Multiple myeloma is a type of cancer that occurs in a type of white blood cell known as a plasma cell. Plasma cells help the body fight off infections by manufacturing antibodies that immediately recognize and attack the invading germs. Multiple myeloma causes the cancerous cells to buildup in the bone marrow, where they start to crowd out the healthy blood cells. These cancer cells start producing abnormal proteins that lead to complications in the body. These abnormal cancerous cells reproduce rapidly and form tumors known as plasmacytomas. There are treatments available for multiple myeloma, and the goal of treatment is to eliminate these abnormal cells in order to allow the healthy blood cells to grow in the bone marrow. However, if you stop your treatment too early due to the side effects or because you think it’s not working, then this could pose some very serious risks to your health. Read on to learn about the risks of stopping multiple myeloma treatment.
Treatment for Multiple Myeloma
Multiple myeloma is a type of cancer that causes your body to start manufacturing too many abnormal plasma cells in the bone marrow. Plasma cells, in their healthy state, help the body fight against infections and other foreign invaders. In people with multiple myeloma, these abnormal plasma cells start to reproduce rapidly and give rise to tumors known as plasmacytomas. (1)
There are several treatment options for multiple myeloma, and the ultimate goal of treatment is to eliminate these abnormal plasma cells so that the healthy blood cells can start to grow once again in the bone marrow. Multiple myeloma treatment can typically involve:
The first stage of treatment for multiple myeloma is known as induction therapy. This line of treatment focuses on killing as many cancerous cells as possible. After induction therapy, patients are moved to maintenance therapy, which works to stop the cancer from growing again. (2)
All types of cancer treatment are known to have side effects. Treatment of multiple myeloma with chemotherapy is known to lead to nausea and vomiting and hair loss. (3)
Radiation therapy can cause red and blistering skin. (4) Targeted therapy causes a reduction in the number of white blood cells in the body, leaving you with a much greater risk of infections. (5)
Risks of Stopping Multiple Myeloma
If you are suffering from the side effects of multiple myeloma treatment, or if you feel that the procedure is not working, you should never make the abrupt decision of stopping your treatment. Stopping your cancer treatment too early can lead to many serious risks. Here are some of the main risks of stopping multiple myeloma treatment.
Risk 1: Reduced Lifespan
The treatment of multiple myeloma generally requires treatment with various therapies. This means that after finishing the first round of treatment, most patients will need to go on to maintenance therapy, which can last for years.
Staying on with cancer treatment in the long-term is known to have adverse effects. This can include undergoing repeated tests, experiencing and dealing with the side effects, and also staying on with your medication routine, which can all become overwhelming for anybody over a period of time. However, stopping your treatment will not prolong your life. Instead, the one upside of following multiple myeloma treatment is that it can help you live longer.
Risk 2: Your Cancer Might Be In Hiding
Even if you are feeling good overall, it is very much possible that a few stray abnormal cancer cells have been left in the body. People who have less than one myeloma cell out of one million cells in the bone marrow are known to have a minimal residual disease (MRD). (6)
Even though one in a million sounds like an excellent prognosis and nothing to be alarmed about, but the fact is that even this one myeloma cell can multiply and give rise to many more cells if there is sufficient time. Your doctor will keep testing for MRD by taking a sample of fluid from the bone marrow or a sample of blood and measure the number of multiple myeloma cells present in it.
Regular counts of the multiple myeloma cells will give your doctor a fair idea about how long your period of remission is going to last for, and when you might possibly experience a relapse of the cancer.
Getting tested every three months, or as per your doctor’s recommendations, will help your doctor catch any stray cancer cells and start the treatment before they are able to multiply and grow.
Risk 3: You Might Miss Out On A More Promising Treatment
As mentioned above, there are many ways of treating multiple myeloma, and there are, of course, more than one doctor available to guide you through the treatment plan. So if you find yourself feeling unhappy with your medical team or the medication you are taking, then seek a second opinion or ask your doctor about trying another medicine instead of stopping the treatment.
Although your cancer may have returned after the first round of treatment, it is very much possible that another treatment will help slow down the progression of your cancer or even help shrink the tumors. By stopping multiple myeloma treatment in between, you are also passing up the opportunity to find a new approach or medication that will finally help you win over your cancer.
Risk 4: Your Symptoms May Worsen
When the cancer cells multiply and grow, they tend to push into other tissues and organs in the body, especially the surrounding organs and tissues. This invasion by the cancer cells can lead to body-wide symptoms.
Multiple myeloma is a progressive cancer that can cause damage to the bone marrow. The bone marrow is the spongy area located inside your bones where the blood cells are manufactured. As the cancer starts to grow and spread inside the bone marrow, it can cause your bones to weaken to the point where they start breaking easily.
Fractures at this stage can be extremely painful and may also take a longer time to heal.
Uncontrolled or untreated multiple myeloma can also cause symptoms such as:
- Shortness of breath due to anemia
- Severe bleeding or bruising from low platelet count
- Higher risk of infections due to lower white blood cell counts
- Extreme constipation, thirst, and frequent urination due to the high levels of calcium present in the bloodstream
- Numbness and weakness due to nerve damage caused by the collapsing of bones in the spinal cord
By sticking with the treatment plan and slowing down the growth of the cancer, you will be able to significantly decrease the risk of developing these symptoms. Even if your current treatment is no longer working towards disrupting or stopping the growth of your cancer, it will still help you manage and deal with the side effects and help maintain a comfortable quality of life. Treatment that is solely aimed at relieving your symptoms is referred to as palliative care.
Risk 5: Treatment Increases The Odds Of Survival
There is no doubt that cancer treatment will leave you feeling exhausted, either due to the treatment process itself or due to the side effects of the treatment. However, if you are able to continue and hang in there, then your chances of surviving through multiple myeloma are much better than what has been observed in the past.
In the 1990s, the average rate of five-year survival for a patient of multiple myeloma was just 30 percent. (7) However, today, the rate of survival is over 50 percent, and for people who are diagnosed at an early stage, the rate is over 70 percent. (8)
The treatment of any type of cancer is never easy. You will need to be mentally prepared to go through multiple visits to the doctor’s office or hospital, there will be no end to the number of tests and therapies you will need to undergo, and you will be jabbed with a needle more times than you will remember. The entire process can last for years. However, if you stick with the treatment plan for the long term, then the odds of managing and even beating your cancer are better today than ever before.
If you have doubts about your treatment, then discuss it with your doctor and medical team. There are many medications available that help you manage the side effects of treatment, and there are many other therapies available as well that are easier to tolerate. So, discuss your concerns with your doctor instead of stopping the treatment.
- San Miguel, J.F., Schlag, R., Khuageva, N.K., Dimopoulos, M.A., Shpilberg, O., Kropff, M., Spicka, I., Petrucci, M.T., Palumbo, A., Samoilova, O.S. and Dmoszynska, A., 2008. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. New England Journal of Medicine, 359(9), pp.906-917.
- Alexanian, R. and Dimopoulos, M., 1994. The treatment of multiple myeloma. New England Journal of Medicine, 330(7), pp.484-489.
- Coates, A., Abraham, S., Kaye, S.B., Sowerbutts, T., Frewin, C., Fox, R.M. and Tattersall, M.H.N., 1983. On the receiving end—patient perception of the side-effects of cancer chemotherapy. European Journal of Cancer and Clinical Oncology, 19(2), pp.203-208.
- Bentzen, S.M., 2006. Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology. Nature Reviews Cancer, 6(9), p.702.
- Gerber, D.E., 2008. Targeted therapies: a new generation of cancer treatments. American family physician, 77(3).
- Paiva, B., van Dongen, J.J. and Orfao, A., 2015. New criteria for response assessment: role of minimal residual disease in multiple myeloma. Blood, The Journal of the American Society of Hematology, 125(20), pp.3059-3068.
- Bmtinfonet.org. (2019). Treatment Options for Multiple Myeloma: What’s Possible Now? What’s in the Pipeline? | BMT Infonet. [online] Available at: https://www.bmtinfonet.org/video/treatment-options-multiple-myeloma-what%E2%80%99s-possible-now-what%E2%80%99s-pipeline [Accessed 30 Nov. 2019].
- Cancer.Net. (2019). Multiple Myeloma – Statistics. [online] Available at: https://www.cancer.net/cancer-types/multiple-myeloma/statistics [Accessed 30 Nov. 2019].
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