

Peripheral stem cell transplant involves giving immature, healthy blood cells to replace bone marrow cells that are damaged by cancer.

Plasmapheresis

Plasmapheresis is done to exchange plasma in the blood. Plasma is the liquid part of the blood that does not contain cells. After the plasma is removed, fresh plasma or a plasma substitute is added back to the blood. This treatment is done to remove the myeloma proteins from the blood.
 

RESOURCES

American Cancer Society
http://www.cancer.org

Multiple Myeloma Research Foundation
http://www.themmrf.org

 

CANADIAN RESOURCES

Canadian Cancer Society
http://www.cancer.ca

Myeloma Canada
http://www.myelomacanada.ca

 

References


Casciato D., Territo M., Manual of Clinical Oncology. 6th edition. Lippincott Williams & Wilkins; 2009.


Multiple myeloma. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003121-pdf.pdf. Accessed August 20, 2014.


Multiple myeloma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 4, 2014. Accessed August 20, 2014.


Multiple myeloma/other plasma cell neoplasms. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/myeloma. Accessed August 20, 2014.


Rajkumar, SV, Hayman, SR, et al. Combination therapy with lenalidomide plus dexamethasone (Rev/Dex) for newly diagnosed myeloma. Blood. 2005;106:4050 .

 

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