At the time of diagnosis, you may not be experiencing any symptoms at all – this is asymptomatic or smoldering myeloma. Patients with symptoms, or those who are likely to develop symptoms in the near future, need treatment.
Many different types of medication are available. The exact choice will depend on many factors, including how old and how fit or unfit you are. Younger patients who are relatively well will be offered higher doses of drug treatments, followed by intensive treatment with chemotherapy to eliminate the abnormal plasma cells, and stem cell transplantation to replace them with healthy stem cells. People aged over about 70, and those who are less able to tolerate the side-effects of intensive treatment, are more likely to be given a combination of drugs but no chemotherapy or stem cell transplant, although a transplant is possible provided it is with their own cells (see section 4.2.3). This is because any side-effects of intensive treatment would be harder to cope with. Other types of treatments, such as radiation therapy and surgery, may be needed according to particular circumstances.
Treatment comes in phases, which are described in the following sections.