Chemotherapy (chemo) is the use of medicines to kill cancer cells. The medicines attack and kill cancer cells, which grow quickly. Some normal cells also grow quickly. Because of this, chemo can also harm those cells. This can cause side effects.

Targeted therapy medicines work differently from standard chemo medicines. They target specific parts of cancer cells, like genes and proteins. They tend to cause different side effects than chemo.

Chemo and targeted therapy are the main treatments for people with multiple myeloma. These medicines are often used along with immunotherapy medicines. The type of medicines you get will depend mainly on:

• How quickly the myeloma is likely to grow and cause problems

• Whether or not you might be able to have a stem cell transplant

• The goal of treatment

• Your age and overall health

• Concerns you have about side effects

• What treatments you’ve had in the past

• Your preferences

Your healthcare provider may recommend using 1 or more of these medicines to treat myeloma in these situations:

• As the first treatment for myeloma

• As part of a stem cell transplant

• As a later treatment if the first treatment is no longer working or if the myeloma starts growing again after treatment

• As maintenance therapy after initial treatment to help keep myeloma in remission

Before treatment starts, you’ll meet with a medical oncologist. This is a doctor who specializes in treating cancer with medicines. These include chemo and targeted therapy. The doctor will talk with you about your treatment options and explain what you can expect. 

The medicines used to treat multiple myeloma are given in 1 of these ways: 

• Intravenous (IV). You’ll get the medicine through a small catheter that’s been put into a vein in your hand or arm. The medicine may drip in slowly over a few hours, or you may get it over a few minutes. 

• Subcutaneous (subQ). You’ll get this medicine as an injection (shot) under your skin.

• Oral. You swallow these medicines as pills or liquids.

Chemo and targeted therapy medicines are normally given in an outpatient setting. This means you get them at a hospital, clinic, or healthcare provider's office. Then you go home after treatment. Less often, you may need to stay in the hospital during treatment.

Your treatment team will watch you for reactions during your treatments. Since each of your treatments may last for a while, you may want to take something that’s comforting to you, like music to listen to. You may also want to bring something to keep you busy, such as a book or mobile device.

To reduce the damage to healthy cells and to give them a chance to recover, you’ll get these medicines in cycles. Each cycle consists of 1 or more days of treatment, followed by some time to rest. In general, cycles last 3 or 4 weeks. Your healthcare provider will discuss your treatment schedule with you.

It's important to know which medicines you're taking. Write their names down, and ask your healthcare team how each medicine works and what side effects each might have.

Talk with your healthcare providers about what signs to look for and when to call them. For example, chemotherapy can make you more likely to get infections, which can cause fever and chills. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?

It may be helpful to keep a diary of your side effects. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.