Monitoring Your Response to Treatment

Your healthcare team will be monitoring your responses and overall well-being every step of the way.  Many of the tests used to diagnose your myeloma will continue to be used to track your response to therapy and the status of your disease. Listed below are the some of the most common terms your healthcare team may use to describe the status of your cancer.

Also below are definitions that describe the quality of your response to therapy. If you are “responsive,” the quality of that response could be, for example, VGPR for a Very Good Partial Response. This, in turn, specifically means you have a 90 percent or greater decrease in M-protein levels in your blood and urine.

These definitions are used carefully in evaluating your progress, especially in clinical trials, and it is useful to know what they are and what they mean as you discuss your status and response with your healthcare team.  Since you may go through several treatment regimens during the course of your illness, you can use the information to track your progress with each new course of therapy. 

 

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The goal of treatment is to put your multiple myeloma into remission, which means your disease is undetected. During remission, there may be no need for treatment other than supportive care to alleviate the ongoing physical and emotional effects of the disease.  A small number of patients may be resistant to initial therapy and should talk to their healthcare provider to see if they may be candidates for other treatments. Over time, the periods of disease-free intervals, or remissions, typically shorten after each successive therapy, especially with chemotherapy. The length of remission depends on the specifics of your disease. Remission may last a few months or for years. A long-lasting remission is called durable, which is a primary goal of treatment, and the ability to achieve this is influenced by the aggressiveness of your multiple myeloma. Eventually, your disease may become non-responsive (also called refractory or resistant) to therapy, and palliative care to relieve symptoms rather than active treatment becomes the best way to help you feel as comfortable as possible.

Helpful Definitions

Disease Status

 
Responsive

Responsive to therapy

 
Stable

Not responsive to treatment but not progressive; M-proteins below 50%

 
Plateau

Disease levels off and remains stable

 
Progressive

M-proteins increasing, disease worsening

 
Relapsed

Initial response, but improvement stops and disease progresses

 
Remission

No signs or symptoms of the disease

 
Resistant / Refractory

No response to treatment or cancer resists a previously effective treatment

 
Recurrent

Cancer comes back after treatment

 

Quality of My Response

CR: Complete response

No detectable M-protein in blood and urine; normal percentage of plasma cells in bone marrow or absence of myeloma cells

 
NCR: Near complete response

M-proteins no longer detectable in blood or urine

 
VGPR: Very good partial response

Greater than 90% decrease in M-proteins

 
PR: Partial response

Greater than 50% decrease in M-proteins

 
MR: Minimal response

Less than 49% decrease in M-proteins; some consider MR to be part of stable disease

 
SD: Stable disease

Does not meet definition of MR or PD

 
PD: Progressive disease

Greater than 25% increase in M-proteins, new bone lesions, a new plasmacytoma, or tumors increase in size

 

*Adapted from the Multiple Myeloma Research Foundation.

WHO IS ON YOUR TEAM?

Nurses like:
Krista Tucker
Nurse and Educator

 
 
 

 

Letter from Nurse Krista Tucker

Myeloma Educator

I'm Krista Tucker, and I have been working as a nurse with myeloma patients for more than 20 years. As a multiple myeloma expert, I've learned that many patients don't have multiple myeloma symptoms until their disease has reached an advanced stage, so you may be entering this conversation with a prognosis that seems very intimidating.

I know the journey won't be easy. But sooner rather than later it's worth the effort to "Take Your Best Shot" -- to take charge of your disease by increasing your understanding of your multiple myeloma, surrounding yourself with people who can help and support you, and educating yourself on treatment options, right down to the financial aspects, so that you and your healthcare team can form a treatment plan that's right for you.

I've cared for many wonderful people with multiple myeloma, and I've seen many different approaches to dealing with their disease. I know how tough it can get, but it pays to stay positive! It's a journey that demands your energy, engagement and determination. You've got to take charge and stay involved in your care.

You need to line up the best team possible to guide you through this journey! Choose your healthcare team and support your diagnosis. Then work through the details with your oncologist about what is right for you, and know that it's okay to get a second opinion when you have questions about treatment decisions.

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When Phil and I were dating we lightheartedly called ourselves "Team P&C" to represent our loyalty and support for one another. Deciding at diagnosis that we would continue to operate as a cohesive unit, Phil and I relied on each other as teammates and used faith, humor and open communication to navigate Phil's health challenges. Always willing to go to bat for one another or to pick up slack if necessary, we know what it means to make sacrifices and see things through.

Phil has a positive attitude and natural charisma which are a perfect match for my practical approach to life. Phil's genuine love of people and my strong empathy for both patients and caregivers inspired us to connect with the myeloma community in as many meaningful ways as possible.

 
 

 

 

 

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