NCCN Guidelines for Patients
Multiple Myeloma, Version 1.2014
Deciding on a treatment plan Parts of a treatment plan
Parts of a treatment plan
A treatment plan addresses all cancer care needs
while respecting your beliefs, wishes, and values.
It is likely to change and expand as you go through
treatment. The plan will include the role of your
doctors and how you can help yourself. A treatment
plan often has the following parts:
Cancer can greatly differ even when people have
cancer in the same organ. Test results that describe
the cancer are reported in the treatment plan. Such
test results include the number of plasma cells and
levels of M-proteins, calcium, and creatinine. If done,
test results of known gene changes are also included.
See Part 2 on page 14 to read more about the tests
used for multiple myeloma.
Your treatment team
Cancer care is a team effort. Who is on your
team depends on the treatments you choose. A
hematologist is a doctor who’s an expert in treating
diseases of the blood. A medical oncologist is a
doctor who’s an expert in treating cancer with drugs.
A surgeon is an expert in operations to remove or
repair a part of the body. A radiation oncologist is an
expert at treating cancer with radiation therapy. Your
primary care doctor can also be part of your team.
He or she can help you express your feelings about
treatments to the team. Treatment of other medical
problems may be improved if he or she is informed
of your cancer care. Besides doctors, you may
receive care from nurses, social workers, and other
health experts. Ask to have the names and contact
information of your health care providers included in
the treatment plan.
There is no single treatment practice that is best for
all patients. There is often more than one treatment
option, including clinical trials. Clinical trials study
how well a treatment works and its safety. Treatment
planning for multiple myeloma takes into account
many factors, such as:
• How far the myeloma has spread,
• Presence of myeloma symptoms,
• Your general health,
• Treatment side effects,
• Costs of treatment,
• Changes to your life,
• What you want from treatment, and
• Your feelings about side effects.
A guide to myeloma treatment options can be found
in Part 4. The cancer treatment that you and your
doctors agree on should be reported in the treatment
plan. It is also important to note the goal of treatment
and the chance of a good treatment response. In
addition, all known side effects should be listed and
the time required to treat them should be noted. See
Part 3 on page 32 for a list of some of the possible
side effects of myeloma treatment.
Your treatment plan may change because of new
information. You may change your mind about
treatment. Tests may find new results. How well
the treatment is working may change. Any of these
changes may require a new treatment plan.
Stress and symptom control
Cancer and its treatments can cause bothersome
symptoms. You may also have symptoms from
the stress of having cancer. Such symptoms may
include pain, sleep loss, and anxiety. Helping you
to be comfortable and stay active are key goals of
the treatment plan. There are ways to treat many
symptoms, so tell your treatment team about any
symptoms you have so they can help make sure you