When Should Myeloma Treatment Begin?

Published on

Topics include: Treatments

The watch-and-wait period can be agonizing for patients. How do you monitor your conditions? When should you start treatment? Dr. John Burke from Rocky Mountain Cancer Centers and Dr. Martha Lacy from the Mayo Clinic explain the factors that are considered when determining when to begin myeloma treatment.

Sponsored by the Patient Empowerment Network through educational grants from Onyx Pharmaceuticals and Takeda Oncology.

View more programs featuring , and

Produced in association with

Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Jeff Folloder:

I have an online question from Sarah.  She says, “I haven't started treatment yet.  When will I know it's time to start?” So, Dr. Burke, how did you know it's time to pull the trigger?

Dr. Burke:            

So, yeah, there's—there [are] a few factors that we use.  And really, what we're trying to do when we have a new patient with myeloma is—is—question number 1, is this someone with asymptomatic myeloma or smoldering myeloma that doesn’t need treatment? Or is this someone with symptomatic myeloma or active myeloma that needs treatment?

Okay, so we're going to classify in those two groups.  So the question is how you distinguish who needs treatment?  How doesn't?  And the answer is—well, there's a clinical factor.  Basically, is the myeloma hurting?  Okay, and the way that myeloma hurts you, is that it causes you to be anemic with low red blood cell count, or it starts causing holes in your bones which if you don't feel pain, you might soon which is making your bones weak and susceptible to fracture?  Is it causing you problems with your kidneys?  So you're either having kidney function or spilling protein in your urine?  Or is it causing other symptoms which such as numbness in the fingers and toes, and what—what we call peripheral neuropathy.

So and the final thing is calcium.  We do see people having problems with real high calcium levels in—in myeloma.  So if any of those things are present, and we think are those from the myeloma, that's when we know that that's probably the time to start treatment. 

Jeff Folloder:     

Anything to add, Dr. Lacy?

Dr. Lacy:                

No, just that there—in the last few weeks, a paper came out that also add high free light chain to that list.  We call it CRAB criteria. 

We found that there's a very high risk that the myeloma won't progress within one to two years if the free light chain changes is very high.  And so, that's now been added to the list of things that define an effect of myeloma.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Related Programs

Can I Treat the Myeloma Now, Without Chemotherapy?

News about coming treatment approaches that won’t involve chemotherapy and the side effects involved is everywhere. Dr. Orlowski discusses what is available now and in the near future.

Published:

Should All Myeloma Patients Be on Bisphosphonates?

At a recent myeloma town meeting, Dr. Gareth Morgan from the University of Arkansas Medical Sciences explains the role of bisphosphonate drugs in the treatment of myeloma.

Published:

Advertisement
Join Our Community Register for Events Read Our Latest Blog
Advertisement

Page last updated on March 24, 2015