Surgery isn’t a typical treatment for multiple myeloma. But in some cases, surgery may be necessary to address complications from the disease.

Multiple myeloma is a rare type of cancer that causes abnormal cells to develop in your bone marrow. As multiple myeloma spreads, it can lead to bone damage or loss.

The American Cancer Society (ACS) estimates that there will be 35,780 new U.S. cases of multiple myeloma in 2024.

First-line treatments for multiple myeloma often include chemotherapy or immunotherapies. However, in certain cases, complications of multiple myeloma may lead a doctor to recommend surgery.

Here’s a look at what surgeries may be part of your myeloma treatment plan and how they work alongside other treatments.

Healthcare professionals typically don’t suggest surgery as the first-line treatment for multiple myeloma. But surgery may be necessary if there are any complications.

According to the International Myeloma Foundation, more than 80% of people with multiple myeloma experience bone disease. This can lead to issues such as:

  • thin and weak bones (osteoporosis)
  • holes in bones (lytic lesions)
  • fractures
  • spinal cord compression causing paralysis
  • severe muscle weakness
  • numbness

Doctors may recommend surgery to treat some of these issues or reduce future risks. Surgery doesn’t improve your life expectancy with multiple myeloma, but it may improve your quality of life.

Surgical options include:

  • Internal fixation: A surgeon stabilizes your bones with plates, screws, or rods.
  • Arthroplasty: A surgeon replaces your joint with an artificial one.
  • Kyphoplasty and vertebroplasty: This minimally invasive procedure treats spinal compression by inflating a balloon to create more space in your spinal bone, which a surgeon then fills with cement.

Solitary plasmacytoma is a rare medical condition in which abnormal plasma cells form a tumor in one area of your bones. Without treatment, it can progress to multiple myeloma.

The risk of a solitary plasmacytoma progressing to multiple myeloma ranges from 10% to 60% within 3 years, depending on specific features of the tumor.

Radiation therapy is the primary treatment for solitary plasmacytoma. But people who undergo radiation with surgery tend to have better outcomes.

According to a 2023 study that involved more than 6,500 people with plasmacytoma from 2004 to 2017, the median survival time after surgery was 112 months. The median survival time for a combination of surgery and radiation therapy was 132 months.

However, doctors may delay radiation therapy until after surgery.

Some people undergo surgery as part of the diagnostic process, which may involve total or partial removal of the tumor.

Recurrence of the disease is possible if doctors don’t fully remove the tumor or if they don’t combine surgery with radiation. Due to the risk of recurrence, doctors may closely monitor you after surgery.

While surgery for bone disease in multiple myeloma may help improve quality of life, 2020 research suggests that people who undergo these surgeries may have a higher risk of complications and early death.

A 2023 study found that people who received spinal surgery for multiple myeloma had a higher chance of experiencing the following health complications:

  • postoperative infection
  • bone weakening
  • pseudoarthrosis (bones that don’t heal properly)
  • hardware or implant failure (mechanical issues with orthopedic hardware)

While surgery can’t treat multiple myeloma itself, doctors may recommend other procedures, such as a stem cell transplant (aka bone marrow transplant).

This doesn’t require surgery like an organ transplant. Instead, it involves receiving an infusion of healthy blood-forming stem cells.

You’ll first need to undergo high dose chemotherapy (and sometimes radiation) to eliminate any cancerous cells in your bone marrow.

Stem cell transplants for multiple myeloma are typically autologous, meaning they use your own stem cells. This doesn’t cure multiple myeloma but may provide a period of remission. Allogeneic stem cell transplants — meaning the stem cells come from a donor — may be curative in theory but have yet to be proven safe or effective.

Standard treatments for multiple myeloma

Typical treatments for multiple myeloma include:

What’s the most successful treatment for multiple myeloma?

According to the National Cancer Institute (NCI), the standard treatment for multiple myeloma is a combination of:

Regarding success rates, the NCI also reports that adding the targeted therapy drug daratumumab (Darzalex) to the standard treatment of multiple myeloma was more successful than standard treatment alone.

Can you fully recover from multiple myeloma?

There’s not currently a cure for multiple myeloma. While some people can achieve remission, most will experience relapse, or the disease will become refractory.

Relapse is when cancer returns after successful treatment. When multiple myeloma becomes refractory, it means it’s not responding to treatment.

Your healthcare team will work with you to develop a treatment plan to increase your chance of remission.

What is the longest you can live with multiple myeloma?

Survival rates for multiple myeloma vary widely and depend on several factors. According to the ACS, about 57% of people with multiple myeloma will live at least 5 years compared to people who don’t have the disease.

The Canadian Cancer Society notes that some people live longer than 10 years.

Multiple myeloma is a rare form of cancer that affects the bones. While the standard treatment for this cancer involves chemotherapy, targeted therapy, and immunotherapy drugs, surgery may be recommended if there have been any complications.

Treating multiple myeloma with surgery is rare but can be lifesaving for some people. If you have any concerns about surgery for multiple myeloma, contact your healthcare team for professional medical advice.