Monitoring smouldering myeloma
Myeloma with no symptoms is also called smouldering or asymptomatic myeloma. You may have active monitoring, which means delaying treatment until it is needed.
What is smouldering myeloma?
Myeloma with no symptoms is also called smouldering or asymptomatic myeloma. The plasma cells show abnormal changes on blood tests, but they usually do not cause symptoms.
You may not need treatment straight away. There is no strong evidence that having treatment at this stage will help. Instead, your cancer team may suggest active monitoring.
What is active monitoring?
Active monitoring may sometimes be called active surveillance or watch and wait. This means you do not have treatment until it is needed.
You will have blood samples and some other tests every few months. If tests show the myeloma is progressing or you develop symptoms, your doctor will talk to you about starting treatment.
Some people may feel worried or anxious about not starting treatment straight away. If you are worried about not having treatment, you might find these tips helpful:
- Make sure you understand why active monitoring is recommended. If you have any concerns, talk to your doctor or nurse.
- Use your time to do things you enjoy, and to get as fit and healthy as you can.
- Try to focus on the present, rather than what might happen in the future.
- Share your feelings. You can do this by talking to family and friends, joining a support group or online forum, or by keeping a journal.
Although active monitoring can be difficult to adjust to at first, many people find it gets easier as time goes on. We have more information about the emotional effects of cancer.
Some people may be offered treatment for smouldering myeloma, but only as part of a clinical trial. Your myeloma team can give you more information about clinical trials if needed.
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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