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Why Has My Multiple Myeloma Returned?

Medically reviewed by Seunggu Han, MD on October 9, 2017Written by Valencia Higuero on October 9, 2017
recurring multiple myeloma

Treatment can slow the progression and improve the outlook of multiple myeloma. However, there is no cure for the condition. Once you’re in remission, you’ll slowly regain strength and be able to resume everyday activities.

Despite successful treatment, there’s a chance of the cancer returning. As a result, you may live in a constant state of fear and worry.

You can’t completely prevent a multiple myeloma relapse, but learning more about a relapse can help you recognize symptoms and get the right treatment. The sooner a multiple myeloma relapse is diagnosed, the better.

Why does multiple myeloma return?

Multiple myeloma is a type of cancer, but it’s different from other malignancies. Some cancers are curable because they produce a mass that can be surgically removed or wiped out.

Multiple myeloma, on the other hand, is a blood cancer. Treatment can help you achieve remission, but the disease doesn’t completely leave your body. Reasons on why are still unknown.

You won’t have symptoms during remission, but there’s always a chance of the cancer growing back and symptoms returning.

The goal of multiple myeloma treatment is to prevent a relapse and control symptoms long term.

Recognizing symptoms of a multiple myeloma relapse

Remission is a time of uncertainty for people living with multiple myeloma. Because of the risk of relapse, ongoing appointments with your doctor are essential.

In the event of a recurrence, early diagnosis is critical. The best thing you can do for your health is keeping up with periodic testing. Even if you feel okay, your doctor may order blood tests to check your level of red blood cells. Because multiple myeloma slows the production of red blood cells, a low red blood cell count could signal a relapse.

Your doctor may also conduct a bone marrow biopsy. A high level of plasma cells in your bone marrow could also indicate a relapse. An imaging test like an MRI can check for abnormalities in your bone marrow. Multiple myeloma can also cause kidney damage, so you’ll likely need a urinalysis to assess your kidney function.

Learn how to recognize signs of a relapse and immediately bring it to your doctor’s attention. Signs of recurrence may include:

  • bone pain
  • muscle weakness
  • dizziness
  • confusion
  • low energy

Treatment options for recurring multiple myeloma

Talk to your doctor about relapse treatment options. There are many ways to attack recurrent multiple myeloma and achieve remission again.

Different factors determine the next step in your treatment. If targeted drug therapy was successful before, your doctor might once again prescribe these medications. They will then monitor the disease’s progression to see if these drugs remain effective.

If targeted therapy didn’t control your symptoms before, your doctor might suggest other options. These include biological therapy drugs to strengthen your immune system. Such drugs include thalidomide (Thalomid), lenalidomide (Revlimid), and pomalidomide (Pomalyst). Other options are:

  • chemotherapy (kills cancer cells)
  • radiation (kills or shrinks cancer cells)
  • bone marrow transplant (replaces diseased bone marrow with healthy bone marrow)

You may get a combination of therapies, or try using different ones until you find something that works. Your doctor may also prescribe medication to treat side effects or complications of the disease. This includes medication to prevent bone loss or to increase your production of red blood cells.

Don’t be afraid to get a second opinion. A different doctor may have other recommendations. Also, ask your doctor about clinical trials or experimental drugs available to you.

Maintenance therapy

Once you achieve remission again, your doctor may suggest maintenance therapy. Maintenance therapy may keep the cancer in remission longer and prevent a relapse.

Maintenance therapy is typically given 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. Due to the low dose, you may not experience side effects from the medication.

Outlook

The thought of multiple myeloma returning might stay on your mind. Be proactive and educate yourself so that you can recognize early signs of a relapse. Continue with follow-up appointments as scheduled 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.

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