FOR YOUR PATIENTS: UNDERSTANDING RELAPSE AND WHAT IT MEANS FOR YOUR MULTIPLE MYELOMA
New therapies for multiple myeloma are dramatically improving prognosis and extending survival. Better disease control is prolonging remission and allowing patients to live without any sign of disease, sometimes for years. Experts predict that in the near future, this currently incurable disease will be reclassified to a chronic manageable condition.
According to the National Cancer Institute estimates, the percentage of patients expected to survive 5 years after initial diagnosis of multiple myeloma is 57.9%, with about 31.6% expected to survive for 10 years.
As a general rule, the longer the period of remission, the better the prognosis or prediction of survival. Ultimately, however, multiple myeloma usually returns, even after successful initial treatment -- a situation known as relapse.
When the disease relapses, there may or may not be symptoms, or there may be different symptoms. Sometimes, subtle signs of disease progression will be detected only by regular follow-up testing.
The symptoms of multiple myeloma relapse include:
- Bone pain, particularly in the skull, hips, or back
- Muscle weakness in the arms or legs
- Bone fracture occurring after minor injury
- Shortness of breath
- Drowsiness and fatigue
- Frequent bruising or bleeding
- Extreme thirst
- Vomiting or constipation
- Frequent infection
Your doctor will discuss a new plan for personalized treatment to regain control of the disease. Your current state of health, how well previous treatments worked, how long you were in remission, and whether this is the first or second relapse will all be taken into consideration.
If the disease is stable and slow-growing, you and your doctor may decide to remain vigilant and hold off on treatment until symptoms worsen. Or, if the myeloma responded well to previous treatment and the remission lasted longer than 6 months, your doctor may recommend reusing the same treatment.
When treatment stops working within 6 months, the relapse is considered early or "refractory." When there is no response to initial treatment, that is considered "primary refractory" disease. In both instances, your doctor will recommend a different chemotherapy regimen.
Multiple myeloma can relapse two or more times, and tends to become more aggressive and more treatment-resistant with each successive relapse. If you develop resistance to key drug classes such as immunomodulatory drugs and proteasome inhibitors, talk to your doctor about enrolling in a clinical trial of other novel therapies.
Worrying about when cancer will return is stressful and self-care is an important part of coping. Although there's no proven way to actually lower the risk of relapse, you can make a point of adhering to lifestyle practices that promote general health -- i.e., don't smoke, maintain a healthy weight, exercise regularly, and eat nutritious food.
It's also important to get professional support beyond what your physician can provide, as well as peer support. Reach out to your cancer care team about having more psychosocial support as part of your treatment plan. Talk to coordinators at your cancer care center to find out what specialist support is available. Finally, explore local and online communities that provide information and resources and can connect you to others with multiple myeloma.
Additional Resources:
The International Myeloma Foundation
Read previous installments of this series:
For Your Patients: What Is Multiple Myeloma?
For Your Patients: Know the Symptoms of Multiple Myeloma
For Your Patients: The Basics of Bone Marrow Aspiration and Biopsy
For Your Myeloma Patients: Are You a Candidate for Autologous Stem Cell Transplant?
For Your Patients: Getting to Know the Options for Newly Diagnosed Multiple Myeloma
For Your Patients: Managing the Complications of Multiple Myeloma
"Medical Journeys" is a set of clinical resources reviewed by physicians, meant for the medical team as well as the patients they serve. Each episode of this journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.
2025-11-06T18:14:48Z
