Multiple myeloma can relapse after successful treatment. But treatment can help manage symptoms long term and slow cancer progression.
There’s no cure for this type of cancer, but treatment can slow the progression and improve the outlook of multiple myeloma. Once you’re in remission (when disease activity stops), you may slowly regain strength and resume everyday activities.
With successful treatment, there’s still a chance of the cancer returning, or relapsing. Doctors may refer to relapsed multiple myeloma as “recurrent” multiple myeloma because the cancer has recurred after remission.
You can’t completely prevent a multiple myeloma relapse, but learning more about cancer recurrence can help you recognize symptoms and get the right treatment. The sooner doctors diagnose a multiple myeloma relapse, the sooner you can get treatment.
Keep reading to learn why multiple myeloma relapses, the symptoms of a relapse, and how doctors treat it.
Multiple myeloma is a type of cancer, but it’s different from cancer types with solid tumors. Some cancers produce a mass that doctors can surgically remove or destroy with radiation therapy.
Multiple myeloma, on the other hand, is a blood cancer, and cancer cells are typically spread throughout the bloodstream. Treatment can help you achieve remission, but with current treatments, the disease doesn’t completely leave your body.
During remission, you do not have symptoms. But there’s always a chance of the cancer growing back and symptoms returning.
The goal of multiple myeloma treatment is to prevent relapse and control symptoms long term.
During remission, doctors regularly monitor you for potential relapse. You may also have maintenance therapy to help prolong your remission. Maintenance therapy typically involves a low dose of medications with the goal of preventing recurrence.
Because of the risk of relapse, ongoing appointments with your cancer care team for regular tests are essential even if you feel OK.
Regular tests may include:
- blood tests to check your level of red blood cells, as a low red blood cell count could be a sign of relapse
- a bone marrow biopsy, as a high level of plasma cells in your bone marrow could indicate a relapse
- imaging tests, like an MRI, to check for abnormalities in your bone marrow
- urinalysis to assess your kidney function, as multiple myeloma can damage the kidneys
In the event of a recurrence, early diagnosis is critical and can keep the cancer from spreading further.
You may also want to learn which symptoms can potentially occur with relapse and let your doctor know immediately if you experience any of them. These symptoms may include:
- bone pain
- muscle weakness
- dizziness
- confusion
- low energy
Doctors have multiple options for treating recurrent multiple myeloma and helping you achieve remission again.
Different factors can determine your treatment plan. If targeted drug therapy was successful before, your doctor might prescribe these medications again. They then monitor the disease’s progression to see whether these drugs remain effective.
If targeted therapy didn’t control your symptoms before, your doctor will likely suggest other options. These include biological therapy drugs to strengthen your immune system, such as:
- thalidomide (Thalomid)
- lenalidomide (Revlimid)
- pomalidomide (Pomalyst)
Your doctor may also recommend other treatment options or a combination of therapies, such as:
- chemotherapy, which destroys cancer cells
- radiation, which destroys or shrinks cancer cells
- bone marrow transplant, which replaces cancerous bone marrow with healthy bone marrow
You may get a combination of therapies or try different ones until you find something that works. Your doctor may also prescribe medication to treat side effects or complications. This includes medication to prevent bone loss or increase your production of red blood cells.
You can always get a second opinion on your treatment plan. A different doctor may have other recommendations. You can also ask your doctor about clinical trials or experimental drugs you may qualify for.
Once you achieve remission again, your doctor may suggest maintenance therapy. Maintenance therapy can keep the cancer in remission longer and prevent relapse.
Doctors typically give maintenance therapy after a bone marrow transplant. If you’re eligible, you’ll receive a low dose of a targeted drug or a corticosteroid for an extended time. Because of the low dose, you may not experience side effects from the medication.
What is the survival rate for relapsed multiple myeloma?
How long a person can live after a multiple myeloma relapse depends on individual factors, including past treatments and how well they worked, how long the first remission lasted, and how well treatment for relapse works.
Eventually, the cancer may stop responding to treatment, known as refractory multiple myeloma. One 2020 retrospective study found that the average survival time of people treated at one hospital in Singapore with multiple myeloma after the first relapse was
What is the life expectancy of multiple myeloma patients?
The 5-year relative survival rate for all stages of multiple myeloma is
This number is based on people who received a diagnosis between 2012 and 2018, so it may not reflect the experience of people with multiple myeloma today. Treatments improve over time, and personal factors can affect an individual’s outlook.
What happens if multiple myeloma comes back?
If multiple myeloma relapses, doctors typically base a treatment plan on multiple factors, including how well past treatments worked. They often recommend a combination of medications to help you achieve another remission. With each remission, multiple myeloma becomes harder to treat, as past medications may not work as well as in the past.
What is an early relapse in multiple myeloma?
A very early relapse in multiple myeloma refers to a disease that relapses during or within 60 days of treatment.
While multiple myeloma may relapse, recognizing and treating early signs and symptoms of relapse may help you achieve remission again.
Continue with all your follow-up appointments with your doctor. There’s no cure for multiple myeloma, but it’s possible to keep the disease in remission long term and prolong your life.