Piecing Together Your Multiple Myeloma Treatment Options
Multiple myeloma is a type of cancer that begins in plasma cells (white blood cells that produce antibodies) and is also called Kahler disease, myelomatosis, and plasma cell myeloma.
Different types of treatments are available for people with multiple myeloma and other plasma cell neoplasms. Some treatments are standard, and some are being tested in clinical trials. Nine types of standard treatment for multiple myeloma are currently used.
Chemotherapy
This is a cancer
treatment that uses drugs to stop the
growth of cancer cells, either by killing
the cells or by stopping them from dividing.
When chemotherapy is taken by
mouth or injected into a vein or muscle,
the drugs enter the bloodstream and can
reach cancer cells throughout the body
(systemic chemotherapy) . When chemotherapy
is placed directly into the spinal
column, an organ, or a body cavity such
as the abdomen, the drugs mainly affect
cancer cells in those areas (regional
chemotherapy) . The way the chemotherapy
is given depends on the type
and stage of the cancer being treated.
Other Drug Therapy
Other types
of drug therapy include the following:
- Corticosteroid therapy: Corticosteroids are steroids that have antitumor effects in lymphomas and lymphoid leukemias.
- Thalidomide and lenalidomide: These drugs are called angiogenesis inhibitors. They prevent the growth of new blood vessels into a solid tumor.
- Bortezomib: This type of drug is called a proteasome inhibitor. It targets certain proteins in cancer cells and may prevent the growth of tumors.
Before starting treatment, you may want to think about taking part in a clinical trial.
High-Dose Chemotherapy with
Stem Cell Transplant
This treatment
is a way of giving high doses of chemotherapy
and replacing blood-forming
cells destroyed by the cancer treatment.
Stem cells (immature blood cells) are
removed from the blood or bone marrow
of the person with cancer or a donor
and are frozen and stored. After the
chemotherapy is completed, the stored
stem cells are thawed and given back to
the patient through an infusion. These
reinfused stem cells grow into (and
restore) the body’s blood cells.
Biologic Therapy
This is a treatment
that uses the person’s immune
system to fight cancer. Substances made
by the body or made in a laboratory
are used to boost, direct, or restore the
body’s natural defenses against cancer.
This type of cancer treatment is also
called biotherapy or immunotherapy.
Monoclonal antibody therapy is one type of biologic therapy. It is a cancer treatment that uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
Radiation Therapy
This is a cancer
treatment that uses high-energy X-rays
or other types of radiation to kill cancer
cells or keep them from growing. There
are two types of radiation therapy. External
radiation therapy uses a machine
outside the body to send radiation toward
the cancer. Internal radiation
therapy uses a radioactive substance
sealed in needles, seeds, wires, or catheters
that are placed directly into or
near the cancer. The way the radiation
therapy is given depends on the type
and stage of the cancer being treated.
Surgery
Surgery to remove the tumor
may be done, usually followed by
radiation therapy. Treatment given after
the surgery, to increase the chances
of a cure, is called adjuvant therapy.
Watchful Waiting
This option involves
closely monitoring a person’s
condition without giving any treatment
until symptoms appear or change.
Plasmapheresis
This is a procedure
in which blood is removed from
the person with cancer and sent through
a machine that separates the plasma
(the liquid part of the blood) from the
blood cells. That person’s plasma contains
the unneeded antibodies and is
not returned to him or her. The normal
blood cells are returned to the bloodstream
along with donated plasma or
a plasma replacement. Plasmapheresis
does not prevent new antibodies from
forming.
Supportive Care
This therapy controls
problems or side effects caused
by the disease or its treatment, and improves
quality of life. Supportive care
is given to treat bone problems or amyloidosis
related to multiple myeloma
and other plasma cell neoplasms.
Clinical Trials
New types of treatment
are being tested in clinical trials.
Clinical trials are studying different
combinations of biologic therapy, chemotherapy,
steroid therapy, and drugs
such as thalidomide or lenalidomide.
Before starting treatment, you may want
to think about taking part in a clinical
trial. Information about clinical trials is
available at cancer.gov/clinicaltrials.
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Source: National Cancer Institute, www.cancer.gov
This article was published in Coping® with Cancer magazine, May/June 2009.
Coping® does not endorse or recommend any particular treatment protocol for readers, and this article does not necessarily include information on all available treatments. Articles are written to enlighten and motivate readers to discuss the issues with their physicians. Coping believes readers should determine the best treatment protocol based on physicians’ recommendations and their own needs, assessments and desires.


