Currently, there is no cure for multiple myeloma, but the life of the patients can be increased by providing the best treatment options available.
What Is The Best Treatment For Multiple Myeloma?
Like any other cancer treatment, the treatment strategy for multiple myeloma is customized for each patient. Although the strategies are made as per the internally recognized guidelines, the frequency of different treatments may be customized. Thus, there is no best treatment which is “the best” for all the patients. The treatment strategy includes various available treatments in varied frequency such as chemotherapy, radiation therapy, and targeted therapy. (1)
The survival rate of the patients suffering from multiple myeloma is significantly increased due to the new treatment options. A few years back, there was no hope for the patients and the life of the patient after diagnosis was just a few weeks or months. Currently, various treatment strategies are available to slow the progression of the disease and allow the patient to lead an active life for years. Further, there are various medical advancements under research which may further improve the life of the patients and increase their survival rate.
Following are the various options available for treatment of multiple myeloma-
Chemotherapy– Chemotherapy is the therapy done through the use of drugs to kill the cancer cells. The route of administration of chemotherapy may be either oral or parenteral. While using the chemotherapeutic drugs, other adjuvant drugs are also be added in the therapy to provide more effective treatment. For example, chemotherapy drugs may be combined with immunomodulating drugs and corticosteroids. The mechanism of action of the chemotherapeutic drugs should be clearly known to the oncologist so that there is no interaction between the treatments with two different strategies. For instance, when the chemotherapy is supported with the stem cell transplant, drugs that damage the bone marrow such as melphalan should be avoided. Various chemotherapeutic drugs used in the treatment of multiple myeloma include Melphalan, vincristine, doxorubicin, bendamustine, etoposide, and cyclophosphamide. In some cases, prior to stem cell transplant, high doses of the chemotherapeutic drug is administered.
Radiotherapy– Radiotherapy is sometimes used as an adjuvant to the chemotherapy. When the myeloma cells are left-over after the chemotherapy and in instances when chemotherapy fails to clear all the cancerous cells, radiation therapy is advised. External beam radiation therapy is used in the treatment of solitary plasmacytoma. Radiation therapy is also used in cases where there is an urgent need to remove the cancerous cells. As the myeloma attacks the spine and causes a vertebral collapse, the risk of paralysis is significantly increased. Such conditions are managed through radiation therapy.
Surgery– Surgery is not directly used to treat the multiple myeloma; rather it is used to manage the negative impact on the disease. Multiple myelomas cause severely weakened bones and vertebral collapse. To manage such conditions, surgery is required.
Stem Cell Transplant– New and healthy stems cells are administered in the bone marrow. Prior to the administration, a high dose of chemotherapy is used to kill all the cancerous cells. The stem cells may either be obtained from the bone marrow or from the peripheral blood.
Biological Therapy– These are the drugs that improve the immune system of the body to fight against the disease. They help the immune system to identify the cancerous cells and kill them. Drugs used under this therapy are pomalidomide, lenalidomide, and thalidomide.
Targeted Therapy– Because of the serious side effects of chemotherapeutic drugs, targeted therapy was developed. The targeted therapy specifically targets the cancerous cells and kills them. They attack genes or proteins of the cancerous cell and either kill them or cease their growth.
Various treatment strategies are available for the treatment for multiple myeloma and more than one treatment option is provided to the patient for effectively managing the disease. The best treatment is one that suits the best to a particular patient.
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