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Fred Hutch Cancer Center offers comprehensive care for multiple myeloma. This includes advanced treatments and new options available only through clinical trials.
Smoldering, or indolent, myeloma doesn’t cause symptoms, and patients with this condition may not need treatment right away. People who have active, or symptomatic, myeloma will be treated by our experienced, compassionate team.
No matter what type of multiple myeloma you have, the myeloma specialists at Fred Hutch will work closely with you, your family and each other to determine a personalized treatment plan.
As you go through treatment, your needs may change. Your care team at Fred Hutch is with you each step of the way. For example, we will help you cope with any side effects. We may suggest adding a new therapy that was just approved. Even after your multiple myeloma treatment is done, we will keep seeing you to protect your health over the long term.
Multiple Myeloma Care Tailored to You
You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.
The main goal of multiple myeloma treatment is to get rid of or reduce the number of myeloma cells in your body. This lets us stop or slow down your disease, stop or reduce complications and help you feel better and live a longer, healthier life. We choose, combine and schedule your treatments based on what will work best for your unique case. Your care team will make sure you understand each type of treatment and all of your choices.
Monitoring Your Health
While you are in active treatment, your multiple myeloma care team will see you regularly for exams and tests to check:
- How well your treatment is working
- If there is any reason to change your treatment
- If you need help with side effects or supportive care services, like nutrition care or mental health counseling
We update your treatment plan based on the best scientific evidence as well as how your disease responds and what you prefer.
Supportive Therapies
Your care team may recommend bone-strengthening medications if you need them. Multiple myeloma can cause holes in the bones that can last even after the cancer is controlled, so preventative bone strengthening can be helpful. This may include medications such as zoledronic acid (Zometa), pamidronate (Aredia) or denosumab (Prolia).
Possible Results of Treatment
Throughout treatment, your care team looks for signs that your multiple myeloma is responding to treatment. To do this, they use the International Myeloma Working Group (IMWG) criteria. Unlike other cancer types that have separate stages, most patients with myeloma will go through relapse at some point, so we think of your outcomes as falling somewhere in a range.
The responses to chemotherapy include:
- Partial response
- Very good partial response
- Complete response
- Stringent complete response
- Minimal residual disease (MRD) negative stringent complete response
If you have a relapse, this is called disease progression.
Along with relapse, you may also hear the word “refractory,” which means that the disease progression happened during your treatment or soon after treatment ended.
Classifications of your disease include:
- Partial response
- Very good partial response
- Complete response
- Stable disease
- Disease progression
- Relapsed/refractory
- Minimum residual disease
What about “cured”? Physicians do not think of myeloma as curable, but it is treatable. Most patients are either on active therapy or being closely monitored.
Treatment Side Effects
You might be wondering about possible side effects from treatment, like hair loss or nausea from chemotherapy. If you are, it may be helpful to know that many of today’s treatments are more targeted to cancer cells, so they don’t cause as many side effects as standard chemotherapy.
You are always at the center of everything we do. Multiple myeloma physicians, nurses and advanced practice providers are here to help prevent or relieve side effects of treatment.
Get Help with Side Effects
Before you begin treatment, we talk with you about what to expect, based on your treatment plan, and what can help if you do have side effects.
At your appointments, we want you to tell us about any side effects you are having. If you have questions or concerns between appointments, you can call or message us in MyChart. We will make sure you know how to reach care providers at Fred Hutch after hours, if that’s when you need us.
We have many tools to help you feel better, such as:
- Antibiotics, vaccines and antiviral drugs to prevent or treat infections
- Transfusions, steroids and medicines that help the immune system treat low levels of blood cells (low blood counts)
- Nutrition care and medicines to help with digestive problems
- Conventional and integrative therapies for pain
Common Side Effects
Side effects are different depending on which treatment you get. They also depend on other factors, like how strong your immune system is. These are some of the common side effects of multiple myeloma treatment:
- Unusual tiredness (fatigue)
- Higher risk of infection (due to low levels of white blood cells or low immunoglobulins/ suppressed immune system)
- Problems in your digestive tract, like sores in your mouth, nausea, vomiting, constipation or diarrhea
- Peripheral neuropathy (weakness, numbness and pain, usually in the hands and feet)
Supportive Care Services
Along with treating your multiple myeloma, Fred Hutch provides a range of services to support you and your caregiver before, during and after treatment. This is part of how we take care of you — not just your disease.
From registered dietitians to Spiritual Health clinicians, we have experts who specialize in caring for people with cancer. We understand this may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need.
Continuing Care
When your disease is in remission and your active treatment ends, it is still important to get follow-up care on a regular basis. At follow-up visits, you will see the same Fred Hutch team who treated your multiple myeloma. They will check your overall health and look for signs that your cancer may have come back (signs of recurrence).
Your team will also help with any long-term side effects (which go on after treatment ends) or late effects (which may start after treatment is over).
Multiple myeloma treatment at Fred Hutch is highly customized to your needs. Your hematologist-oncologist works with an entire group of multiple myeloma specialists. They include other hematologist-oncologists, radiation oncologists, pathologists, nephrologists, cardiologists, spine specialists, transplant specialists and researchers who are all looking for better ways to treat this disease.
Every week, this team gathers in a meeting to discuss their patients’ treatment plans. This meeting is called a tumor board. This approach means each patient benefits from the experience of the whole group.
With support from the larger team, your physician will:
- Decide if your disease needs treatment now, or if watchful waiting is best
- Talk about the standard therapies
- Check if any clinical trials match your needs, so you can think about joining them
Your hematologist-oncologist will walk you through the treatment plan that the tumor board has recommended for you. You will have a chance to share your personal preferences and options, and you will decide together what happens next.
The treatment plan we design for you depends on many things, including:
- If your multiple myeloma is asymptomatic (also called smoldering or indolent) or symptomatic
- If your multiple myeloma is high-risk or standard
- If you have had treatment for multiple myeloma in the past
- Your age and overall health
- Your needs and preferences, like what type of treatment schedule works in your life and if you want to join a clinical trial