If you have multiple myeloma, your outlook can depend on the stage of your cancer at diagnosis, your age, your overall health, and how well your cancer responds to treatment.

Multiple myeloma is a type of blood cancer. It develops in plasma cells, which are white blood cells that help fight infection by making antibodies.

In multiple myeloma, cancer cells build up in your bone marrow, crowding out healthy blood cells. They also create abnormal proteins that can damage your kidneys and other organs.

There’s no cure for multiple myeloma, but its symptoms can wax and wane. It’s possible to have a long period of remission, which could last several years, before a relapse.

Many factors affect your outlook for multiple myeloma, including the stage of the cancer at diagnosis, your age, and the treatment options.

In this article, we’ll take a closer look at these factors and the current 5-year survival rates for this cancer.

The overall 5-year survival rate for myeloma, based on data from people who received this diagnosis between 2013 and 2019, is 59.8%, according to the National Institutes of Health’s SEER program.

What is a 5-year survival rate?

Health professionals often use 5-year survival rate as a measure of a disease’s outlook. It refers to the percentage of people with a disease who are still alive at least 5 years after their diagnosis.

The 5-year survival rate for a disease is based on people who received a diagnosis at least 5 years earlier.

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The SEER program groups cancers based on their location in your body. Myeloma can be either localized, which means a single tumor (solitary plasmacytoma) is present inside or outside the bone, or distant, which refers to what is classically thought of as multiple myeloma.

Only 4% of cases are diagnosed at the localized stage, while the distant stage makes up 96% of diagnoses.

The 5-year survival rates for myeloma, based on diagnoses between 2013 and 2019, are:

  • Localized: 79.5%
  • Distant: 59%

These survival rates were calculated using data collected from a large number of people with myeloma. That means these rates don’t account for individual factors such as your age, your overall health, and your cancer’s response to your specific treatment regimen.

The Food and Drug Administration (FDA) has approved many new treatments for multiple myeloma in recent years, and many more are in development, so it’s likely that survival rates have improved and will continue to improve.

Researchers determine average survival rates based on the averages of people with a specific disease. They do not account for all the factors that could affect an individual’s outlook with multiple myeloma.

An oncologist can provide an estimate of your life expectancy with multiple myeloma based on your specific factors.

Factors that can affect your outlook include:

  • Cancer stage at diagnosis: Cancer that is more advanced at the time of diagnosis may have a less favorable outlook.
  • Cancer progression: Multiple myeloma can be asymptomatic and progress slowly, or it can grow and progress quickly.
  • Genetic changes in the tumor: Some types of high risk genetic abnormalities can affect your risk level.
  • Blood levels of specific proteins and enzymes: Low albumin levels or increased levels of beta 2 microglobulin can indicate more advanced cancer, while high levels of the enzyme lactate dehydrogenase can indicate organ damage.
  • Kidney function: The M protein, which is made by cancer cells in multiple myeloma, can go on to damage your kidneys. Inadequate kidney function generally indicates a less favorable outlook.
  • Age: Younger people tend to have a better outlook than older people, as they may be able to tolerate more intensive treatments.
  • Overall health: The presence of other health conditions can affect your outlook. For example, having heart disease or diabetes that isn’t well managed can predict a less favorable outlook.

How staging affects the outlook for people with multiple myeloma

A primary factor in determining the outlook for people with multiple myeloma is the stage of the cancer at diagnosis.

As with many other cancers, doctors break down multiple myeloma into stages that indicate how advanced it is. Staging helps doctors track the disease and prescribe the right treatments.

Doctors use two staging systems for multiple myeloma: the Durie-Salmon staging system and the Revised International Staging System (RISS). Both of these help doctors express how advanced the cancer is.

RISS helps doctors estimate progression-free survival, which is the amount of time a person is estimated to stay in remission after their first round of treatment. RISS is used only at initial diagnosis and does not change with relapses (periods when the cancer worsens).

Smoldering multiple myeloma

You may receive a diagnosis of smoldering multiple myeloma. This means that myeloma cells are present in your body but are not progressing or causing damage to your bones or kidneys. These cells may be undetectable in your blood.

This is considered a precancerous condition, distinct from multiple myeloma.

According to a 2007 research review, smoldering multiple myeloma progresses to multiple myeloma at a rate of about 10% per year in the 5 years after initial diagnosis.

How does active vs. relapsed/refractory multiple myeloma affect outlook?

If your cancer responds well to initial treatment and you enter remission, your outlook may be better. However, this is not always the case.

When multiple myeloma comes back, it’s called relapsed multiple myeloma. Multiple myeloma that doesn’t respond to treatment is called refractory multiple myeloma. People typically don’t develop refractory myeloma until after multiple rounds of treatment.

Most people with multiple myeloma will experience relapsed/refractory multiple myeloma (RRMM).

The outlook for RRMM is generally less favorable, although it can depend on many factors, such as the effectiveness of previous treatments, your age, and your overall health.

In a 2021 study, researchers evaluated 12,987 people with RRMM. They found that the median survival time after restarting treatment was 32.4 months. “Median survival time” means that roughly half of the people lived for less than 32.4 months and half lived longer than that.

Advances in treatment may gradually improve the outlook for RRMM. For example, the authors of another 2021 study estimated that newer treatments for RRMM may increase life expectancy by an average of 2.5 years. Newer and future treatments for RRMM may extend this even further.

The treatment of newly diagnosed multiple myeloma can depend on many factors. Your doctor will evaluate these factors to choose a treatment plan that’s right for your situation.

The typical pattern of treatment for multiple myeloma involves starting with aggressive induction therapy to reduce the number of myeloma cells in your bone marrow. Consolidation or long-term maintenance therapy then follows.

At some point, most people’s disease will relapse and require a second-line treatment. This may be followed by another period of remission or maintenance therapy, followed by eventual relapse.

This cycle of treatment, remission, and relapse may repeat several times, with a shorter remission period for each subsequent line of therapy. At some point, either the disease will no longer respond to standard therapies or all standard therapies will be exhausted. A doctor will work closely with you and explain all your options.

Drug-based treatments

Typically, doctors treat active myeloma with a combination of two or three drugs. They may prescribe drugs from several classes, such as:

  • monoclonal antibodies
  • immunomodulatory drugs
  • proteasome inhibitors
  • traditional cytotoxic chemotherapy drugs
  • corticosteroids

Stem cell transplants

A stem cell transplant (SCT) may be an option for some people. Doctors refer to this as a “consolidation” treatment. It will typically be used after you reach your first remission to lengthen the remission.

Ideal candidates for this procedure are typically younger and in good overall health. While an SCT won’t cure your myeloma, it can improve your outlook.

Additional treatments

You may receive a variety of other treatments as part of your care, such as:

  • bisphosphonates or radiation therapy to help address bone disease
  • plasmapheresis to remove M protein that has built up in your blood
  • antimicrobial drugs or intravenous immunoglobulin to prevent or treat infections
  • blood transfusions or erythropoiesis-stimulating agents to boost red blood cell counts
  • platelet transfusions to help with low platelet levels

Treatment for relapsed/refractory multiple myeloma

At some point, most people with multiple myeloma will experience RRMM. In these situations, the course of treatment will depend on individual factors similar to the ones that affect your outlook.

If a previous treatment regimen worked well initially, a doctor may consider using that therapy again. It’s also possible that a doctor will recommend a different treatment plan, which may include:

  • starting an alternative drug regimen, which may involve one or a combination of these drugs:
    • targeted therapy drugs
    • immunomodulating agents
    • corticosteroids
    • chemotherapy drugs
  • following the drug regimen with one or more SCTs
  • using CAR-T therapy, such as idecabtagene vicleucel (Abecma), a type of immunotherapy in which some of your body’s T cells are modified to target cancer cells

If your myeloma has relapsed multiple times, a doctor may recommend enrolling in a clinical trial. Clinical trials investigate new drug combinations and forms of treatment for people with limited or no FDA-approved treatment options.

Receiving a diagnosis of multiple myeloma can be difficult. You may have questions about the disease, your treatment, and your outlook.

Learning more about multiple myeloma will help you and your caregivers make appropriate decisions about your care.

A strong support system can help you cope with problems or anxieties you may have. A support system may include:

When living with multiple myeloma, try to treat your body well. This can involve:

  • eating nutritious foods
  • getting enough rest and relaxation so you’re better able to deal with stress and fatigue
  • setting achievable goals that help you feel satisfied without overextending yourself

If you’re caring for someone with multiple myeloma, it can be helpful to educate yourself about the disease, symptoms, and treatment side effects.

You can show your support by asking what role you should play in their treatment. Be honest with them and with yourself. Seek additional help if needed.

You might also benefit from joining a caregiver support group where you can talk with others who are caring for loved ones with multiple myeloma.

What is the life expectancy of someone with multiple myeloma?

Life expectancy with multiple myeloma can vary greatly from person to person, depending on factors such as stage at diagnosis, age, overall health, and specific tumor mutations. The average 5-year survival rate for people with myeloma is 59.8%.

Is myeloma classed as a terminal illness?

Multiple myeloma is a terminal illness that has no cure, but with treatment, people with this type of cancer can experience remissions that may last for years.

Is multiple myeloma one of the worst cancers?

Like many other types of cancer, multiple myeloma has no cure. However, people with multiple myeloma can live for multiple years with treatment, and treatments are continuing to improve. Some people with multiple myeloma may experience remissions that last for years.

What are the 3 stages of multiple myeloma?

Doctors determine the stage of multiple myeloma based on the amount of myeloma cells in your body and the damage these cells have caused to your bones and kidneys. The criteria for stages 1, 2, and 3 can vary depending on the staging system used.

Your outlook with multiple myeloma depends on many factors, such as the stage of the cancer at diagnosis, the type of treatment you receive, and your age and overall health. The sooner you receive a diagnosis and begin treatment, the better your outlook will be.

While there is no cure for multiple myeloma, treatment can help promote remission. Remissions can sometimes last for years. However, many people with multiple myeloma eventually experience relapsed/refractory multiple myeloma.

With recent advances in treatment, the outlook for people with multiple myeloma, including relapsed/refractory multiple myeloma, has been steadily improving. Doctors and scientists continue to discover newer, more effective ways to diagnose and treat this disease.

The outlook for multiple myeloma varies for each person. You can talk with your doctor about your individual outlook and how treatment options may affect it.