Do i need to begin treatment immediately or are you going to monitor my multiple myeloma for now? why?

It depends: Standard of care for mgus is observation. Standard of care for smoldering/asymptomatic (no crab sx) mm is observation. Ecog e3a06 is evaluting Lenalidomide vs. Observation in smm. The reason to treat symptomatic mm include: improve survival, reduce bone fractures, reduce infections, improve blood counts, etc. The intensity and type of treatment are highly variable and actively evolving...

Yes and no: Most myeloma needs treatment, but some are indolent means very slow growing without causing any damage to u, after a thorough check your oncologist will tell you if you need tretment or close follow up untill you have an indication.