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Why Multiple Myeloma Remission Doesn’t Mean Treatment Is Over

For some patients, entering remission may necessitate additional forms of follow-up.

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Updated on September 1, 2023

Though multiple myeloma was once considered an incurable disease, there is reason to be optimistic. Medical advances, new research, and broader treatment options are leading to long-term remission and increased survival rates. 

For people with a multiple myeloma diagnosis, remission is good news. But it doesn’t mean an end to treatment or visits with healthcare providers (HCPs). They will continue with follow-up care, to ensure the disease hasn’t returned and to manage any side effects from the cancer or treatment.

Here’s what you can expect from follow-up care.

Watching for symptoms

As with any cancer, monitoring for a recurrence is essential. Your HCP and healthcare team will set up regular appointments to check your status. These visits will entail the following:

  • Physical examinations: Your HCP will spend some time discussing how you feel and whether you’re experiencing any symptoms, such as fatigue or bone pain, either due to a recurrence or to the treatments.
  • Blood tests: These tests are used to check M-protein levels (which indicate the return of multiple myeloma), along with other key signs such as anemia (low red blood cells), hypercalcemia (high blood calcium), and renal impairment (poor kidney function).
  • Imaging tests: CT scans and X-rays are used to detect tumors. Plus, since multiple myeloma has such a profound effect on bone health, they can also reveal breaks or weak spots.

Note that you won’t undergo tests at every appointment. You can expect bone marrow evaluation every one to three months, for instance, and blood and other tests will be performed periodically.

Your HCP may also share a list of symptoms to watch for that could indicate a relapse. Watch for dizziness (which could be a sign of anemia), bone pain, signs of an infection, and swelling, tingling, or numbness in your feet and legs.

Treatment for side effects and related conditions

Cancer is hard on your body, but so is treatment. Many of the complications and side effects from treatment can linger even when you are no longer actively being treated. During visits with your HCP, share any symptoms or changes that you observe. This will help your HCP recommend strategies to handle lingering side effects.

If you received radiation, HCPs may recommend thyroid tests, electrocardiograms, and mammography, depending on the location of your radiation therapy.

Maintenance therapy

After receiving an initial treatment that helps you achieve remission—such as a stem cell transplant or radiation therapy—maintenance therapy helps to prevent a recurrence of your cancer. It can involve chemotherapy, targeted therapy, or another kind of therapy. 

A 2020 follow-up study published in the Journal of Clinical Oncology reviewed 1,000 patients treated with a three-drug combination therapy followed by risk-adapted maintenance therapy and found that patients responded well to this treatment. The study included people who were both eligible and ineligible for stem cell transplantation with high response rates.  

Following up for emotional health

While your multiple myeloma may be under control, the stress that your body goes through isn’t purely physical. The mental burden and emotional stress are something for which your HCP can provide resources to work through your feelings. Emotional support may come in the form of support groups, professional counselors, or family and friends, but your HCP can provide you with local resources to get you started. 

Article sources open article sources

American Cancer Society. Survival Rates for Multiple Myeloma. Page last updated March 2, 2023. 
American Cancer Society. Living as a multiple myeloma survivor. Page last updated February 28, 2018.
American Society of Clinical Oncology. Multiple Myeloma: Follow-Up Care. Page last updated July 2022.
American Cancer Society. Signs and Symptoms of Multiple Myeloma. Page last updated February 28, 2018.
Leukemia & Lymphoma Society. Disease Complications. Accessed on June 5, 2023. 
American Society of Clinical Oncology. The Importance of Follow-Up Care. Page last updated July 2022.
National Cancer Institute. Maintenance Therapy. Accessed on June 6, 2023.
American Cancer Society. Treatment Options for Multiple Myeloma and Other Plasma Cell Disorders. Page last updated March 1, 2022. 
Joseph NS, Kaufman JL, Dhodapkar MV, et al. Long-term follow-up results of lenalidomide, bortezomib, and dexamethasone induction therapy and risk-adapted maintenance approach in newly diagnosed multiple myeloma [published correction appears in J Clin Oncol. 2020 Aug 10;38(23):2702]. J Clin Oncol. 2020;38(17):1928-1937.
American Cancer Society. Living as a Multiple Myeloma Survivor. Page last updated February 28, 2018.

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