View All Pages

Multiple Myeloma - Introduction

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Multiple Myeloma. Use the menu to see other pages. Think of that menu as a roadmap for this entire guide.

Myeloma is a blood cancer of cells found in the bone marrow, specifically the so-called “plasma cells.” The bone marrow is the spongy tissue inside your bones that normally creates the different parts of your blood. Plasma cells are a key part of the body's immune system. They produce antibodies that help the body fight infection. Myeloma begins when healthy plasma cells change and grow out of control. This may result in multiple bone lesions that increase the risk of bone fractures.

Abnormal plasma cells can crowd out or suppress the growth of other cells in the bone marrow, including red blood cells, white blood cells, and platelets. They also reduce the creation of normal plasma cells, which lowers a person’s immunity. This suppression may result in:

  • Anemia, from a shortage of red blood cells

  • Excessive bleeding from cuts to the skin, from a shortage of platelets

  • Decreased ability to fight infection, from a shortage of white blood cells and the body’s inability to respond to infection because of the presence of abnormal antibodies

It is important to note that, like regular plasma cells, myeloma cells can produce antibodies. But myeloma cells are unable to produce healthy, functioning antibodies. Instead, they make what is called “M protein," also called “monoclonal protein” or "monoclonal immunoglobulin." M protein can build up in the blood and urine, potentially damaging the kidneys and other organs, as well as reducing immunity. A healthy person who is found to have a small amount of this M protein is said to have monoclonal gammopathy of undetermined significance (MGUS).

Myeloma causes structural bone damage, which can result in weakened bones and leads to painful fractures or bone breaks over time.

Solitary plasmacytoma is a mass, or tumor, of myeloma cells that involves only 1 site in the bone or, less commonly, in other organs, such as those in the upper respiratory tract, including the nose and throat, or the gastrointestinal system.

Extramedullary plasmacytoma describes myeloma that started outside the bone marrow in locations such as the lymph glands, sinuses, throat, liver, digestive tract, or under the skin.

Normal Bone Marrow

Normal Bone Marrow
Click to Enlarge

Multiple Myeloma Disease

Multiple Myeloma
Click to Enlarge

In multiple myeloma, numerous malignant plasma cells are shown. They are characterized by a pale area within the cytoplasm, near the nucleus. Compare with normal bone marrow cells. These images used with permission by the College of American Pathologists.

Looking for More of an Introduction?

If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:

The next section in this guide is Statistics. It helps explain how many people are diagnosed with multiple myeloma and general survival rates. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Statistics

Approved by the Cancer.Net Editorial Board, 03/2023

ON THIS PAGE: You will find information about the estimated number of people who will be diagnosed with multiple myeloma each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors, and no 2 people with cancer are the same. Use the menu to see other pages.

Every person is different, with different factors influencing their risk of being diagnosed with multiple myeloma and the chance of recovery after a diagnosis. It is important to talk with your doctor about any questions you have around the general statistics provided below and what they may mean for you individually. The original sources for these statistics are provided at the bottom of this page.

How many people are diagnosed with multiple myeloma?

In 2023, an estimated 35,730 adults (19,860 men and 15,870 women) in the United States will be diagnosed with multiple myeloma. Worldwide, an estimated 176,404 people were diagnosed with multiple myeloma in 2020.

It is estimated that 12,590 deaths (7,000 men and 5,590 women) from this disease will occur in the United States in 2023. In 2020, an estimated 117,077 people worldwide died from multiple myeloma.

What is the survival rate for multiple myeloma?

There are different types of statistics that can help doctors evaluate a person’s chance of recovery from multiple myeloma. These are called survival statistics. A specific type of survival statistic is called the relative survival rate. It is often used to predict how having cancer may affect life expectancy. Relative survival rate looks at how likely people with multiple myeloma are to survive for a certain amount of time after their initial diagnosis or start of treatment compared to the expected survival of similar people without this cancer.

Example: Here is an example to help explain what a relative survival rate means. Please note this is only an example and not specific to this type of cancer. Let’s assume that the 5-year relative survival rate for a specific type of cancer is 90%. “Percent” means how many out of 100. Imagine there are 1,000 people without cancer, and based on their age and other characteristics, you expect 900 of the 1,000 to be alive in 5 years. Also imagine there are another 1,000 people similar in age and other characteristics as the first 1,000, but they all have the specific type of cancer that has a 5-year survival rate of 90%. This means it is expected that 810 of the people with the specific cancer (90% of 900) will be alive in 5 years.

It is important to remember that statistics on the survival rates for people with multiple myeloma are only an estimate. They cannot tell an individual person if cancer will or will not shorten their life. Instead, these statistics describe trends in groups of people previously diagnosed with the same disease, including specific stages of the disease.

The 5-year relative survival rate for multiple myeloma in the United States is about 58%.

The survival rates for multiple myeloma vary based on several factors. These include the stage of cancer, a person’s age and general health, and how well the treatment plan works. For instance, it is known that survival rates for multiple myeloma are higher in younger people than in older people.

There are 2 conditions that arise before myeloma. One is called monoclonal gammopathy of undetermined significance (MGUS), and the other is called smoldering myeloma (SMM). MGUS typically means that there are less than 10% plasma cells in the marrow and there is no evidence of organ damage. For people diagnosed with MGUS, the risk of progression to myeloma is 1% per year. A person with MGUS should be regularly monitored for health changes by their doctor. People who have SMM may develop myeloma and should also be monitored by their doctor. There is emerging evidence that suggests that people who have a high-risk type of SMM should be offered early treatment or be monitored.

Experts measure relative survival rate statistics for multiple myeloma every 5 years. This means the estimate may not reflect the results of advancements in how multiple myeloma is diagnosed or treated from the last 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society’s publication, Cancer Facts & Figures 2023, the International Agency for Research on Cancer website, and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. (All sources accessed February 2023.)

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by multiple myeloma. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Medical Illustrations

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will find a drawing of the main body parts affected by multiple myeloma. Use the menu to see other pages.

This illustration shows a detail of the human skeleton. A section cut out of the outer edge of the hip bone, called the iliac crest, shows a thin outer layer of bone surrounding the bone marrow, a spongy, red tissue.  Copyright 2004 American Society of Clinical Oncology. Robert Morreale/Visual Explanations, LLC.

The illustration shows where bone marrow is most easily accessed. However, this illustration does not show a bone marrow biopsy procedure.

Copyright 2004 American Society of Clinical Oncology. Robert Morreale.

The next section in this guide is Risk Factors. It describes the factors that may increase the chance of developing multiple myeloma. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Risk Factors

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will find out more about the factors that increase the chance of developing multiple myeloma. Use the menu to see other pages.

What are the risk factors for multiple myeloma?

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. But knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The causes of myeloma are not known or well understood. There are currently no known ways to prevent it. Currently, there are also no obvious, strong risk factors for myeloma.

Although the genetic mutations that cause myeloma are acquired and not inherited, family history is a known risk factor for multiple myeloma. First-degree relatives of people with multiple myeloma have a 2 to 3 times higher risk of developing the disease. First-degree relatives are parents, siblings, and children.

The following factors can raise a person's risk of developing myeloma:

  • Age. Myeloma occurs most commonly in people over 60. The average age at diagnosis is 70. Only 2% of cases occur in people under 40.

  • Race. Myeloma occurs twice as frequently in Black people than in White people. The reasons why are unclear, although the disease appears to also be more common in the Middle East, North Africa, and the Mediterranean.

  • Exposure to radiation or chemicals. People who have been exposed to radiation or to asbestos, benzene, pesticides, and other chemicals used in rubber manufacturing may be at higher risk for developing myeloma. People often exposed to wood products, such as carpenters, furniture makers, and paper makers, are also at higher risk. There is also a high incidence of myeloma among professional firefighters and those exposed to herbicides, including Agent Orange.

  • Personal history. People with a history of a solitary plasmacytoma of the bone are at greater risk for developing multiple myeloma.

  • Monoclonal gammopathy of undetermined significance (MGUS). As explained in the Introduction, a person with a small amount of M protein in their blood has a 1% to 2% chance of developing myeloma, lymphoma, or another blood-related cancer called Waldenstrom macroglobulinemia per year (see the Stages section for more information).

  • Sex. Myeloma is slightly more common in men.

The next section in this guide is Symptoms and Signs. It explains what changes or medical problems multiple myeloma can cause. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will find out more about the changes and medical problems that can be a sign of multiple myeloma. Use the menu to see other pages.

What are the symptoms and signs of multiple myeloma?

People with multiple myeloma may experience a number of different symptoms and signs. Symptoms are changes that you can feel in your body. Signs are changes in something measured, like taking your blood pressure or doing a lab test. Together, symptoms and signs can help describe a medical problem. Sometimes, people with multiple myeloma do not have any of the symptoms and signs described below. For people with myeloma who have no symptoms, their cancer may be discovered by a blood or urine test that is performed for a different reason, such as for an annual physical exam. Or, the cause of a symptom or sign may be a medical condition that is not cancer.

  • Anemia is a low level of red blood cells. This happens when myeloma plasma cells suppress or crowd out healthy red blood cells.

  • Fatigue is usually caused by anemia or other factors associated with myeloma, such as abnormal cytokine production. It occurs in most people with myeloma.

  • Bone pain is a common symptom. Myeloma cells grow in the bone marrow and bone, causing local bone damage or generalized thinning of the bone, which is called osteoporosis. This makes the bone more likely to break. The back or ribs are the most common sites of bone pain, but any bone can be affected. The pain is usually worse when someone moves and at night. If cancer is in the spine, the vertebrae (the individual bones that make up the spine) can collapse, which is known as a compression fracture. In advanced multiple myeloma, a person may lose inches from their height due to compressed vertebrae over the course of their illness.

  • Pain, numbness, and weakness can sometimes happen when collapsed vertebrae press against the spinal cord or pinch a nerve coming out of the spine.

  • Too much M protein may lead to kidney damage or failure, an important issue to be aware of. Kidney damage in its early stages often does not cause any symptoms and may only be diagnosed through blood and urine tests. When the kidneys begin to fail, symptoms include itching, weakness, fatigue, shortness of breath, muscle cramps, nausea, appetite loss, trouble sleeping, urination changes, anemia, and swelling of the legs, feet, or ankles.

  • Hypercalcemia is a high level of calcium in the blood that can arise as a result of bone breakdown. It can cause drowsiness, constipation, and kidney damage.

  • Symptoms of weight loss, nausea, thirst, muscle weakness, and mental confusion are related to kidney failure, hypercalcemia, or other imbalances in blood chemicals.

  • Fever and infections, especially of the upper respiratory tract and lungs, may arise as a result of the lower immunity that people with myeloma have. This makes it harder to fight infection.

  • Blood clots, nosebleeds, bleeding gums, bruising, cloudy vision caused by hyperviscosity, which is thickened blood, and low platelets are other symptoms of multiple myeloma.

If you are concerned about any changes you experience, please talk with your health care team. Your clinicians will try to understand what is causing your symptom(s). They may do an exam and order tests to understand the cause of the problem, which is called a diagnosis.

If multiple myeloma is diagnosed, relieving symptoms remains an important part of cancer care and treatment. Managing symptoms may also be called "palliative and supportive care," which is not the same as hospice care given at the end of life. This type of care focuses on managing symptoms and supporting people who face serious illnesses, such as cancer. You can receive palliative and supportive care at any time during cancer treatment. Learn more in this guide’s section on Coping with Treatment.

Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Diagnosis

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If the cancer has spread, it is called metastasis. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

How multiple myeloma is diagnosed

There are different tests used for diagnosing multiple myeloma. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of earlier medical tests

The following tests may be used to diagnose multiple myeloma:

Blood and urine tests. Blood and urine tests play a key role in diagnosing myeloma.

  • M protein. Myeloma cells often secrete the monoclonal antibody immunoglobulin, known as M protein. M protein levels in a patient's blood and urine are used to determine the extent of the disease, as well as to monitor how well treatment is working and whether the disease is progressing or coming back. In some people, the myeloma cells only secrete part of the antibody, which is called the light chain. The amount of M protein in the blood or urine is measured by serum protein electrophoresis (SPE or SPEP) or urine protein electrophoresis (UPE or UPEP).

  • Immunoglobulin. Immunoglobulin levels are measured to help check the amount of antibody levels in the blood. These antibodies are immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM). In multiple myeloma, when the cancer protein level is up, the normal antibody levels are down.

  • Light chains. The amount of free light chains in the blood can be measured before the blood is filtered by the kidneys. This test is called a serum free light chain assay. This is a more sensitive test than measuring M protein in the urine, but both are important to measure. When a light chain is found in the urine, it is called the Bence Jones protein.

  • Serum albumin and serum beta-2 microglobulin (β2-M). The levels of serum albumin and serum β2-M are measured using blood tests. Serum albumin is a blood protein made by the liver that is necessary for maintaining proper blood volume and general health. β2-M is a small protein that plays a role in the body's immune response.

  • Lactase dehydrogenase (LDH). LDH is an enzyme, which is a type of protein. It is in almost all tissues in the body. Damaged tissues release LDH into the bloodstream, so LDH is used as a sign that the body has been injured or a disease is present. In myeloma, LDH levels can be used to help determine prognosis, which is the chance of recovery, and the stage (see Stages).

These test results are important for determining the stage of the myeloma. Blood tests are also used to measure kidney function, calcium levels, and blood cell counts for possible anemia and other low blood counts.

X-ray. An x-ray creates a picture of the structures inside of your body using a small amount of radiation. X-rays taken as part of the doctor’s evaluation of the patient’s skeletal system are typically the first step in evaluating bones when myeloma is suspected or diagnosed. An x-ray skeletal survey may not find myeloma as early as the more advanced tests described below.

Magnetic resonance imaging (MRI). An MRI produces detailed images of the inside of the body using magnetic fields, not x-rays. An MRI can show if normal bone marrow has been replaced by myeloma cells or by a plasmacytoma, especially in the skull, spine, and pelvis. A plasmacytoma is a plasma cell tumor growing in bone marrow or soft tissue. The detailed images may also show compression fractures of the spine or a tumor pressing on nerve roots. MRI can also be used to measure a tumor’s size.

Computed tomography (CT or CAT) scan. A CT scan creates a detailed, cross-sectional view that shows any abnormalities or tumors in soft tissues. A computer then combines these pictures into a 3-dimensional image of the inside of the body. It is important to note that the intravenous contrast dye often used for CT scans for other types of cancer is specifically avoided in people with multiple myeloma. Tell the radiologist or the radiology technician about your diagnosis before receiving dye injection into your vein, because this can cause kidney damage in people with myeloma.

Positron emission tomography (PET) or PET-CT scan. A PET scan is a way to create pictures of organs and tissues inside the body. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. But you may hear your doctor refer to this procedure just as a PET scan.A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. However, the amount of radiation in the substance is too low to be harmful. A scanner then detects this substance to produce images of the inside of the body.

Bone marrow aspiration and biopsy. These 2 procedures are done to examine the bone marrow. Bone marrow has both a solid and a liquid part. A bone marrow aspiration removes a sample of the fluid with a needle. A bone marrow biopsy is the removal of a small amount of solid tissue using a needle. These procedures are often done at the same time and may be called a bone marrow examination. This is important for making a diagnosis of myeloma.

A pathologist then analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. The genetics of the malignant plasma cells are examined using cytogenetics (see below) and a special testing called fluorescence in situ hybridization (FISH). These tests determine the genetic makeup of the myeloma and whether it is standard or high risk. Samples can also be examined using genomic sequencing to determine with great accuracy exactly what changes have occurred in the DNA of the cancer cells.

A common site for a bone marrow aspiration and biopsy is the pelvic bone, which is located in the lower back by the hip. The skin in that area is numbed with medication beforehand. This medication is called local anesthesia. Other types of anesthesia may also be used to block the awareness of pain.

Fat pad aspirate. If certain M proteins that are misfolded in a particular way are deposited in body tissues, it can cause organs to stop functioning normally. This condition is called amyloidosis. If your doctor suspects you may have amyloidosis, then it may be necessary to take a sample of the abdominal fat pad (the collection of fat around a person's abdomen) to be examined under a microscope, called a biopsy.

Biomarker testing of the tumor. Your doctor may recommend running laboratory tests on a tumor and/or bone marrow sample to identify specific chromosomes (cytogenetics), genes (FISH or genomic sequencing; see above), proteins, and other factors unique to the tumor, as mentioned above. This may also be called molecular testing of the tumor. Results of these tests can help determine your treatment options.

  • Cytogenetics. Cytogenetics, which is the study of genetic changes in cells, and molecular studies may be performed on a tissue sample removed during a biopsy to find out how aggressive the cancer is. In myeloma, the genetics in plasma cells are routinely studied using the FISH test to identify standard and high-risk disease. This may help guide treatment. More genetic tests are being developed, usually in ongoing research studies.

  • Fluorescence in situ hybridization (FISH). The FISH test is a type of cytogenetic test that uses a fluorescent dye to find changes in a person's chromosomes. FISH helps the doctor know whether the myeloma is high risk and aggressive, and it helps predict the prognosis. The FISH test will be used for most people with myeloma.

  • Minimal residual disease (MRD) tests. As treatments have become increasingly effective in treating myeloma, new approaches to measure how well a treatment works have been developed, including for MRD. The principle is that the harder it is to detect the disease, the better. If a very small amount of disease is found after treatment (called "MRD positive") by this testing, additional treatment may be offered to suppress the disease further.

After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is myeloma, these results also help the doctor describe the cancer. This is called staging.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Stages

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will learn about how doctors describe myeloma’s growth or spread. This is called the stage. Use the menu to see other pages.


What is cancer staging?

Staging is a way of describing where a cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor recommend the best kind of treatment, and it can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

Return to top


For myeloma, it is important to begin with whether the patient is experiencing symptoms. It is common to classify people with newly diagnosed myeloma as either:

  • Asymptomatic. This means the person does not have symptoms and signs of the disease. Patients without symptoms are generally watched closely without specific treatment, although therapies are sometimes offered to stop the disease from growing or spreading. This is called active surveillance for smoldering myeloma (see Types of Treatment).

  • Symptomatic. This means the person has symptoms and signs of the disease. Patients with symptoms, or who are about to develop symptoms, need treatment.

The symptoms related to myeloma are described with the mnemonic acronym "CRAB," with each letter corresponding to a symptom:

  • Calcium levels are increased, which is known as hypercalcemia. This is defined as a serum calcium level greater than 0.25 mmol/L above the upper limit of normal or a level that is greater than 2.75 mmol/L.

  • Renal, or kidney, problems, identified as a creatinine level higher than 173 mmol/L.

  • Anemia is defined as having a low hemoglobin level, which is 2 g/dL below the lower limit of normal or a hemoglobin level that is less than 10 g/dL.

  • Bone pain or lesions, including:

    • Lytic lesions (areas of bone damage)

    • Osteoporosis (thinning of the bones)

    • Compression fracture of the spine

Other symptoms include symptomatic hyperviscosity (thickening of the blood), amyloidosis, and repeated serious bacterial infections (more than 2 episodes in 12 months). Patients with 1 or more CRAB feature need active treatment for the myeloma.

People may also be treated, even if they do not have CRAB features, if any of the following conditions apply:

  • More than 60% of the cells in the bone marrow are plasma cells.

  • The involved-to-uninvolved free light chain ratio is greater than 100, based on serum testing, with absolute values greater than 100 mg/L or 10 mg/dL. The light chain is a fragment of an antibody and is the product of cancerous plasma cells. The light chains are classified as kappa or lambda. The plasma cells of myeloma will secrete excess amounts of either of these light chains.

  • Bone lesions seen on MRI or PET-CT scans (see Diagnosis).

Return to top

Revised International Staging System

The Revised International Staging System (R-ISS) is now used more commonly to classify multiple myeloma. The R-ISS is based on data collected from people with multiple myeloma from around the world. The system has 3 stages based on the measurement of serum albumin, lactase dehydrogenase (LDH), and serum beta-2 microglobulin (β2-M) and whether high-risk chromosomes are found using the fluorescence in situ hybridization (FISH) test (see Diagnosis).

Recent efforts have been made to further classify myeloma based on patterns of gene expression in myeloma cells. This is an ongoing area of research.

Stage I: All of the following apply:

  • β2-M less than 3.5 mg/L

  • Serum albumin of 3.5 g/dL or more

  • Normal LDH

  • No high-risk chromosome changes in myeloma cells found by FISH test

Stage II: Not stage I or stage III.

Stage III: β2-M is more than 5.5 mg/L, plus one of the following:

  • Myeloma cells have high-risk chromosome changes found by FISH test

  • High LDH

The R-ISS is most commonly used to predict prognosis. Higher blood levels of LDH indicate a poorer prognosis.

Recurrent or relapsed myeloma. Myeloma that returns after a period of being in control after treatment is called recurrent myeloma or relapsed myeloma. If there is a recurrence, the cancer may need to be staged again (called re-staging) using one of the systems above.

Return to top

Other classifications

Some people have no symptoms of myeloma, but they may have abnormal plasma cells producing M protein. Doctors generally monitor these people closely, and active treatment does not begin unless the person starts to experience symptoms and/or shows signs of damage to major organs, called end-organ damage; this is so-called symptomatic myeloma.

Monoclonal gammopathy of undetermined significance (MGUS)

This condition occurs when people have a low level of M protein, meaning there are small amounts of abnormal plasma cells but they do not have any other evidence of myeloma, such as bone damage, excessive plasma cells in the marrow, or low numbers of components of the blood count, such as red blood cells, white blood cells, and/or platelets. People with MGUS have a cumulative 1% chance per year of developing myeloma or, rarely, other types of blood problems such as chronic lymphocytic leukemia (CLL), lymphoma, Waldenstrom macroglobulinemia, or amyloidosis. For this reason, a person with MGUS should be regularly monitored for health changes by their doctor.

Smoldering multiple myeloma (SMM) or asymptomatic myeloma

People who are diagnosed with SMM have higher levels of M protein and more plasma cells in the bone marrow than people with MGUS (10% to 60% of all cells in marrow are plasma cells). However, there is still no evidence of symptoms or signs of myeloma, such as significant bone disease or anemia. A person with SMM may be prescribed bisphosphonates for symptoms of osteoporosis or osteopenia and/or a new treatment being studied in a clinical trial. Osteopenia is a condition in which a person has a low density of bone minerals. Most people with SMM eventually develop myeloma. For this reason, the health of people with SMM should be closely monitored by their doctors, who may recommend starting treatment if the disease is progressing and especially for those who are at risk of developing symptoms within 18 months to 2 years.

Return to top


The R-ISS of myeloma gives information about prognosis and predicts the person’s chance of recovery. Researchers are also looking at other ways to predict prognosis for people with multiple myeloma. Some of the current approaches for evaluating prognosis include:

  • High levels of β2-M may indicate that a large number of myeloma cells is present and that kidney damage has occurred. The level of this protein increases as myeloma becomes more advanced.

  • Lower amounts of serum albumin may indicate a poorer prognosis.

  • Higher blood levels of LDH indicate a poorer prognosis.

  • Abnormalities of chromosomes (determined by cytogenetics) in the cancer cells may show how aggressive the cancer is. This approach to testing the genetics of the myeloma include FISH and even the testing of individual gene mutations.

  • A plasma cell labeling index can be done in a specialized laboratory using bone marrow samples to find out how fast the cancer cells are growing.

Learn more about talking with your doctor about prognosis in a separate article on this website.

Return to top

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Types of Treatment

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will learn about the different types of treatments doctors use to treat people with multiple myeloma. Use the menu to see other pages.

This section explains the types of treatments, also known as therapies, that are the standard of care for multiple myeloma. “Standard of care” means the best treatments known. Information in this section is based on medical standards of care for multiple myeloma in the United States. Treatment options can vary from one place to another.

When making treatment plan decisions, you are also encouraged to discuss with your doctor whether clinical trials offer additional options to consider. A clinical trial is a research study that tests a new approach to treatment. Doctors learn through clinical trials whether a new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option for all stages of cancer. Your doctor can help you consider all your treatment options. Research for new myeloma treatments is very active, and many clinical trials are offered. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

How multiple myeloma is treated

In cancer care, different types of doctors who specialize in cancer, called oncologists, often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams include other health care professionals, including physician assistants, nurse practitioners, oncology nurses, oncology social workers, pharmacists, counselors, dietitians, physical therapists, occupational therapists, and others. Learn more about the clinicians who provide cancer care.

The treatment of multiple myeloma depends on whether the patient is experiencing symptoms (see Stages) and the patient’s overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan. The goals of treatment are to eliminate myeloma cells, control tumor growth, control pain, and allow patients to have an active life. While there is no cure for multiple myeloma, the cancer can be managed successfully in many patients for years.

Take time to learn about all of your treatment options, including clinical trials, and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. These types of conversations are called “shared decision-making.” Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is important for multiple myeloma because there are different treatment options. Learn more about making treatment decisions.

The common types of treatments used for multiple myeloma are described below. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care. The information below explains the treatment options for people without symptoms and for people with symptoms. In addition, treatment options may depend on whether the patient is newly diagnosed with myeloma or is experiencing a recurrence of the disease.


Treatment overview for people with smoldering multiple myeloma

People with early-stage myeloma and no symptoms, called smoldering multiple myeloma or SMM (see Stages), may simply be closely monitored by the doctor through checkups. This approach is called active surveillance or watchful waiting. As noted previously, if there is evidence of bone thinning, or osteoporosis, periodic infusions of bisphosphonates to reverse this process may be recommended. There are also clinical protocols, or processes, used to evaluate whether using medications called targeted therapy (see below) or immunotherapy (see below and Latest Research) can prevent or delay myeloma from developing into a disease that requires treatment.

If symptoms appear, then active treatment starts. Two clinical trials in high-risk SMM have shown that early treatment can slow the progression to myeloma with symptoms for some patients, but whether this helps people live longer is not known.

Return to top

Treatment overview for patients with symptoms

Treatment for people with symptomatic myeloma includes both treatment to control the disease as well as supportive care to improve quality of life, such as by relieving symptoms and maintaining good nutrition. Disease-directed treatment typically includes therapy using medications, such as targeted therapy and/or chemotherapy, with or without steroids. Bone marrow/stem cell transplantation may be an option. Other types of treatments, such as radiation therapy and surgery, are used in specific circumstances.

The treatment plan includes different phases.

  • Induction therapy for rapid control of cancer and to help relieve symptoms.

  • Consolidation with more chemotherapy or a bone marrow/stem cell transplant.

  • Maintenance therapy over a prolonged period to prevent cancer recurrence.

Return to top

Therapies using medication

The treatment plan may include medications to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy. Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body.

This treatment is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication.

Medications are often given through an intravenous (IV) tube placed into a vein using a needle or as a pill or capsule that is swallowed (orally). If you are given oral medications to take at home, be sure to ask your health care team about how to safely store and handle them.

The types of medications used for multiple myeloma include:

  • Chemotherapy

  • Targeted therapy

  • Immunomodulatory drugs

  • Steroids

  • Bone-modifying drugs

  • Immunotherapy

Each of these types of therapies are discussed below in more detail. A person usually receives a combination of medications given at the same time. They can also be given as part of a treatment plan that includes surgery and/or radiation therapy.

Combination regimens are an important part of the treatment of multiple myeloma. Combining different treatment effects from different types of drugs—such as a combination of an immunomodulatory drug, a proteasome inhibitor, and a steroid—can be an effective way of managing the disease. In addition, other targeted treatments may be added, depending on the individual's specific situation.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications.

It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications, causing unwanted side effects or reduced effectiveness. Learn more about your prescriptions by using searchable drug databases.


Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient usually receives combinations of different drugs at the same time.

Conventional chemotherapy has been used successfully for the treatment of myeloma. These drugs include cyclophosphamide (available as a generic drug), doxorubicin (available as a generic drug), melphalan (Evomela), etoposide (available as a generic drug), cisplatin (available as a generic drug), carmustine (BiCNU), and bendamustine (Bendeka). Chemotherapy drugs like these may be used in certain situations. For people newly diagnosed with myeloma, these treatments are used less commonly. For example, melphalan is most commonly used when a bone marrow transplantation (see below) is part of the treatment plan. A high dose of melphalan is used to suppress the myeloma for a long time, and the patient's own bone marrow cells are used to recover from this treatment.

It may also be recommended to combine chemotherapy with other types of treatment, including targeted therapies or steroids (see both, below). For instance, the combination of melphalan, the steroid prednisone (multiple brand names), and a targeted therapy called bortezomib (Velcade) is approved by the U.S. Food and Drug Administration (FDA) for the initial treatment of multiple myeloma. However, there are several more effective regimens described below that are used much more commonly.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea or constipation. Other side effects include peripheral neuropathy (tingling or numbness in feet or hands), blood clotting problems, and low blood counts. These side effects usually go away once treatment is finished. Occasionally an allergic reaction such as skin rash may occur, and the drug may have to be stopped.

The length of chemotherapy treatment varies from patient to patient and is usually given until the myeloma is well controlled.

Learn more about the basics of chemotherapy.

Return to top

Targeted therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells and limits damage to healthy cells. In recent years, targeted treatment, sometimes called novel therapy, has proven to be increasingly successful at controlling myeloma and improving prognosis. Researchers continue to investigate new and evolving drugs for this disease in clinical trials.

Not all tumors have the same targets. To find the most effective treatment, your doctor may run tests on cancer cells to identify genes, proteins, and other factors. This helps doctors better match each patient with the most effective treatment whenever possible. In addition, research studies continue to find out more about specific molecular targets and new treatments directed at them. Learn more about the basics of targeted treatments.

Targeted therapy for multiple myeloma includes:

  • Proteasome inhibitors. Bortezomib (Velcade), carfilzomib (Kyprolis), and ixazomib (Ninlaro) are classified as proteasome inhibitors. They target specific enzymes called proteasomes that digest proteins in the cells. Because myeloma cells produce a lot of proteins (see the Introduction), they are particularly vulnerable to this type of drug. These drugs may be used to treat newly diagnosed myeloma and recurrent myeloma.

  • Monoclonal antibodies. Elotuzumab (Empliciti) and daratumumab (Darzalex) are monoclonal antibodies that bind to myeloma cells and label them for removal by the person's own immune system. Daratumumab may be given to treat newly diagnosed multiple myeloma. A drug combination of daratumumab and hyaluronidase-fihj (Darzalex Faspro) with or without pomalidomide (Pomalyst) and dexamethasone (multiple brand names) may also be used to treat multiple myeloma. This combination is given under the skin of the abdomen and is quicker than when it is given by injection through a vein. Daratumumab with or without hyaluronidase-fihj combined with carfilzomib and dexamethasone may be used to treat multiple myeloma that has stopped responding to 1 to 3 previous treatments. Isatuximab-irfc (Sarclisa) is a monoclonal antibody approved by the FDA for the treatment of adults with multiple myeloma who have received 1 to 3 previous treatments. Isatuximab-irfc may be given in combination with pomalidomide and dexamethasone or carfilzomib and dexamethasone.

  • Nuclear export inhibitors. Selinexor (Xpovio) is a targeted therapy that is given in combination with dexamethasone. This combination is used to treat adults with multiple myeloma that has come back after 4 or more previous treatments. It may also be given in combination with bortezomib and dexamethasone to people who have received at least 1 previous treatment.

  • B-cell maturation antigen (BCMA) targeting agent. Belantamab mafodotin-blmf (Blenrep) is an antibody-drug conjugate approved by the FDA to treat adults with recurrent or refractory multiple myeloma who have received at least 4 previous treatments. Belantamab mafodotin-blmf uses an antibody to bind to BCMA and delivers chemotherapy directly to the myeloma cell. BCMA is a protein on the surface of myeloma cells.

  • Bispecific T-cell engagers (updated 08/2023). Bispecific antibodies can attach to both a T cell and a myeloma cell at the same time, activating an immune attack on the cancer cells. Unlike CAR T cells, bispecific T-cell engagers can be delivered without removing a patient’s immune cells. Elranatamab (Elrexfio), talquetamab (Talvey), and teclistamab-cqyv (Tecvayli) are bispecific T-cell engagers that are approved for the treatment of recurrent or refractory multiple myeloma after at least 4 previous lines of treatment. Elranatamab and teclistamab target the BCMA protein, while talquetamab targets GPRC5D.

Targeted therapies may also be used in combination with chemotherapy (see above), immunomodulatory drugs, or steroid medications (see below), because certain combinations of drugs can sometimes have a better effect than a single drug. For example, the drugs lenalidomide, bortezomib, and dexamethasone, as well as bortezomib, cyclophosphamide, and dexamethasone, are offered in combination as initial treatment. Clinical trials are exploring whether the combination of lenalidomide, bortezomib, and dexamethasone may be as effective as lenalidomide, bortezomib, and dexamethasone followed by a bone marrow/stem cell transplant (see below).

Lenalidomide and bortezomib can also be effectively used as maintenance therapy to extend the disease's response to the initial therapy or after a bone marrow/stem cell transplant. However, the decision to undergo a transplant is complex and should be discussed carefully with your doctor.

Research has shown that maintenance therapy with lenalidomide and/or bortezomib increases how long patients survive and extends how long they live without active myeloma. Maintenance therapy has to be used with some caution, although recent studies have shown significant improvement with survival using this approach.

Return to top

Immunomodulatory drugs

Lenalidomide (Revlimid) and pomalidomide (Pomalyst) are classified as immunomodulatory drugs, which stimulate the immune system. These drugs also keep new blood vessels from forming and feeding myeloma cells. Thalidomide and lenalidomide are approved to treat newly diagnosed patients. Lenalidomide and pomalidomide are also effective for treating recurrent myeloma.

Return to top


Steroids, such as prednisone and dexamethasone, may be given alone or at the same time as other medications, such as targeted therapy or chemotherapy (see above). Steroids are very effective at reducing the burden of plasma cells, but this effect is only temporary.

For example, lenalidomide and dexamethasone as induction and maintenance therapy is recommended for those who are not able to have bone marrow/stem cell transplantation. Adding bortezomib to this combination has recently been shown to be effective in a clinical trial.

Return to top

Bone-modifying drugs

Most people with myeloma receive treatment with bone-modifying drugs. These drugs help strengthen the bone and reduce bone pain and the risk of fractures.

There are 2 types of bone-modifying drugs available for treating bone loss from multiple myeloma. The choice of medications depends on your overall health and your individual risk of side effects.

  • Bisphosphonates, such as zoledronic acid (Zometa) and pamidronate (Aredia), block the cells that dissolve bone, called osteoclasts. For multiple myeloma, either pamidronate or zoledronic acid is given by IV every 3 to 4 weeks. Each treatment of pamidronate lasts at least 2 hours, and each treatment of zoledronic acid lasts at least 15 minutes. Patients with existing severe kidney problems usually receive lower doses of pamidronate given over a longer time (such as 4 to 6 hours instead of 2 hours). Zoledronic acid is generally not recommended for people with severe kidney problems.

  • Denosumab (Xgeva) is an osteoclast-targeted therapy called a RANK ligand inhibitor. It is approved to treat multiple myeloma and may be an option for people with severe kidney problems. Denosumab has been shown to have similar effectiveness to bisphosphonates.

Treatment with a bone-modifying drug is recommended for up to 2 years. At 2 years, treatment may be stopped if it is working. If the myeloma comes back and new bone problems develop, treatment with a bone-modifying drug is usually started again. Talk with your doctor for more information about stopping and restarting treatment with these medications.

Side effects of bisphosphonates may include flu-like symptoms, anemia, joint and muscle pain, and kidney problems. If you are taking pamidronate or zoledronic acid, you should have a blood test to check how well the kidneys are working before each time you receive the drug. Side effects of denosumab may include diarrhea, nausea, anemia, and back pain.

Osteonecrosis of the jaw is an uncommon but potentially serious side effect of both types of bone-modifying drugs. The symptoms may include pain, swelling, and infection of the jaw; loose teeth; and exposed bone. Before treatment, patients should receive a thorough dental examination, and any tooth or mouth infections should be treated. While receiving treatment with a bone-modifying drug, patients should avoid having any invasive dental work done, such as dental surgery. Take care of your teeth, gums, and tongue with regular brushing and flossing. Learn more about dental and oral health during cancer treatment.

Bone-modifying drugs are not always recommended for people with the following conditions:

  • Solitary plasmacytoma (1 bone tumor)

  • Smoldering or indolent myeloma

  • Conditions of abnormal plasma cells that are not myeloma but may eventually become myeloma, such as monoclonal gammopathy of undetermined significance (MGUS)

This information on bone-modifying drugs is based on ASCO recommendations for bisphosphonate treatment for multiple myeloma. (Please note that this link takes you to a different ASCO website.)

Return to top


Immunotherapy uses the body's natural defenses to fight cancer by improving your immune system’s ability to attack cancer cells.

The cellular immunotherapies approved to treat multiple myeloma are idecabtagene vicleucel (Abecma) and ciltacabtagene autoleucel (Carvykti). These are chimeric antigen receptor (CAR) T-cell therapies that target BCMA. BCMA is a protein on the surface of myeloma cells. These treatments may be used to treat multiple myeloma that has not been stopped by 4 or more treatments.

In CAR T-cell therapy, some T cells are removed from a patient’s blood. Then, the cells are changed so they have specific proteins called receptors. The receptors allow the changed T cells to recognize the cancer cells. In the case of idecabtagene vicleucel and ciltacabtagene autoleucel, the cells recognize the BCMA protein. The changed T cells are then returned to the patient’s body. Once there, they seek out and destroy cancer cells. Learn more about the basics of CAR T-cell therapy.

Different types of immunotherapy can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes. Talk with your doctor about possible side effects for the immunotherapy recommended for you. Learn more about the basics of immunotherapy.

Return to top

Bone marrow transplant/stem cell transplant

A bone marrow transplant is a medical procedure in which bone marrow that contains cancer is replaced by highly specialized cells. These cells, called hematopoietic stem cells, develop into healthy red blood cells, white blood cells, and platelets in the bone marrow. Hematopoietic stem cells are blood-forming cells found both in the bloodstream and in the bone marrow. This procedure is also called a stem cell transplant.

Before recommending a transplant, doctors will talk with the patient about the risks of this treatment. They will also consider several other factors, such as the type of cancer, results of any previous treatment, and the patient’s age and general health.

There are 2 types of hematopoietic stem cell transplantation, depending on the source of the replacement blood stem cells: allogeneic (ALLO) and autologous (AUTO). ALLO uses donated stem cells, while AUTO uses the patient’s own stem cells. For multiple myeloma, AUTO is more commonly used. ALLO is being studied in clinical trials. In both types, the goal is to destroy all of the cancer cells in the marrow, blood, and other parts of the body using high doses of chemotherapy (usually melphalan) and then allow replacement blood stem cells to create healthy bone marrow and restore the body's immune response.

Side effects depend on the type of transplant, your general health, and other factors. Learn more about the basics of bone marrow and stem cell transplant.

Return to top

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time.

Doctors may recommend radiation therapy for patients with bone pain when chemotherapy is not effective or to control pain. However, using radiation therapy is not an easy decision. In many instances, pain (especially back pain) is due to structural damage to the bone. Radiation therapy may not help relieve this type of pain and may affect the bone marrow's response to future treatment. Radiation therapy can be helpful in some situations, but for people with newly diagnosed myeloma, therapies using medication are preferred because of their greater effectiveness.

Side effects of radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Learn more about the basics of radiation therapy.

Return to top


Surgery is not usually a treatment option for curing multiple myeloma, but it may be used to relieve specific symptoms. Surgery is used to treat bone disease, especially if there are fractures, and recent plasmacytomas, especially if they occur outside the bone. If surgery is recommended for you, talk with your health care team about the details of the surgery, including the recovery period. Learn more about the basics of cancer surgery.

Return to top

Physical, emotional, social, and financial effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative and supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative and supportive care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. It often works best when it is started right after a cancer diagnosis. People who receive palliative and supportive care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments, such as chemotherapy, surgery, or radiation therapy, to improve symptoms.

Before treatment begins, talk with your doctor about the goals of each treatment in the recommended treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options. Many patients also benefit from talking with a social worker and participating in support groups for additional emotional support. Ask your doctor about these resources, too.

Cancer care is often expensive, and navigating health insurance can be difficult. Ask your doctor or another member of your health care team about talking with a financial navigator or counselor who may be able to help with your financial concerns.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative and supportive care in a separate section of this website.

Return to top

Refractory myeloma

The disease is called relapsed and refractory myeloma if the cancer no longer responds to the most recent treatment. If this happens, it is a good idea to talk with doctors who have experience in treating refractory myeloma. Doctors can have different opinions about the best standard treatment plan. Also, clinical trials can be an important option.

Sometimes, medications that have gone through advanced phases of clinical trials and are awaiting FDA approval are made more readily available to patients with refractory myeloma through FDA’s Expanded Access Clinical Trial Program. For example, daratumumab was first approved in 2015 to be used alone to treat relapsed and refractory myeloma after other treatments had failed. In 2016, the FDA approved the use of daratumumab in combination with lenalidomide and dexamethasone or with bortezomib and dexamethasone to treat people who have already received at least 1 previous treatment. Since then, daratumumab has received 5 more approvals from the FDA and is now approved in combination with bortezomib, thalidomide, and dexamethasone to treat newly diagnosed patients with multiple myeloma who may also receive an AUTO bone marrow/stem cell transplant. You may want to talk to your doctor about which treatments are being studied in clinical trials.

Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

For people with refractory myeloma, palliative and supportive care may also be important to help relieve symptoms and side effects.

For many people, a diagnosis of relapsed or refractory myeloma is very stressful and difficult. You and your family are encouraged to talk about how you feel with your doctors, nurses, social workers, or other members of your health care team. It may also be helpful to talk with other patients, such as through a support group or other peer support program.

Return to top

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. It is important to talk with your doctor about the possibility of the cancer returning, which is common with myeloma, despite recent advances in treatments and testing. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer returns after the original treatment, it is called recurrent myeloma or relapsed myeloma. If a recurrence happens, a new cycle of testing will begin to learn as much as possible about it. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above, such as targeted therapy and chemotherapy, but they may be used in a different combination or given at a different pace. Recent advances in newer therapies mean that the chances of effective treatment for relapsed myeloma are increasing.

Your doctor may also suggest clinical trials that are studying new ways to treat recurrent or relapsed myeloma. There are multiple medications currently being researched in the late stages of clinical trials that have shown promise as treatments for recurrent or relapsed myeloma. See the Latest Research section for more information. Whichever treatment plan you choose, palliative and supportive care will also be important for relieving symptoms and side effects.

People with relapsed myeloma sometimes experience emotions such as disbelief or fear. You are encouraged to talk with your health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.

Return to top

If treatment does not work

Recovery from and a cure for myeloma are unlikely. The disease is still considered incurable despite recent progress. If the cancer cannot be controlled even with the newer treatments available, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

Planning for your future care and putting your wishes in writing is important, especially at this stage of disease. Then, your health care team and loved ones will know what you want, even if you are unable to make these decisions. Learn more about putting your health care wishes in writing.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with your doctor or a member of your palliative care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable options for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

Return to top

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are studied to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for people with multiple myeloma. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. Every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Clinical trials are used for all types and stages of multiple myeloma. Many focus on new treatments to learn if a new treatment is safe, effective, and possibly better than the existing treatments. In general, these types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. New treatments for multiple myeloma are a very active area of cancer research.

People who participate in clinical trials can be some of the first to get a treatment before it is available to the public. There is no guarantee that the new treatment will be safe, effective, or better than what doctors use now. However, recent successes in a growing number of clinical trials in the treatment of myeloma and resulting FDA approvals is encouraging.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects. In addition, there are ongoing studies for patients with SMM to try to prevent it from progressing to active disease.

Deciding to join a clinical trial

People decide to participate in clinical trials for many reasons. For some, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Others volunteer for clinical trials because they know that these studies are the only way to make progress in treating multiple myeloma. Even if they do not benefit directly from the clinical trial, their participation may benefit future people with multiple myeloma.

Insurance coverage and the costs of clinical trials differ by location and by study. In some programs, some of the expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” When used, placebos are usually combined with standard treatment in most cancer clinical trials. In myeloma, this is always the case due to the nature of the disease. Study participants will always be told when a placebo is used in a study. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, people must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the treatment options so that the person understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different from the risks of standard treatment.

  • Explain what will be required of each person in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

  • Describe the purposes of the clinical trial and what researchers are trying to learn.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together. You will need to meet all of the eligibility criteria in order to participate in a clinical trial. Learn more about eligibility criteria in clinical trials.

People who participate in a clinical trial may stop participating at any time for personal or medical reasons. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that people participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if they choose to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for multiple myeloma, learn more in the Latest Research section.

Cancer.Net offers more information about cancer clinical trials in other areas of the website, including a complete section on clinical trials.

There are many resources and services to help you search for clinical trials for myeloma, including the following services. Please note that these links will take you to separate, independent websites:

  • This U.S. government database lists publicly and privately supported clinical trials.

  • World Health Organization (WHO) International Clinical Trials Registry Platform. The WHO coordinates health matters within the United Nations. This search portal gathers clinical trial information from many countries’ registries.

Read more about the basics of clinical trials matching services.

PRE-ACT, Preparatory Education About Clinical Trials

In addition, you can find a free video-based educational program about cancer clinical trials in another section of this website.

The next section in this guide is Latest Research. It explains areas of scientific research for multiple myeloma. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Latest Research

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will read about the scientific research being done to learn more about multiple myeloma and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about myeloma, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the best diagnostic and treatment options for you. With the fast pace of myeloma research, you are encouraged to ask about available clinical trials.

  • New drugs. Myeloma represents a new treatment paradigm (a set of assumptions and practices) in cancer because the new drugs that target the tumor cell, tumor-bone marrow interaction, and bone marrow environment can overcome normal drug resistance. Drugs are first tested in clinical trials for advanced myeloma and then used to treat earlier-stage myeloma. A variety of new drugs are being studied for the treatment of relapsed myeloma and relapsed, refractory myeloma, including the examples below.

    • B-cell maturation antigen (BCMA). BCMA is a marker on the plasma cells that can be targeted for the treatment of myeloma. As discussed in Types of Treatment, several treatments that target BCMA are now approved to treat myeloma. Antibodies that bring immune cells to destroy myeloma cells are called bispecific antibodies, and they work similarly to the way bispecific T-cell engagers work (see below). Antibody-drug conjugates (ADCs) are antibodies that carry a drug that kills cancer cells when the antibody binds to them. Belantamab mafadotin is the only antibody-drug conjugate approved to treat multiple myeloma at this time. There are also chimeric antigen receptor (CAR) T-cell therapies that target BCMA.

    • Venetoclax (Venclexta, Venclyxto). This BCL-2 inhibitor has been used to treat some types of lymphoma and leukemia, and there may be benefit to using it to treat myeloma with a specific genetic mutation that appears in about 20% of patients with myeloma.

    • Bispecific T-cell engagers. As described in Types of Treatment, bispecific antibodies are monoclonal antibodies that target a protein on the myeloma cell surface and a T cell. Clinical trials are studying this treatment in multiple myeloma, and the first bispecific T-cell engager that targets both BCMA (a myeloma marker) and CD3 (a T-cell marker) was approved to treat multiple myeloma in 2022.

  • Drug combinations. Most myeloma cells will eventually become resistant to standard chemotherapy, a condition called multidrug resistance. Many new drug combinations have been developed and are being studied in various settings, including:

    • Bortezomib and lenalidomide in combination with dexamethasone

    • Bortezomib, cyclophosphamide, and dexamethasone

    • Carfilzomib, lenalidomide, and dexamethasone

    • Ixazomib, lenalidomide, and dexamethasone

    • Pomalidomide, bortezomib, and dexamethasone

    • Carfilzomib, pomalidomide, and dexamethasone

    • Pomalidomide, ixazomib, and dexamethasone

    • Pomalidomide, dexamethasone, and clarithromycin (Biaxin)

    • Daratumumab, bortezomib, and dexamethasone

  • Immunotherapy. This type of therapy uses the body's natural defenses to fight cancer by improving your immune system’s ability to attack cancer cells. Vaccines are a type of immunotherapy being explored in the treatment of multiple myeloma. Research on using these therapies to treat advanced myeloma is ongoing. Learn more about the basics of immunotherapy.

    • CAR T-cell immunotherapy. In this type of immunotherapy, some T cells are removed from a patient’s blood. Then, the cells are changed so they have specific proteins called receptors. The receptors allow the changed T cells to recognize the cancer cells. The changed T cells are then returned to the patient’s body. Once there, they seek out and destroy cancer cells. Two CAR T-cell therapies, idecabtagene vicleucel and ciltacabtagene autoleucel, have received FDA approval (see Types of Treatment), and more clinical trials are studying other CAR T-cell therapies in myeloma. Researchers are also examining the effectiveness of BCMA-targeted CAR T cells in combination with other treatments, as well as working to identify other antigens found on myeloma cells that may be effective immunotherapy targets. Learn more about the basics of CAR T-cell therapy.

    • Immune checkpoint inhibitors. Checkpoint inhibitor therapies include antibodies to block PD-L1 on multiple myeloma cells and PD-1 on immune cells. PD-1 is found on the surface of T cells, which are a type of white blood cell that directly helps the body’s immune system fight disease. Because PD-1 keeps the immune system from destroying cancer cells, blocking PD-1 allows the immune system to better eliminate the disease. Current research is trying to work out which patients benefit most from these treatments and in which combinations of other drugs they should be used. The FDA stopped all clinical trials using PD-1 checkpoint inhibitors in multiple myeloma. In 1 study of combination therapy that included pembrolizumab (Keytruda), researchers saw an increased death rate. Other checkpoint inhibitors targeting LAG3, TIM3, and TIGIT are being studied.

    • Cancer vaccines. Vaccines are another type of immunotherapy being explored in the treatment of multiple myeloma. Learn more about therapeutic cancer vaccines.

  • Palliative and supportive care. A limited number of clinical trials are underway to find better ways of reducing symptoms and side effects of current myeloma treatments to improve comfort and quality of life for patients.

Looking for More About the Latest Research?

If you would like more information about the latest areas of research in myeloma, explore these related items that will take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance on how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people do not experience the same side effects even when given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.


As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. This part of cancer treatment is called palliative and supportive care. It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for multiple myeloma are described in the Types of Treatments section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Talk with your health care team regularly about how you are feeling. It is important to let them know about any new side effects or changes in existing side effects. If they know how you are feeling, they can find ways to relieve or manage your side effects to help you feel more comfortable and potentially keep any side effects from worsening.

You may find it helpful to keep track of your side effects so it is easier to talk about any changes with your health care team. Learn more about why tracking side effects is helpful.

Sometimes, side effects can last after treatment ends. Doctors call these long-term side effects. Side effects that occur months or years after treatment are called late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Return to top

Coping with emotional and social effects

You can have emotional and social effects after a cancer diagnosis. This may include dealing with a variety of emotions, such as sadness, anxiety, fear, or anger, or managing stress. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

With myeloma, it may be necessary to change medications over time, such as if the myeloma develops resistance to the first drug. Learn more about how to cope after first-line treatment stops working.

You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Return to top

Coping with the costs of cancer care

Cancer treatment can be expensive. It may be a source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.

Return to top

Coping with barriers to care

Some groups of people experience different rates of new cancer cases and experience different outcomes from their cancer diagnosis. These differences are called “cancer disparities.” Disparities are caused in part by real-world barriers to quality medical care and social determinants of health, such as where a person lives and whether they have access to food and health care. Cancer disparities more often negatively affect racial and ethnic minorities, people with fewer financial resources, sexual and gender minorities (LGBTQ+), adolescent and young adult populations, adults older than 65, and people who live in rural areas or other underserved communities.

If you are having difficulty getting the care you need, talk with a member of your health care team or explore other resources that help support medically underserved people.

Return to top

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they likely to happen?

  • What can we do to prevent or relieve them?

  • When and who should I call about side effects?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, social, and financial effects of cancer.

Return to top

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with myeloma. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away. Being a caregiver can also be stressful and emotionally challenging. One of the most important tasks for caregivers is caring for themselves.

Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

A caregiving plan can help caregivers stay organized and help identify opportunities to delegate tasks to others. It may be helpful to ask the health care team how much care will be needed at home and with daily tasks during and after treatment. Use this 1-page fact sheet to help make a caregiving action plan. This free fact sheet is available as a PDF, so it is easy to print.

Learn more about caregiving or read the ASCO Answers Guide to Caring for a Loved One With Cancer in English or Spanish.

Return to top

Looking for More on How to Track Side Effects?

Cancer.Net offers several resources to help you keep track of your symptoms and side effects. Please note that these links will take you to other sections of Cancer.Net:

Return to top

The next section in this guide is Follow-up Care. It explains the importance of checkups after cancer treatment is finished. Use the menu to choose another section to read in this guide.

Multiple Myeloma - Follow-Up Care

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with myeloma does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations and medical tests. Doctors want to keep track of your recovery in the months and years ahead. Your doctor may recommend maintenance therapy to prevent cancer recurrence. Most patients requiring treatment for systemic myeloma are also treated on a regular schedule with intravenous bisphosphonates. However, the development of kidney problems or osteonecrosis (a small area of dead bone) of the jaw in a small fraction of patients after long-term use may change how bisphosphonates are used in the future.

For myeloma, follow-up care typically includes blood tests, periodic imaging scans, and bone marrow evaluation every 1 to 3 months. Treatment usually continues in myeloma over the long term, so this is usually integrated with watching for a recurrence.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, occupational therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible. Learn more about cancer rehabilitation.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Over time, myeloma recurs and arises because small areas of this cancer may remain undetected and resistant to treatment in the body. In turn, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will also ask specific questions about your health. Some people may have blood tests or imaging tests as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given.

The anticipation before having a follow-up test or waiting for test results may add stress to you or a family member. This is sometimes called “scanxiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to have side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years after treatment has ended. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on your diagnosis, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to ask about any concerns you have about your future physical or emotional health. The American Society of Clinical Oncology (ASCO) offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan once treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, treatments received, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Survivorship

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” is complicated because it means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and continues during treatment and through the rest of a person's life.

For some, the term “survivorship” itself does not feel right, and they may prefer to use different language to describe and define their experience. Sometimes long-term treatment will be used for months or years to manage or control cancer. Living with cancer indefinitely is not easy, and the health care team can help you manage the challenges that come with it. Everyone has to find their own path to name and navigate the changes and challenges that are the results of their cancer diagnosis and treatment.

Survivors may experience a mixture of feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain of how to cope with everyday life. Feelings of fear and anxiety may still occur as time passes, but these emotions should not be a constant part of your daily life. If they persist, be sure to talk with a member of your health care team. Learn more about coping with uncertainty.

Survivors may feel some stress when frequent visits to the health care team end following treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true as new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexual health and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the help and support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make lifestyle changes.

People recovering from multiple myeloma are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, exercising regularly, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

In addition, it is important to have recommended medical checkups and tests (see Follow-up Care) to take care of your health.

Talk with your health care team to develop a survivorship care plan that is best for your needs.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment changes, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note these links will take you to other sections of Cancer.Net:

  • ASCO Answers Guide to Cancer Survivorship: Get this 48-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print.

  • Survivorship Resources: Cancer.Net offers information and resources to help survivors cope, including specific sections for children, teens and young adults, and people over age 65. There is also a main section on survivorship for people of all ages.

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Questions to Ask the Health Care Team

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will find some questions to ask your doctor or other members of the health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with the health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.

Questions to ask after getting a diagnosis

  • Can you explain my pathology report (laboratory test results) to me?

  • What stage is the myeloma?

  • Am I symptomatic or asymptomatic? What does this mean?

  • Is my kidney function being affected?

  • Should I consider cytogenetic or genomic testing? What is involved, and what do the results mean?

  • Can you refer me to a social worker or psychologist who can help me cope with my diagnosis?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What types of research are being done for multiple myeloma in clinical trials? Do clinical trials offer additional treatment options for me?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • What are the possible side effects of this treatment, both in the short term and long term?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment?

  • Should I get a second opinion?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • What support services are available to me? To my family?

  • If I have questions or problems, who should I call?

Questions to ask about having therapies using medication

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • Will I receive this treatment at a hospital or clinic? Or will I take it at home?

  • What side effects can I expect during treatment?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term or late effects of having this treatment?

  • What can be done to prevent or relieve the side effects?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will those tests be needed?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • When should I return to my primary care doctor for regular medical care?

  • Who will be leading my follow-up care?

  • What support services are available to me? To my family?

  • Where can I get more information about myeloma?

The next section in this guide is Additional Resources. It offers more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.

Multiple Myeloma - Additional Resources

Approved by the Cancer.Net Editorial Board, 07/2022

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Multiple Myeloma. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Multiple Myeloma. Use the menu to choose a different section to read in this guide.