How treatment for myeloma is planned

In most hospitals, a multidisciplinary team (MDT) who specialise in treating myeloma will plan the treatment they feel is best for you.

For people with early-stage myeloma, long-term control of the disease is often possible. For people with more advanced disease, treatment can be given to control the myeloma, reduce symptoms and allow a better quality of life.

If different treatments are available for the stage of myeloma you have, your doctors may offer you a choice. Make sure you have enough information about the different options. You might want to ask more about what’s involved in each treatment and about possible side effects.

Treatment can be given for different reasons, and the benefits and side effects will depend on your individual situation. Remember that the side effects of cancer treatments can usually be controlled with medicines.

Before you have treatment, your doctor will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.

If you choose not to have treatment, you can still have supportive (palliative) care to help with symptoms.

Planning your treatment

In most hospitals, a team of staff who specialise in treating myeloma will work together to plan the treatment they feel is best for you. They will then talk to you about the treatment options.

This multidisciplinary team (MDT) may include:

  • a haematologist – a doctor who specialises in treating blood disorders
  • a clinical oncologist – a doctor who is a chemotherapy and radiotherapy specialist
  • a specialist nurse who gives information and support
  • a pathologist – a specialist doctor who studies biopsies and tissue samples to see how disease affects the body
  • a radiologist – a doctor who specialises in x-rays and scans
  • a palliative care doctor or nurse who specialises in managing symptoms such as pain.

The team may also include doctors such as orthopaedic surgeons and renal doctors. It may also include other health professionals, such as a dietitian, physiotherapist, occupational therapist, psychologist or counsellor.


Treatment choices

If different treatments are available for the stage of myeloma you have, your doctors may offer you a choice. If you have to decide between treatments, make sure that you have enough information about the different options.

You might want to ask more about what is involved in each treatment, and about possible side effects, before you decide what is right for you.


Giving your consent

Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.

No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:

  • the type and extent of the treatment
  • its advantages and disadvantages
  • any significant risks or side effects
  • any other treatments that may be available.

If you don't understand what you've been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it's not unusual to need repeated explanations.

It's a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.

You can always ask for more time if you feel that you can't make a decision when your treatment is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you don't have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don't have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.


The benefits and disadvantages of treatment

Many people are frightened by the idea of having cancer treatments, particularly because of the side effects that can occur. However, these can usually be controlled with medicines. Treatment can be given for different reasons, and the benefits and side effects will depend on your individual situation.

For people with early-stage myeloma who are fit enough for intensive treatment, long-term control of the disease is often possible. For people with more advanced disease for whom intensive treatment isn’t suitable, other treatment can be given to control the myeloma. This should reduce symptoms and allow a better quality of life.

Some treatments for myeloma have more side effects and risks than others. For some people, treatment will help to control the myeloma and the side effects of the treatment will be mild. However, for others, treatment will have no effect on the cancer and they’ll get the side effects with little benefit.


Treatment decisions

Making decisions about treatment can be difficult, and you may want to talk more with your doctor before deciding to go ahead. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion.

If you choose not to have treatment, you can still have supportive (palliative) care to help with symptoms.

Back to Who will be involved in my treatment decision?

Getting a second opinion

There are many reasons for wanting a second opinion about your treatment. Speak to your specialist or GP.

Making a complaint

Talking to your healthcare team can make it easier to cope. If you find talking difficult, there are things you can do.