Treatment Options

“Cure vs. control” is the main difference behind many of the treatment plans, trials, and debates related to the management of myeloma.

Myeloma is generally not considered curable but a sustained complete response (CR) for a long period, which has been defined as an “operational cure”, may be achieved. If this is the goal, more aggressive, more toxic chemotherapy may be required producing more adverse side effects.

“Control” treatment goals for myeloma aim to reduce symptoms, slow the disease and provide remissions considering myeloma more of a chronic disease; this is the common approach. How the person is feeling rather than their level of myeloma protein is the reason for treatment. Treatment may not be started immediately unless there are problems such as high calcium levels, kidney damage, anemia, or bone damage and even then only ways to reduce these symptoms may be all that is needed.

Some people want a curative approach and are less concerned about the risk of harmful side effects of treatment, whereas others think quality of life is more important than overall survival and refuse to risk their well being for a possible cure. There are benefits and risks associated with both approaches.