Myeloma Treatment

How is Myeloma Diagnosed?

A person with suspected myeloma should be assessed by a haematologist or haemato-oncologist. Treatment planning may include blood and urine tests for abnormal proteins, calcium, kidney function and blood counts, along with a bone marrow biopsy and imaging such as CT, PET-CT or MRI. Cytogenetic testing can also help assess risk and guide treatment.

How is Myeloma Treated Based on Severity?

Myeloma is not usually treated according to simple mild, moderate and severe symptom categories. Treatment intensity depends more on whether the disease is smouldering or active, its risk features, organ involvement, symptoms and previous response to treatment. As the disease becomes active or more difficult to control, treatment generally becomes more intensive.

The table below summarises the usual treatment approach for myeloma according to clinical status:

Types of Myeloma and Their Treatment

Myeloma treatment varies according to whether myeloma is smouldering, newly diagnosed or has returned after treatment. The table below summarises the main treatment-relevant clinical forms of myeloma:

Other Treatments for Myeloma

Other treatments for myeloma are listed below:

Oral Medications for Myeloma

Oral medicines are usually used as part of combination treatments for myeloma. Some of these are given below:

• Lenalidomide: Used in induction and maintenance regimens.

• Pomalidomide: Used in selected relapsed or refractory myeloma.

• Thalidomide: May be used in selected regimens.

• Ixazomib: An oral proteasome inhibitor used in combination treatment.

• Dexamethasone: Commonly combined with other anti-myeloma medicines.

• Cyclophosphamide or selinexor: May be used in selected regimens.

• Iberdomide: A newer oral medicine for selected previously treated patients, where approved and available.

Ayurvedic and Alternative Treatments for Myeloma

Ayurvedic, herbal and complementary treatments cannot replace disease-directed treatment for myeloma. The following alternative therapies should complement the ongoing treatment of myeloma for better health:

• Yoga or gentle exercise may support mobility and well-being when medically appropriate.

• Meditation and relaxation may help manage stress.

Herbal or ayurvedic products should not be started without medical advice because they may interact with cancer medicines or affect the liver, kidneys or blood counts.

Home Care for Managing Myeloma

Home care for myeloma can support overall well-being. These measures are listed below:

• Take myeloma medicines exactly as prescribed.

• Maintain adequate hydration unless fluids are restricted.

• Follow nutritional and infection-prevention advice.

• Follow dental-care advice during bone-directed treatment.

• Exercise within safe limits to reduce fracture risk.

• Attend scheduled blood tests and treatment reviews.

• Seek prompt care for fever, severe pain, breathing difficulty, reduced urine output or unusual bleeding.

How Long Does Treatment for Myeloma Take?

Myeloma treatment is usually long-term because treatment may continue through induction, transplantation, maintenance and later treatment if the disease returns. Treatment duration varies according to response and treatment type.

The table below summarises approximate durations for major myeloma treatments:

Myeloma Treatment Side Effects

Myeloma treatment side effects can vary depending on the medicines or procedures used. Common side effects of myeloma treatment may include:

• Low blood cell counts

• Fatigue

• Increased risk of infections

• Blood clots

• Nausea

• Peripheral neuropathy, such as numbness or tingling

• Infusion or injection-site reactions

• Sleep disturbances

• Mood changes

• Increased blood glucose levels

• Mouth sores

• Cytokine release syndrome

• Neurological complications

• Low calcium levels

• Osteonecrosis of the jaw in rare cases

Lifestyle Changes for Managing Myeloma

Lifestyle changes can support overall health and recovery during and after myeloma treatment. Some of these changes are given below:

• Follow a balanced diet with enough protein and calories, and maintain good hydration unless advised otherwise.

• Exercise within safe limits based on bone strength, overall health and physical ability.

• Avoid smoking and tobacco, and limit alcohol intake.

• Maintain regular sleep, rest and good personal and dental hygiene.

• Follow appropriate food-safety precautions, especially when immunity is reduced.

• Avoid herbal supplements unless approved by the treating doctor.

• Attend regular follow-up appointments and monitoring as advised.

Triggers That Can Worsen Symptoms of Myeloma

Myeloma does not have predictable symptom triggers. However, the following factors can worsen related problems:

• Dehydration, particularly when kidney function is affected

• Untreated infections

• Falls or high-impact activity when bones are weakened

• Missing or stopping prescribed myeloma treatment

• Delaying medical assessment of new bone pain, weakness or reduced urine output

• Taking medicines or supplements that may affect kidney function without medical advice

Treatment Cost of Myeloma in India

Myeloma treatment costs in India vary widely according to the medicines used, duration of therapy, hospital and need for transplantation or advanced immunotherapy. Monitoring or lower-intensity treatment may cost considerably less than multi-drug therapy. Autologous stem cell transplantation costs roughly ₹12 lakh to ₹25 lakh, while ongoing targeted medicines, bispecific antibodies or CAR T-cell therapy can substantially increase total treatment costs.

Note: These are estimated prices. Actual costs should be confirmed with the treating hospital.

Does Health Insurance Cover Treatment of Myeloma in India?

Yes. Health insurance covers myeloma treatment in India. Coverage may include the cost of hospitalisation, systemic treatment and stem cell transplantation, subject to policy terms and conditions. However, coverage for outpatient medicines, bispecific antibodies or CAR T-cell treatment may be available only if the policy has an OPD cover.

Besides, waiting periods may apply before coverage can be availed. Hence, patients should check the inclusions, waiting periods, co-payments, sub-limits and exclusions before raising a claim.