Treatment and prognoses for multiple myeloma

Treatment and prognoses for multiple myeloma

Treating multiple myeloma involves slowing down the progress of the disease, addressing the various symptoms, and minimizing or eliminating the complications.

When multiple myeloma initially sets in, there may not be any symptoms. This stage is called smoldering multiple myeloma. There may not be any specific treatments at this stage. Physicians will need to periodically monitor the progress of the disease. This will involve urine and blood tests. If the tests show that the disease is progressing, and the patient shows signs and symptoms of the disease, treatment can be started. Most of the treatment options involve the use of medications and chemicals. The range of treatments includes:

Targeted therapy: These medications destroy the proteins in the diseased cells, thus causing the cells to die. These medications are administered intravenously or in pill form. This therapy is not very aggressive. These medications cause a number of side effects such as tiredness, nausea and vomiting, fever, decreased appetite, and lower blood cell count, peripheral neuropathy (nerve damage in the feet).

Biological therapy: A range of medications are used to boost the immune system in the body. A strong immune system attacks and kills the myeloma cells. These medications are generally taken in pill form; they have varying side effects, including drowsiness, fatigue, constipation and neuropathy, low blood cell count, and the risk of blood clots.

Corticosteroids: Corticosteroids are used to regulate the immune system in the body, thus helping in controlling inflammation. These drugs also act against myeloma cells. Taken in pill form or intravenously, they help decrease the incidents of nausea and vomiting that are common while administering chemotherapy. Common side effects are mood changes, sleep problems, high blood sugar, and increased appetite and weight gain. Using corticosteroids over long periods will cause bones to weaken and suppress the immune system.

Chemotherapy: Chemotherapy is an aggressive form of treatment, where the drugs attack and kill fast-growing cells. Both pill and intravenous forms are used. These drugs are often combined with corticosteroids to control the immune system. Chemotherapy is known for killing cancer cells and destroying healthy cells too. These medications are administered carefully to avoid or reduce the known side effects like nausea and vomiting, loss of appetite, mouth sores, hair loss, and low blood counts. However, most of these side effects go away after treatment is completed.

Radiation therapy: Radiation therapy uses high-energy rays like X-rays or proton rays to destroy cancer cells. This therapy is used to quickly eliminate myeloma cells in a specific area like where the cells have formed a tumor on the bone tissue and is causing bone pain and destroying the bone. Side effects include fatigue, nausea, diarrhea, changes in skin where the treatment is focused, and low blood counts.

Bone marrow transplant: This form of treatment involves using a heavy dose of chemotherapy and then replacing the bone marrow with a healthy bone marrow. Of late, bone marrow transplants have been replaced with stem cells transplants, wherein the stem cells are harvested from blood. The side effects are similar to but more severe than those experienced during radiation therapy and chemotherapy.

Surgery: Surgery is prescribed to remove single plasmacytomas (bone lesions) or replace the damaged bone with metal rods and plates.

Alternate medicine: There are no known alternate medicine treatments for multiple myeloma. What is possible is only to support a patient in coping with the disease and may include exercise, meditation acupuncture, massage, aromatherapy, art, and music therapy.

Early stages of the disease can be treated effectively, with patients learning to cope with minor side effects. However, if the disease has progressed to stage I and after, survival rates decrease to approximately five years for stage I, to about two to three years for stage III.

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