Chemotherapy
One of the standard treatments for stage 1 multiple myeloma is chemotherapy. Chemotherapy works by administering medications that poison and kill cancer cells--sometimes by damaging their DNA and sometimes by other mechanisms. One agent that can be used for stage 1 myeloma is called Bortezomib. This drug blocks the action of proteins that break down the connective tissue that surrounds the cancer cells, making it hard for cancer cells to remodel their environment (which they need to do in order to get blood and nutrients). Another medication is called Lenalidomide. It is similar to a drug called thalidomide, which used to be given to women suffering from morning sickness due to pregnancy. Aside from being a sedative, this medication is effective at treating newly diagnosed cases of multiple myeloma partly by directly killing the cells and partly by making it difficult for myeloma tumors to make new blood vessels for nutrient supply.
Radiation
Radiation treatment uses high energy X-ray beams that cause DNA damage to cells that are dividing. Because the cancer cells in myeloma patients divide more rapidly than normal cells, radiation treatment preferentially kills the cancer cells. One hazard of radiation treatment is that it can damage the surrounding (normal) cells, but in the case of early stage myeloma, this is less of a concern because myeloma is a cancer of the bone marrow. Even if the healthy bone marrow cells are damaged, they can grow back.
Transplantation
One treatment that may not be an option for all people with stage 1 myeloma but can be highly effective when used is transplantation. Patients who are healthy enough to go through the transplant process first receive an intensive course of chemotherapy, which is used to kill off all of their bone marrow. Then they receive a bone marrow transplant, either from a donor or from their own "stem cells," which are cells present in the patient's blood that have the ability to regrow bone marrow. Once a patient has received a bone marrow transplant, another course of chemotherapy (typically mild) is usually given to ensure that all of the cancer cells are gone.
