Treatment for myeloma
Planning your treatment
When your cancer team have the results of tests they can plan the best treatment for you.
Myeloma cannot usually be cured, but it is treatable. Treatment can be very effective and is used to:
- stop the myeloma developing further
- control symptoms
- improve your quality of life.
You and your doctor can decide together on the best treatment plan for you. Your doctor is an expert in the best treatments. But you know your preferences and what is important to you. You may need more than one meeting with your doctor or nurse to talk about your treatment plan.
Types of treatment for myeloma
Treatment aims to reduce the number of myeloma cells to as few as possible. The type of treatment your doctor offers you depends on a number of things, including your general health.
If the myeloma is not causing symptoms, you do not usually need treatment straight away. Myeloma with no symptoms is called smouldering or asymptomatic myeloma.
If the myeloma begins to cause symptoms, you will start treatment. Myeloma with symptoms is sometimes called active or symptomatic myeloma.
Treatment overview for myeloma
Myeloma without symptoms
Myeloma with no symptoms is also called smouldering or asymptomatic myeloma.
You may not need treatment straight away. Instead, your cancer team may suggest active monitoring. This means you will have blood samples and some other tests every few months.
Controlling symptoms of myeloma
Treating symptoms is an important part of your treatment for myeloma. Always tell your doctor or nurse if you notice:
- any new symptoms
- a symptom getting worse
- a symptom not getting better with treatment.
Myeloma can cause bone pain or other bone problems. Other symptoms might include tiredness or difficulty fighting infections. Sometimes the kidneys are affected by myeloma. There are different ways these problems can be managed.
We have more information about controlling symptoms.
Active myeloma with symptoms
Active myeloma means you have symptoms, or are at a high risk of developing symptoms. It may also be called symptomatic myeloma.
You will usually start treatment. You may have intensive treatment or less intensive treatment.
The aim of treatment is to get the myeloma into remission and to manage symptoms. Remission means the myeloma cannot be found in tests.
Less intensive treatments for myeloma
Less intensive treatments include:
- cancer drugs such as targeted therapies, chemotherapy and steroids
- symptom control.
Usually, a combination of these treatments is used.
Intensive treatment for myeloma
Some people might have intensive cancer drug treatment. If your cancer team recommends this as part of your treatment, they will discuss the possible benefits and disadvantages with you.
Because intensive treatment is more complicated, it is usually only offered in specialist hospitals. This means you may have to travel to a different hospital. You are likely to be in hospital for several weeks and it may take some months to fully recover.
Intensive treatment is divided into the following 2 stages:
- Induction therapy – this is treatment with targeted therapy, chemotherapy and steroids. The aim of induction therapy is to get rid of as many myeloma cells as possible.
- Consolidation therapy – this uses treatment with high dose chemotherapy treatment and a stem cell transplant to get rid of remaining myeloma cells.
Maintenance or continuous treatment
Your doctor may suggest continuing treatment to get the best possible response for you and delay relapse for as long as possible. This is called continuous therapy or maintenance treatment.
If the myeloma does not respond to the first treatment, your cancer team will look at other treatments.
Some people who are in remission may also be offered continuous treatment. The aim of this is to keep myeloma in remission.
Making decisions about treatment
You may be worried about having cancer treatments because of the possible side effects. But these can usually be controlled with medicines. Treatment can be given for different reasons, and the benefits and side effects depend on your individual situation.
- If you have early-stage myeloma and are well enough for intensive treatment, it is often possible to control the cancer long-term.
- If you have more advanced myeloma, you may have treatment to help control the cancer, reduce symptoms and improve your quality of life.
Some treatments for myeloma have more side effects and risks than others. For most people, treatment helps to control the myeloma and the side effects of the treatment are manageable. But for some people, treatment has little or no effect on the cancer and they get the side effects with little benefit.
It can help to talk to your family or friends about your treatment options. Your doctor or nurse can help you with your decision. You do not usually need to decide straight away.
You could write a list of benefits and disadvantages for each treatment. When choosing a treatment, you may want to think about:
- how long you need to have it for
- how it may affect your everyday life
- how much time you will need to spend in hospital
- the different side effects and how they are likely to affect you.
We have more information about making treatment decisions.
Related pages
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our myeloma information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Hughes D, Yong K, Ramasamy K, et al. Diagnosis and management of smouldering myeloma: A British Society for Haematology Good Practice Paper. Br J Haematol. 2024;204(4):1193-1206. Available from: www.doi.org/10.1111/bjh.19333
Sive J, Cuthill K, Hunter H, et al. Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline. Br J Haematol.2021;193(2):245-268. Available from: www.doi.org/10.1111/bjh.17410
Reviewer
Senior Clinical Research Fellow and Honorary Consultant in Molecular Diagnostics and Leukaemia
Date reviewed
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