Considering chemo for multiple myeloma? Learn more about this treatment and potential risks and benefits with PeopleBeatingCancer.
When I talk about chemo for multiple myeloma, for the purposes of this post, I am talking about all forms of chemo e.g. “Chemotherapy” (often abbreviated to chemo and sometimes CTX or CTx) that is a type of cancer treatment that uses one or more anti-cancer drugs (chemotherapeutic agents or alkylating agents) as part of a standardized chemotherapy regimen.” In short, “chemo” in an all encompassing definition.
If you have been diagnosed with multiple myeloma, depending on your stage at diagnosis and possible symptoms you are experiencing, you may undergo one or more of the three types of conventional treatments:
- Surgery
- Radiation
- Chemotherapy
in an effort to control your cancer while living the longest possible overall survival (OS) as well as achieving the highest possible quality of life (QOL). Board certified oncologists prescribe only Food and Drug Administration (FDA) approved chemotherapy regimens.
The FDA approved standard-of-care therapy (SOC) plan for newly diagnosed myeloma patients is:
- Induction Therapy
- Autologous Stem Cell Transplant
- Low-dose maintenance therapy
Because this is the SOC therapy plan for multiple myeloma does not mean that the plan is right for you. Your goals, age, stage, symptoms, health, etc. all play a role in your thinking about how to treat your blood cancer.
Years of experience have taught me that the key to living with multiple myeloma is to walk the fine line between the damage done by your incurable cancer and the damage done by conventional therapies.
Chemo for Multiple Myeloma — Weighing the Benefits and Risks
As a long-term survivor of multiple myeloma, I am the first person to caution newly diagnosed patients about chemotherapy’s strengths and weaknesses. All myeloma patients — young or old, early or advanced — must undergo some chemotherapy.
Your challenge is to understand their risks and benefits as you navigate your life as a myeloma survivor.
According to research, 96% of all newly diagnosed myeloma patients are stage 2,3. Multiple myeloma is difficult to diagnose. I consider myeloma to be a stealthy form of cancer because people can live with pre-myeloma or early stage myeloma for years before they are formally diagnosed.
The good news is that conventional oncology has become adept at stabilizing the average newly diagnosed patient. Because this patient usually has advanced disease (stage 2 or 3) and is usually over the age of 65, formally diagnosing and then stabilizing each newly diagnosed patient is a remarkable achievement.
The bad news is that the average patient undergoes a lot of toxicity in order to stabilize their advanced cancer. All forms of chemotherapy cause short, long-term and late stage side effects. As I stated above, your challenge is to balance the damage from myeloma with damage from chemo.
If you are in the 4% of myeloma patients who are diagnosed at an early stage, are comparatively young (less than 65 years of age) or may have not sustained much if any organ damage from your multiple myeloma, the standard-of-care therapy plan may be too much toxicity for you to achieve a long OS and/or high quality of life.
All myeloma patients eventually reach multi-drug resistance (MDR) essentially running out of chemotherapy regimens that can hold the survivor’s myeloma at bay, and can no longer control his/her blood cancer.
The Gold Standard Treatment for Multiple Myeloma
There really is no one single best chemotherapy treatment for all patients. Each newly diagnosed patient has different goals, health, age, stage, etc. etc. Having said this, the SOC induction chemo cocktail of RVd- Revlimid (lenalidomide), Velcade (bortezomib) and dexamethasone (dex) is the FDA approved standard induction therapy because studies conducted in 2010 showed that almost all patients responded to RVd and many achieve either a very good partial remission (VGPR) or complete remission. Some may even achieve minimal residual disease (MRD).
The standard-of-care for newly diagnosed multiple myeloma is a one size fits all approach to treating your incurable blood cancer. It is in your best interest to explore the dozens of individual chemo regimens as well as the chemo cocktails as well as adjunct therapies such as local radiation.
Is Chemotherapy Safe? The Side Effects of Chemo for Multiple Myeloma
No. I don’t consider chemotherapy to be safe in the general sense of the word. Necessary? Yes. Again, your goal is to manage the risks and benefits and manage your myeloma for the rest of your life.
When you are diagnosed with multiple myeloma, understanding what is involved with your chemo treatment will help you understand the process, hopefully feeling less anxious.
Chemo for multiple myeloma is toxic. There is no getting around this fact. Many people have heard the old saw “the cure is worse than the disease.”
Each and every myeloma patient will experience a different degree of adverse events, aka side effects. Everyone will experience different short, long-term and late stage side effects. And it is critical to stress that the newly diagnosed patient can “pre-habilitate” and prepare for chemo in order to improve efficacy why reducing side effects.
Multiple Myeloma — Hope for the Future
One of the single greatest strengths of conventional myeloma therapy e.g. Big Pharma, is their ability to invent, trial and get FDA approval of new chemotherapy treatments for multiple myeloma. During my life as a myeloma survivor I have witnessed numerous new individual chemotherapy regimens as well as numerous chemo cocktails developed, trialed and approved by the FDA.
The payoff is that each chemo for multiple myeloma can result in more life for each myeloma survivor.
One of the greatest strengths of PeopleBeatingCancer is that we research, write and communicate about evidence-based, non-toxic, non-conventional therapies for the multiple myeloma survivor.
Chemo for multiple myeloma is the original double-edged sword.
Let me know if you have any questions.
Hang in there,
David Emerson
- Myeloma Survivor
- Myeloma Cancer Coach
- Director PeopleBeatingCancer
