Virtually all patients treated for MM will receive systemic therapy. Induction therapy is the first phase of initial therapy. It aims to rapidly reduce the burden of MM. Induction therapy can include a combination of: immunomodulatory drugs (IMiDs) proteasome inhibitors (PIs) chemotherapy monoclonal antibodies (mAbs) Induction regimens will differ depending on whether the patient is…

The timing of specialist referral is guided by clinical severity and the presence of end-organ damage. Indicators of end-organ damage in patients with MM include (Quach & Prince 2019; Rajkumar et al. 2014): hypercalcaemia: corrected serum calcium 0.25 mmol/L above the upper limit of normal or higher than 2.75 mmol/L renal impairment: creatinine clearance 177…

Presenting symptoms should be promptly assessed. If there are no severe symptoms or severe blood test abnormalities, work-up can be initiated in general practice.

Cancer and cancer treatment may cause fertility problems. This will depend on the age of the patient, the type of cancer and the treatment received. Infertility can range from difficulty having a child to the inability to have a child. Infertility after treatment may be temporary, lasting months to years, or permanent (AYA Cancer Fertility…

Cancer prehabilitation uses a multidisciplinary approach combining exercise, nutrition and psychological strategies to prepare patients for the challenges of cancer treatment such as systemic therapy or radiation therapy. Team members may include haematologists, clinical psychologists, exercise physiologists, physiotherapists and dietitians, among others. Patient performance status is a central factor in cancer care and should be…

In discussion with the patient, the lead clinician should undertake the following: establish if the patient has a regular or preferred general practitioner and if the patient does not have one, then encourage them to find one provide written information appropriate to the health literacy of the patient about the diagnosis and treatment to the…

The multidisciplinary team should meet to discuss newly diagnosed patients before definitive treatment so that a treatment plan can be recommended and there can be early preparation for the post-treatment phase. The level of discussion may vary, depending on the patient’s clinical and supportive care factors. If patients are not discussed at an MDM, they…

A number of factors should be considered at this stage: the patient’s overall condition, life expectancy, personal preferences and decision-making capacity discussing the multidisciplinary team approach to care with the patient appropriate and timely referral to an MDM pregnancy and fertility support with travel and accommodation teleconferencing or videoconferencing as

The general practitioner who made the referral is responsible for the patient until care is passed to another practitioner who is directly involved in planning the patient’s care. The general practitioner may play a number of roles in all stages of the cancer pathway including diagnosis, referral, treatment, shared follow-up care, post-treatment surveillance, coordination and…

The multidisciplinary team should be composed of the core disciplines that are integral to providing good care. Team membership should reflect both clinical and supportive care aspects of care. Pathology and radiology expertise are essential. See Appendix E for a list of team members who may be included in the multidisciplinary team for MM. Core…