1. With the difficulty in a timely diagnosis of multiple myeloma (MM) for underserved patient populations, including Black African Americans and Hispanics, what are the early symptoms that a patient can share with their health care provider (HCP)?
There are significant disparities with regards to the timely diagnosis of MM in underserved patient populations. While many symptoms of MM such as fatigue and bone pain are nonspecific and can be seen in many other conditions, patients should see a doctor to determine the cause of these symptoms. It is very important for patients to be advocates for their own health and to be persistent in finding a cause for their symptoms.
2. Given the disparity in treatment of MM in certain underserved patient populations, what is the standard of care that patients should be asking for?
Unfortunately, there are barriers to appropriate therapy that contribute to application of treatment approaches for underserved patient populations that are inconsistent with current recommended practice. Currently there is a no one-size-fits-all treatment option for MM. There are very broad guidelines doctors adhere to when selecting treatment for each individual patient. A newly diagnosed patient should be treated with either a 3- or 4-drug regimen as first-line therapy. There are different factors that would favor the use of either the 3- or 4-drug combination. All patients should be evaluated to see if they are eligible for a stem cell transplant. Supportive care should be provided to every patient. Supportive care is treatment that addresses the symptoms and complications of a disease rather than the disease itself. Examples include bisphosphonates for bone health, antibiotics for infections, and pain control measures.
In the relapse setting, it is very important for patients to ask their doctor why a certain treatment is being chosen, and if possible, patients should be included in the decision-making process. Also, it is vital that patients seek the opinion of a myeloma specialist during key treatment decision points, such as when relapse necessitates a change in therapies.