Watchful waiting for multiple myeloma

Last medical review:

Watchful waiting means that your healthcare team watches the cancer closely rather than giving other treatment right away. They will use tests and exams to see if the multiple myeloma is progressing or your condition is getting worse. Other treatment is given when you develop symptoms or the cancer changes.

This approach helps avoid side effects that can happen with treatments such as targeted therapy or stem cell transplants. There is no evidence so far that people won't live as long when they get watchful waiting compared to other treatments. And there is no evidence that watchful waiting has other negative effects if or when you start treatment.

You may be offered watchful waiting if:

  • you don't have any symptoms of multiple myeloma
  • the cancer is progressing very slowly and isn't affecting your health

Expert review and references

  • Guido Lancman, MD, MSc
  • Bergstrom DJ, Kotb R, Louzada ML, et al. Consensus guidelines on the diagnosis of multiple myeloma and related disorders: recommendations of the Myeloma Canada Research Network Consensus Guideline Consortium. Clinical Lymphoma, Myeloma and Leukemia. 2020: 20(7):e352–e367.
  • Mikhael J, Ismaila N, Cheung MC, et al. Treatment of multiple myeloma: ASCO and CCO joint clinical practice guideline. Journal of Clinical Oncology. 2019: 37(14):1228–1263.
  • Rajkumar SV. Multiple myeloma: 2022 update on diagnosis, risk-stratification and management. American Journal of Hematology. 2022: 97(8):1086–1107.

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