While there are statistics that give median life expectancy for people with multiple myeloma as a whole, each person’s prognosis will vary. A number of factors influence outcomes, including the stage of the disease, chromosome changes, age, and other medical problems. The expertise of the oncologist who treats your multiple myeloma may also affect how well you feel and how long you live. RELATED: Cancer Trends: How Has the COVID-19 Pandemic Affected Cancer Screening?
Why Statistics Don’t Tell the Whole Story
Thanks to research advances, the National Cancer Institute estimates that the median five-year survival for people with multiple myeloma has increased from around 25 percent in 1975 to 50.7 percent today. (1) But it’s not unusual for people with myeloma to live 10 years or more. A small subset of people remain in remission for decades. It is important to realize that survival statistics are based on typically out-of-date data, and do not account for the significant improvements in myeloma therapies that have been developed in the past five years. Doctors are hesitant to use the word “cure” because multiple myeloma is generally considered incurable. They may, however, use the phrase “functionally cured” to describe prolonged remissions. Smoldering multiple myeloma (SMM), for instance, is an early-stage cancer that does not produce symptoms. Physicians don’t typically treat SMM, opting instead for regular check-ins. Around 10 percent of people with SMM go on to develop multiple myeloma within five years of diagnosis. (2) Other people may have an especially tough time battling multiple myeloma because of the genetics of the cells. Certain chromosome changes, such as the loss of a piece of chromosome 17, make multiple myeloma more aggressive and lead to a poorer prognosis. Physicians may run tests to determine the genetic makeup of myeloma cells as part of the staging process. Once they determine whether a cancer is standard or high risk, they make treatment decisions accordingly. (3) RELATED: Cancer News Digest: Latest Developments in Cancer Research and Treatment for May 2021
Finding the Best Treatment for You
Physicians treat multiple myeloma with a wide array of approaches, with more and better options opening up new possibilities. Someone who does not respond to one drug or drug combination, for instance, may do much better with another. For people who are healthy enough to undergo the procedure, an autologous stem cell transplant appears to lead to the best prognosis. A study from the University of California in Davis, published in June 2018 in the Journal of the National Cancer Institute, found that people who received this type of transplant had a significant improvement in survival compared with those who didn’t. (4) Those who had a transplant decreased their risk of dying by 20 percent. Their median survival was around 73 months, compared with 50 months for people with myeloma who did not have a transplant. Most older people with multiple myeloma are not even offered a transplant as an option, but the study found that the procedure improved survival in all age groups. (4)
Pushing for Better Care When You’re Black
African-Americans have twice the incidence of multiple myeloma as white Americans, accounting for 1 out of every 5 people diagnosed with this cancer. Yet studies have found that African-Americans are less likely to get the newest therapies and more likely to have delays in treatment. They are also less likely to participate in clinical trials, which can give people early access to medication that might extend their survival or significantly improve their quality of life. During a clinical trial of the multiple myeloma drug Ninlaro (ixazomib), for instance, which was approved by the U.S. Food and Drug Administration in 2015, Black participants accounted for only 13 of the 722 people involved. (5) The Leukemia & Lymphoma Society is working to raise awareness of this disparity and advocate for Black Americans. Together with the National Black Church Initiative, the society has launched a program called Myeloma Link, aimed at providing African-American communities with improved access to the best available treatments and clinical trials. (6) RELATED: Mental Health Resources for Black Americans
Myeloma Specialists Can Improve Your Prognosis
For people with multiple myeloma, the more experience their medical center or physician has with this rare kind of cancer, the better the prognosis. A study published in February 2017 in the Journal of Clinical Oncology found that people treated for multiple myeloma at centers seeing 10 new patients per year had a 20 percent higher risk of death than those treated at centers seeing 40 new patients per year. (7) Adding to the evidence, a study published in December 2017 in the journal Blood found that people with multiple myeloma who saw a specialist at a National Cancer Institute–designated comprehensive cancer center had better overall survival than those who saw a community oncologist. (8) The Leukemia & Lymphoma Society urges people with myeloma to seek out a myeloma specialist or a doctor who works in consultation with one.
