Multiple myeloma is a cancer that originates in the plasma cells of the bone marrow. These specialized white blood cells, normally responsible for producing infection-fighting antibodies, multiply uncontrollably, leading to abnormal protein production and interference with healthy blood cell formation. Many wonder if multiple myeloma is considered a “terminal illness.” Understanding this condition and its management is important.
Understanding “Terminal Illness”
Medically, the term “terminal illness” refers to a disease that is progressive and for which there is no cure or effective treatment to halt its progression. The expected remaining lifespan for someone with a terminal illness is often measured in months, or in some cases, a few years, and interventions primarily focus on comfort and symptom management rather than disease reversal.
This definition distinguishes a terminal illness from an “incurable” one. An incurable condition, while not having a definitive cure, can often be managed effectively for many years, sometimes even decades, allowing individuals to maintain a relatively normal life. The focus shifts from eradicating the disease to controlling its progression and managing its impact over a prolonged period.
Myeloma’s Classification and Prognosis
While multiple myeloma is generally considered an incurable cancer for most patients, it is typically not classified as a “terminal illness” at the time of diagnosis. Instead, it is increasingly viewed and managed as a chronic, relapsing-remitting disease, meaning it can be controlled for extended periods, but may return after periods of remission. This shift in understanding is largely due to significant advancements in treatment over the past two decades.
These therapeutic breakthroughs have substantially improved life expectancy and overall quality of life for many patients. For instance, the five-year relative survival rate for multiple myeloma has improved, with some data indicating it is around 57-60% for patients diagnosed between 2013 and 2019. Some individuals with multiple myeloma have been able to live for 10 years or more, with some even exceeding 20 years. This demonstrates that a diagnosis of multiple myeloma is not an immediate death sentence for the majority of patients.
The concept of “remission” plays a significant role in the disease course. Remission means there is a decrease in or disappearance of the signs and symptoms of multiple myeloma. Patients may experience periods of complete or partial remission, where the disease is stable or undetectable by standard tests. Most patients will go through several periods of remission and relapse, requiring adjustments in treatment over time.
Current Treatment Strategies
Current treatment strategies for multiple myeloma aim to achieve deep and durable remissions, control disease progression, alleviate symptoms, prolong life, and enhance the patient’s quality of life. These therapies do not typically offer a cure, but they effectively manage the disease as a chronic condition. The approach often involves a combination of different drug classes.
Therapies include chemotherapy, which targets rapidly dividing cells, and targeted therapies that specifically interfere with processes essential for myeloma cell growth. Immunotherapies are also used to harness the body’s immune system to fight cancer cells. For eligible patients, high-dose chemotherapy followed by autologous stem cell transplantation remains a treatment option to achieve longer remission periods. Maintenance therapy, often with oral medications, is frequently used after initial treatment to sustain remission.
Life with Myeloma
Living with multiple myeloma often involves managing it as a chronic condition, similar to other long-term illnesses. Patients typically undergo ongoing monitoring, including regular blood tests and imaging, to track the disease and detect any signs of progression or relapse. Symptom management, such as addressing bone pain or fatigue, is also an ongoing aspect of care.
Supportive care measures are important for maintaining quality of life. This can include physical therapy, nutritional support, and psychological counseling to address the emotional and social aspects of living with a chronic cancer. Many patients find value in connecting with support groups or other individuals living with myeloma, which can provide a sense of community and shared understanding. The goal of treatment and ongoing care is to enable individuals to live full and meaningful lives, despite the presence of the disease.