How often should I get scans to monitor my Multiple Myeloma

Monitoring Scans for Multiple Myeloma

This is an important question, and the answer depends on several factors specific to your situation. Let me explain what the guidelines recommend and what questions to ask your care team.

What the Guidelines Say About Follow-Up Testing

According to the NCCN Guidelines for Patients: Multiple Myeloma, follow-up tests are a critical part of your care plan. These tests let your care team know if your primary treatment is working and help monitor your disease over time.

The guidelines emphasize that follow-up tests should include imaging scans, but the specific frequency isn't one-size-fits-all. Here's why:

Factors That Affect Your Scan Schedule

Your scan frequency depends on:

• Your treatment phase (initial treatment vs. maintenance vs. monitoring for relapse)
• How well your myeloma is responding to treatment
• Your disease status (newly diagnosed, in remission, progressing, or relapsed)
• Your specific treatment plan (whether you had a transplant, what drugs you're on, etc.)
• Your individual risk factors and disease characteristics

Common Imaging Tests Used for Monitoring

According to NCCN Guidelines, the main imaging tests for follow-up include:

• PET/CT scans - Excellent at showing where active myeloma is located in bones and elsewhere
• Low-dose CT scans - Used to check for lytic bone lesions (bone damage)
• MRI scans - Particularly useful for certain situations and soft tissue evaluation
• Bone surveys - X-rays of your skeleton (less commonly used now than PET/CT)

Blood and Urine Tests Are Also Important

Don't forget that imaging is just part of monitoring. The NCCN Guidelines emphasize that follow-up also includes:

• Blood tests (CBC, metabolic panel, immunoglobulin levels)
• M protein testing in blood and urine - This should be done at least every 3 months
• Free light chain assays
• Tests for proteins and light chains in urine

These blood and urine tests are often done more frequently than imaging and can show how well treatment is working.

Questions to Ask Your Oncology Team

Since monitoring schedules are personalized, here are specific questions to discuss:

1. "Based on my specific diagnosis and treatment plan, how often should I have imaging scans (PET/CT, CT, or MRI)?"

2. "How often will I need blood and urine tests to monitor my M protein levels?"

3. "What signs or symptoms should prompt me to call you between scheduled scans?"

4. "If my scans show good response, will the frequency of monitoring change?"

5. "What happens if my scans show progression—how will that affect my monitoring schedule and treatment?"

Key Takeaway

The NCCN Guidelines make clear that regular monitoring is essential because myeloma often comes back and requires additional treatment. However, your specific scan schedule should be determined by your oncologist based on your individual case, treatment response, and disease characteristics.

Your care team will create a monitoring plan tailored to you—this isn't something with a universal schedule that applies to everyone with myeloma.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.