|Multiple-Myeloma Cancer and MGUS|
Anuj Mahindra, M.D., answers questions via email about the plasma-cell cancer multiple myeloma. Dr. Mahindra is an attending physician at the Center for Multiple Myeloma at Massachusetts General Hospital and an instructor at Harvard Medical School.
The questions are based on queries readers posted on our original article about the blood disorder MGUS. (Some people with MGUS eventually develop multiple myeloma.) Answers are only meant as general information, not individual advice.
This article will make the most sense to people who are already familiar with MGUS and multiple myeloma. For an introduction to MGUS, please see our previously mentioned original article on the topic.
Q. What's the significance of the M-protein level?
The significance of an M-protein is to evaluate the patient and diagnose the underlying disorder.
Smoldering myeloma has progressed to what's called symptomatic multiple myeloma if damage to the body starts, no matter what your M-protein level is.
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If your levels are unchanged and the diagnosis remains MGUS, once-a-year blood tests are appropriate in most cases.
Q. Another reader says she has smoldering multiple myeloma. Her doctor doesn't want to start treatment until it becomes more active. How long will this be?
People with smoldering multiple myeloma should get repeat blood tests two months after they're diagnosed. If the results are stable, the recommendation is to get them every three to four months after that (in some cases six months).
Q. Why do doctors wait to treat smoldering myeloma? Why don't you catch it in the bud?
There are many new treatment options, and it remains to be seen if studies will find that they lengthen life spans.
There are risks associated with the older treatments, such as second cancers, and we're waiting to see if the newer treatments will be safe and effective in the long run. Hence, treatment for smoldering myeloma is considered in the context of clinical trials.
There is no cure for multiple myeloma yet, but we can slow its progression and address symptoms. Treatments include chemotherapy, immunotherapy and bone-marrow transplants.
written by Sister Mary Sharon Verbeck , November 06, 2013
I have smoldering myeloma at high risk. My oncologist/hemotologist has me on 20 mg. of dexamethasone once a week. Will this dosage increase if my blood work and bone survey