• Relapsed and refractory multiple myeloma (RRMM) is a complex condition that requires a multidisciplinary healthcare team.
  • Specialists manage the treatment of RRMM and its potential physical, emotional, and social effects.
  • Choosing the right team members involves several factors, including their expertise and experience with RRMM.

Multiple myeloma (MM) is a cancer of immune system cells called plasma cells. The condition can affect the body in many ways and potentially cause anemia, bone fractures, and high blood calcium levels. MM can also raise the risk of infection and kidney problems.

Relapsed and refractory multiple myeloma (RRMM) is when MM no longer responds to therapy after prior treatment was effective. While there have been significant advances in MM treatment in recent years, the majority of people experience relapse.

Your care team for RRMM may look a little like the people you have had around you since your initial diagnosis. Depending on how the condition has changed for you, a new specialist or mental health professional may support you on the journey.

Your family doctor takes care of your whole health. They may have been the first person you turned to about symptoms that led to your diagnosis. As you manage RRMM, you may continue to see your family doctor for routine medical concerns.

Choosing a primary care physician is a personal process. You may want to consider whether:

  • the doctor’s care is covered by insurance
  • the office is physically accessible and open for appointments at convenient times
  • the doctor has privileges at nearby hospitals
  • the doctor listens to your concerns and invokes a feeling of trust

With a complicated condition like multiple myeloma, the family doctor remains an important coordinator of care.

A hematologist specializes in conditions that affect the blood, including blood cancers like MM. Your hematologist may be the main individual leading your treatment.

To choose a hematologist, ask about their experience with blood cancers and specifically MM. Consider whether it’s essential that they have privileges at a cancer center where you want to receive care.

Hematologists can administer treatments including chemotherapy and stem cell transplants. There may be new and improved treatments since you were first diagnosed with MM. Talk with your hematologist about the latest treatments and their opinion about the benefits and drawbacks of your various options.

A medical oncologist is a cancer specialist.

Treatment for MM is usually coordinated by either a hematologist or a medical oncologist, which means either doctor might have provided your initial diagnosis and led you through treatment.

A radiation oncologist is another kind of cancer doctor who provides radiation therapy.

You may require radiation after chemotherapy or other treatments haven’t worked, as well as to treat painful bone lesions that are affected by MM.

Multiple myeloma can damage your bones. Sometimes people need surgery to repair their bones, joints, and muscles.

An orthopedic surgeon performs these procedures and often treats spinal fractures caused by MM.

If you require orthopedic surgery, talk with the surgeon about their background and history of working with people diagnosed with MM. Also, ask what kinds of procedures they perform. Minimally invasive surgeries could be an option that reduces your recovery time.

RRMM can cause changes in your eating patterns. You may have different nutritional needs or need to consume different foods because of treatment side effects.

A dietitian can help you to maintain nutritional balance during treatment, including a plan to manage weight loss or weight gain. They can also give tips on reducing nausea, vomiting, and navigating dry mouth or mouth soreness.

As many as 10% of people with MM have acute kidney injury.

Your care team may include a kidney specialist, or nephrologist, who manages this aspect of your treatment.

A psychotherapist works with people experiencing medical illness and other life events that impact emotional well-being.

You may choose to participate in psychotherapy, also called “talk therapy,” to work through your feelings about RRMM. You may also want to join a support group to connect with other cancer survivors.

Many people in cancer treatment find comfort in talking about their experiences. The American Cancer Society’s portal offers a listing of support programs, such as the Cancer Survivors Network.

MM can affect all aspects of your life and cause significant changes for you and your family. A social worker can help you to navigate the emotional, financial, and occupational impacts of cancer.

Depending on your specific needs, they can connect you to social and financial support, as well as other services that can ease the challenges of the condition.

Treating RRMM requires an interdisciplinary team who takes care of your physical and emotional health. Finding the right professionals for your needs helps ensure you have the best possible support.