And Related Blood Diseases
Duke's myeloma specialists use the latest medical advances to detect and treat myeloma at the earliest possible stage. Our advanced training and experience in the latest therapies, and our ongoing myeloma research, ensures you receive the best possible care for this blood cancer and related blood diseases. While myeloma cannot be cured, we develop a personalized treatment plan designed to control your myeloma, minimize painful symptoms, and maximize your quality of life.
Leaders in Myeloma Diagnosis and Treatment
Multiple myeloma is a form of blood cancer that usually starts in and spread throughout the bone marrow. Left untreated, it can weaken your immune system and increase your risk for infection. Myeloma can lead to anemia and kidney damage, and cause bone pain and fractures.
As myeloma specialists, we are skilled in identifying and treating the complex distinctions between myeloma and related diseases. When myeloma cells develop into a single collection of cells, typically in the bone, it is called a solitary plasmacytoma. Multiple myeloma refers to the presence of several myeloma tumors. MGUS (monoclonal gammopathy of uncertain significance) and smoldering myeloma cause no symptoms, but refer to the development of abnormal cells that can eventually lead to multiple myeloma or related cancers. We also treat rare diseases related to myeloma, including POEMS syndrome, amyloidosis, and light or heavy chain deposition disease, and Waldenstrom's macroglobulinemia, a form of lymphoma. Our advanced training and knowledge ensures you receive the best care for your specific condition.
As a National Cancer Institute-designated Comprehensive Cancer Center, we offer a level of expertise that can only be found in the top four percent of cancer centers across the country with this designation. We treat 1,000 people with blood cancer each year, more than any other facility in North Carolina, and we have a team dedicated to working with people who have multiple myeloma. As a result, we are acutely aware of your needs. Following a comprehensive evaluation and exam, we design a personalized treatment plan that is right for you. For example, if you are experiencing smoldering myeloma or MGUS, which typically do not produce symptoms, we may recommend active surveillance of your myeloma. Young, healthy people with symptoms may tolerate more intensive therapies, while older or frail people may benefit from gentler treatment options. We routinely see people who travel to Duke for consultations, and work with physicians near your home to ensure you receive the optimal care for your stage and type of myeloma.
Choose Duke for your multiple myeloma treatment because we offer:
- Top ranked care. We are among the top cancer programs in the nation, according to U.S. News & World Report. We are also part of the National Comprehensive Cancer Network (NCCN), an alliance of the nation’s leading cancer centers dedicated to improving patient care.
- Team approach. Because myeloma can affect your blood, your bones, your kidneys, and other organs, you benefit from the close relationships our hematology/oncology specialists have with orthopaedic surgeons, kidney specialists, and other physicians throughout Duke who have extensive experience with myeloma. We discuss your care, collect opinions, and offer coordinated treatment recommendations and follow up.
- Pioneering myeloma therapies. Our researchers bring new discoveries to the clinic every day. We develop and provide more new treatment options than most other cancer centers. We offer a wide range of clinical trials that may give you access to new drugs and new approaches not offered at other hospitals. For example, we offer clinical trials in bone marrow transplants and promising new drugs that are not yet available outside of a clinical trial. We also offer supportive care interventions such as exercise and stress management techniques, and senior adult assessments. Many of these approaches were pioneered at Duke and now offer new hope to people with myeloma.
- Comforting environment. Our new Duke Cancer Center features spacious waiting areas, a Quiet Room, large infusion rooms, and a rooftop garden area where people may be able to receive their chemotherapy outdoors.
- Personalized care and support for you and your family. Our comprehensive support services are here for you throughout your treatment journey. We help minimize the side effects of treatment, and offer support to help you cope with the emotional and psychological effects of diagnosis and treatment. You may also utilize our services focusing on nutrition, guided imagery, anxiety control, and meditation. Our cancer survivorship clinic pulls together a range of resources specially designed to help you after your treatment ends. View all of our cancer support groups in our event calendar.
Often recommended if you have smoldering myeloma, or MGUS, which do not cause symptoms. We monitor you regularly and start treatment if symptoms appear or changes in your condition occur.
Multiple myeloma damages the cells in the bone marrow where healthy white blood cells, red blood cells and platelets are made. Blood and bone marrow transplant restores your healthy cell function by killing the multiple myeloma cells and replacing them with healthy cells. You may be eligible for a blood or bone marrow transplant using your own cells (autologous) or cells from a donor (allogeneic). Transplant is a very intensive and complex treatment. Determining if transplant is right for you is part of the expert care you will receive at Duke.
Kills or slows the growth of cancer cells. Systemic chemotherapy is administered orally or by injection. Some forms of chemotherapy must be given in the hospital or in a clinic, and others can be given at home.
Newer drugs that target precise targets in the cells, while sparing normal cells. Targeted therapy include proteasome inhibitors such as bortezomib (Velcade) and carfilzomib (Kyprolis), and “immunomodulatory agents” such as lenalidomide (Revlimid) and pomalidomide (Pomalyst). May be used in combination with steroids or chemotherapy.
High-energy beams target the tumor to kill or slow the growth of cancer cells. Often used to treat specific painful spots of multiple myeloma in bones.
May be prescribed to prevent broken bones related to myeloma.
May be recommended to alleviate pain, stabilize broken bones or bones that are in danger.
Look for high calcium, anemia, elevated creatinine, and high protein levels, which may indicate the presence of myeloma or related conditions.
X-rays, MRI, PET and CT scans sometimes help diagnose the type and stage of your myeloma and provide information for your treatment plan.
Removes a small amount of tissue for examination under a microscope. Biopsy is generally required to make a definitive diagnosis of cancer, including multiple myeloma.
Examines the genetic makeup of your myeloma. This is different from other forms of “genetic testing,” which look for conditions that may run in your family. Genetic studies help us to better understand the biology behind your myeloma. This can help us to predict how myeloma may act over time, and in some cases, choose the best possible therapies. Some genetic studies are only available at Duke.