Stage I Multiple Myeloma
Stage I multiple myeloma occurs when there is a relatively small amount of cancer in the body. Other frequently used terms that represent minimal cancer burden and include patients with stage I myeloma are monoclonal gammopathy of undetermined significance (MGUS) and smoldering or indolent myeloma.
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The following is a general overview of the treatment of stage I multiple myeloma. Circumstances unique to your situation and prognostic factors of your cancer may ultimately influence how these general treatment principles are applied. The information on this Web site is intended to help educate you about your treatment options and to facilitate a mutual or shared decision-making process with your treating cancer physician.
Most new treatments are developed in clinical trials. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. The development of more effective cancer treatments requires that new and innovative therapies be evaluated with cancer patients. Participation in a clinical trial may offer access to better treatments and advance the existing knowledge about treatment of this cancer. Clinical trials are available for most stages of cancer. Patients who are interested in participating in a clinical trial should discuss the risks and benefits of clinical trials with their physician. To ensure that you are receiving the optimal treatment of your cancer, it is important to stay informed and follow the cancer news in order to learn about new treatments and the results of clinical trials.
The major decisions concerning treatment of stage I multiple myeloma are if and when treatment should be initiated. It may be useful to think of monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma and stage I myeloma as a continuation or gradual progression of multiple myeloma. The term monoclonal gammopathy of undetermined significance (MGUS) means that a small amount of an abnormal protein, or M-protein, typically measures less than 3 grams per deciliter in blood and less than 10% of a bone marrow biopsy contains plasma cells. Patients with stage I multiple myeloma do not have involvement of the bones, nor do they experience any additional signs or symptoms from the cancer. Stage I multiple myeloma is relatively common among older people and often there is no progression to later stage myeloma.
When doctors refer to smoldering myeloma, the M-protein is typically over 3 grams and there may be more than 10% plasma cells on bone marrow biopsy; however, patients still remain asymptomatic and have no evidence of bone involvement. Both MGUS and smoldering myeloma require no immediate treatment, as these conditions may persist and be stable for several years. Patients should be followed at regular intervals by their physician in order to detect clinical signs or symptoms that represent a progression of the myeloma. For patients with a stable clinical situation of longer than 6 months, the risk of serious disease progression occurs in only 1-3% of patients per year.
Other patients will experience progression of their myeloma requiring treatment. Common reasons for initial treatment of myeloma include the following:
A steady increase in the amount of serum or urine monoclonal or M-protein.
Development of bone lesions.
Worsening kidney function.
For a general discussion of the treatment options that exist for patients experiencing myeloma progression from what was previously considered to be a MGUS, or smoldering myeloma, proceed to the Treatment Overview of Stage II-III Multiple Myeloma.
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