Myeloma is rarely curable, but it is treatable. What is more, treatment can be highly effective at controlling the symptoms and helping to stop the disease from developing further.
At BMI Healthcare, we use haemato-oncology to diagnose and treat all blood cancers, including myeloma. Treatment in most cases is chemotherapy, sometimes in combination with radiotherapy.
Benefits of haemato-oncology
Treatment for most people with myeloma helps to alleviates symptoms, improves survival and, for some people, can cure the disease.
Once our consultant haematologists know the stage of your myeloma, they can plan your treatment. The treatment type you will be offered depends upon a few factors, which includes your general health and the stage of your myeloma.
The aim of treatment
The aim of any treatment we provide is to get the myeloma under control, so it goes into remission - so that no abnormal myeloma cells can be found in the blood or bone marrow, and normal bone marrow starts to develop again.
However, a complete remission isn't always possible for everyone with myeloma. But treatment can still help to reduce the amount of myeloma in the body (called a partial response), or stop it from developing further.
Throughout your treatment, you will have tests to check for the amount of paraprotein and light chains in your blood and to see how the myeloma is responding to treatment.
Myeloma without symptoms
If the myeloma is diagnosed early and is developing slowly (sometimes called asymptomatic or smouldering myeloma), you might not need treatment immediately.
You'll see your consultant every few months and they will take blood samples to do tests - this is known as active monitoring. Treatment will only be started if the myeloma begins to develop quicker or if you experience symptoms (the myeloma is then sometimes called symptomatic or active myeloma).
If your myeloma is active, the main treatments are chemotherapy, targeted therapies and steroids.
And, depending on your overall health and how the myeloma makes you feel, you might be offered a course of intensive chemotherapy (also called high dose) followed by a stem cell transplant.
But for people who would be able to tolerate the side effects of intensive chemotherapy treatment, there are options to have a combination of chemotherapy, targeted therapies and steroids.
You may have treatment with a single chemotherapy drug or a combination of different drugs. Steroids are usually given with chemotherapy to improve its effect.
This is another group of drugs commonly used to treat myeloma, and they might be used on their own or in combination with chemotherapy treatment. As with chemotherapy, steroids are often given with targeted therapy to improve its effect.
Bisphosphonate drugs can also be given with chemotherapy. These help to prevent bone damage, relieve pain and may also help people to live longer.
Intensive chemotherapy with stem cell transplant
Also called high dose chemotherapy, this is an intensive chemotherapy drug treatment that can help to improve the chances of controlling your myeloma in the long term. It uses high doses of chemotherapy followed by a stem cell transplant.
Stem cell transplant
A stem cell transplant is where stem cells are injected into your vein through a drip to replace stem cells that the high dose chemotherapy has killed.
Stem cells are essential to our survival - they are embryonic blood cells in your bone marrow that develop into red blood cells, white blood cells and platelets.
Having a stem cell transplant enables you to tolerate higher doses of chemotherapy, to give the drugs more chance of curing the myeloma.
If your myeloma goes into remission, then maintenance therapies may be used to keep the disease under control for longer - to suppress your symptoms.
But, for a few people, treatment doesn't help to control the effects of myeloma. In these cases, it's called refractory myeloma, and your consultant haematologist may offer you another type of treatment to help control the disease.
But for many people, treatment achieves a good response, yet the symptoms of myeloma often come back. This is sometimes called a relapsed myeloma - you will then be offered further treatment for this relapse.
Radiotherapy is often used to treat small areas of myeloma (sometimes called a localised disease) that are causing bone pain. This therapy is sometimes used in combination with high dose (intensive) chemotherapy treatments.
Surgery is sometimes required to help repair or strengthen bones that have suffered damage by the myeloma.
Paying for your haemato-oncology treatment
Haemato-oncology costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation.
Ask the hospital for a quote beforehand, and ensure that this includes the consultants' fees and the hospital charge for your procedure.
You'll have regular check-ups following your treatment. How often and for how long depends on the kind of treatment that you had.
At follow-up appointments, your consultant haematologist will ask how you're feeling and examine you. You might also need a blood test, CT scan, ultrasound, X-rays or a combination.
Want to know more?
If you'd like to read more about blood cancer, treatment or living with blood cancer, please visit cancerresearchuk.org.uk.