Detection Most residual or recurrent disease will be detected via routine follow-up or by the patient presenting with symptoms. Treatment Evaluate each patient for whether referral to the original multidisciplinary team is appropriate. Treatment will depend on the location and extent of disease, previous management and the patient’s preferences. Advance care planning Advance care planning…

Palliative care Consider a referral to palliative care. Ensure an advance care directive is in place. Communication The lead clinician’s responsibilities include: being open about the prognosis and discussing palliative care options with the patient establishing transition plans to ensure the patient’s needs and goals are considered in the appropriate environment. Checklist Supportive care needs…

Detection Most relapsed or progressive disease will be detected via routine follow-up blood tests or by the presence of symptoms. Treatment Treatment will depend on patient factors (age and frailty), disease factors (tempo of relapse, risk-group stratification), prior treatment-related factors (responsiveness and side effects to prior treatment type) and the patient’s preferences. When managing people…

Provide a treatment and follow-up summary to the patient, family and/or carer and GP outlining: the diagnosis, including tests performed and results treatment received (types and date) current toxicities (severity, management and expected outcomes) interventions and treatment plans from other health professionals potential long-term and late effects of treatment and the care of these supportive…

MM is complex and treatment aims may change throughout the disease course. It’s important to note that MM is an incurable cancer, and nearly all patients will eventually relapse after each line of therapy. Establish intent of treatment For MM: to obtain deep remission for durable disease control to improve quality of life and/or longevity…

Diagnosis and staging Tests that are always indicated include: Blood and urine tests to assess for myeloma and myeloma-defining events: full blood count, differential and blood film urea and electrolytes, calcium, phosphate, magnesium, urate liver function test, albumin beta-2 microglobulin, LDH, C-reactive protein serum protein electrophoresis and immunofixation serum free light chain 24-hour urine collection:…

Signs and symptoms to investigate MM can present with many otherwise unexplained, non-specific symptoms and/ or blood test abnormalities, as well as end-organ complications or related organ tissue injury. End-organ complications that are often associated with MM include: bone loss, renal failure, hypercalcaemia, immune suppression or anaemia. Signs and symptoms include: fatigue and general weakness…

Prevention The causes of multiple myeloma (MM) are not fully understood, and there is currently no clear prevention strategy. Risk factors The risk factors for developing MM include: age (occurs mainly in people aged over 60) clinically defined monoclonal gammopathy of undetermined significance (MGUS) having a first-degree relative with MM, however the absolute risk for…

Visit the guides to best cancer care webpage for consumer guides. Visit the OCP webpage for the optimal care pathway and instructions on how to import these guides into your GP software. Endorsed by: ALLG <www.allg.org.au> ANZTCT <www.anztct.org.au> Cancer Council <www.cancer.org.au> HSANZ <www.hsanz.org.au> Leukaemia Foundation <www.leukaemia.org.au>

Palliative care For patients with blast phase CML, consider a referral to palliative care. Ensure an advance care directive is in place. Communication The lead clinician’s responsibilities include: being open about the prognosis and discussing palliative care options with the patient establishing transition plans to ensure the patient’s needs and goals are considered in the…