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.
If I need treatment now, what are my options for multiple myeloma and how successful are they likely to be?
It depends... Treatment options for mm are plentiful and are dependent on: patient characteristics (age, comorbidities -- diabetes, neuropathy, cv disease, etc), mm cytogenetics (risk), disease burden, etc. Treatment options need to be customized to the individual patient -- more so than in the past because of rapid developments in mm. That is good news.
It depends... An international team has put together guidelines on when patients with myeloma should be treated. Your cancer doctor should be aware of them. There are many things now which can predict how well you will do with treatment and what type of treatment you should have. Patients live much longer with this disease than a decade ago. Some over 20 years making this a chronic illness in many ways.
"Many" Myeloma and other plasma cell dyscrasia treatments has evolved from standard cytotoxic approaches (eg mp, vad, hypercvad) to "novel" therapies. Immunomodulatory drugs (imids) - eg thalidomide, lenalolidomide, pomalidomide proteasome inhibitors - eg, bortezomib, carfilzomib, etc other: hsp90 inhibitors, hdaci, b-raf, etc. Over the last few years multiple new drugs have been approved for myeloma.
Multiple options. There are a variety of options for treating multiple myeloma. The main therapy is chemotherapy but radiation treatments are sometimes used for localized areas. Also a stem cell transplant is often part of the treatment. Chemotherapy or a stem cell transplant are used for a related plasma cell problem called 'primary systemic al amyloidosis.'.
Minimal. It us a fairly well tolerated drug. Its main side effect is neuropathy which can menifest as tingling, numbness of the toes and fingers and lead to weakness in the hands if the drug is continued for long time. But it does recover after stopping or change over to once weekly use.
Has tinospora ever been used to treat multiple myeloma or be used at the same time as other multiple myeloma treatment?
Maybe no data? Never heard of tinospora until your question. I saw a scattering of mentions on an internet search, but no real data. A recent august 2011 review on tinospora in various conditions (not myeloma) is here: http://www. Lahey. Org/departments_and_locations/departments/cancer_center/ebsco_content/multiple_myeloma. Aspx? Chunkiid=111811.
Many. There are many options. One source of updated, risk-stratified treatment are the Mayo Clinic Stratification for Myeloma And Risk-adapted Therapy (mSMART) guidelines: http://www. Msmart. Org/msmart_mar09_002.htm Treatment depends on disease (MM) and host (patient) characteristics as well as the goals of therapy.
Possible. Bortezomib, the proteosome inhibitor is licensed for use in multiple myeloma. It has also been used to treat antibody mediated transplant rejection. One side effect is peripheral neruopathy--about 10% of patients. One can speculate that the same mechanism can cause either a failure to emtpy or some urgency of urination. You would need a formal urodynamic assessment to determine this.
What types of questions should I ask my doctor regarding treatment for multiple myeloma or other plasma cell cancer?
1-2-3. Cancer 1-2-3: 1) diagnosis - myeloma vs.? 2a) stage - iss (not that relevant for individual) 2b) prognostic factors - eg cytogenetics, pcli (if avail), gep (new), bone disease, etc. 3) treatment -- goals (response or quality or....) and options. Some regiments are easy eg rd which is good for a low burden mm disease and working pt vs. More complicated "induction" regimen for high risk/burden.
Www. Cancer. Net. Please check out www. Cancer. Net for an excellent patient resource, including questions to ask your physicians. Http://www. Cancer. Net/cancer-types/multiple-myeloma.
The doctor prescribed melpalan, velcade (bortezomib) and dexamethasone for 78 yrs old male with multiple myeloma. He later increase the dose of melphalan from 10 mg to 14 mg despite the treatment progress. Is this warranted considering high AST and alt?
Speak with physician. The best advice at this point is to speak with the treating physician and ask for an explanation regarding the increase in the medication given the progression of disease on the current treatment. If you are not satisfied with the explanation then by all means seek a second opinion consultation. At times, changes in regimens are easily explained; don't be afraid to ask.
Treatable, incurable. Amyloid/multiple myeloma in general are still incurable diseases. It is treatable and there are many different treatment available for amyloid/multiple myeloma which can prolonged survival. Please discuss further with your oncologist re- treatment options for you. See more at : www. Cancer. Gov or www. Cancer. Net or www. Nccn. Com.
Many. There are many treatments for amyloidosis and multiple myeloma. Many new drugs have been approved for these diseases in the past several years including -- thalidomide, lenalidomide, bortezomib, Doxil (liposomal doxorubicin) (with bortezomib). Carfilzomib was suggested for fda approval by odac recently & may be approved very soon. Pomalidomide expected approval soon. Other drugs in the pipeline. Cure rate still low.
Treatment, no cure. There are a number of treatments that can be used for multiple myeloma and primary systemic amyloidosis. There are numerous chemotherapy drugs that can be used which generally have modest side effects. Also an autologous stem cell transplant can be used in many cases. But our current therapies do not cure these diseases.