Multiple Myeloma

Often multiple myeloma causes no symptoms until it reaches an advanced stage and therefore it is difficult to diagnose it early. The cancer grows so slowly it may take several years before symptoms appear. Symptoms include fatigue, shortness of breath from anemia, fevers and as the cancer progresses, bone pain and broken bones. Multiple myeloma can be found early when a routine blood test shows an abnormally high amount of protein in the blood.

At our centers we offer treatment options that are proven to slow the progress of multiple myeloma, stabilize your condition and help minimize discomfort and pain. Because the tumors are located in bone, surgery is not a treatment option but multiple myeloma can be treated with chemotherapy, targeted therapy, radiation therapy and bone marrow (stem cell) transplant.

Chemotherapy for multiple myeloma

Chemotherapy refers to drugs that destroy cancer cells. Our expert teams may recommend chemotherapy before or after other treatments, or on its own. The type of chemotherapy you’ll receive will also depend on how advanced your multiple myeloma is. Chemotherapy can effectively slow the progress of multiple myeloma.

Targeted therapy for multiple myeloma

As researchers know more about multiple myeloma, they have developed new treatments that can specifically target it. We use targeted therapy to seek and attack cellular activity that the cancer depends on to survive and grow. They are used depending on the specific genetic make up of your cancer. Types of targeted therapy for multiple myeloma include:

• Proteasome inhibitors – block the action of a substance in myeloma cells that breaks down protein. This action causes the cells to die
• HDAC inhibitors – affect which genes are active or turned on inside cells. They do this by interacting with proteins in chromosomes called histones
• Monoclonal antibodies – bind to the specific proteins on myeloma cells, causing them to die

Immunotherapy for multiple myeloma

Immunotherapy helps your body’s own immune system to recognize and fight the cancer. In multiple myeloma, biological therapy drugs such as thalidomide, lenalidomide and pomalidomide are used to enhance the immune system cells which identify and attack cancer cells.

Bone marrow or stem cell transplant for multiple myeloma

A bone marrow transplant, also known as a stem cell transplant, is a procedure which removes the diseased bone marrow and replaces it with healthy, cancer-free bone marrow. It is often used to treat multiple myeloma.

There are two types of bone marrow transplants:

• Autologous transplant – this removes your own stem cells. Blood or marrow is removed and the blood-forming stem cells are separated out. The blood is returned to you and the stem cells are stored until they are needed for the transplant. You will then be treated with high dose chemotherapy to destroy the cells in your bone marrow, including the cancer cells. The stem cells are then returned into your blood through a vein. They travel to your bones and begin rebuilding your bone marrow.
• Allogeneic transplant – this follows the same process as above but it uses stem cells from a donor rather than your own. The donor needs to be closely related to you or have a very similar cell type.

You may need to have two stem cell transplants, 6 to 12 months apart.