How Men and Women Make Multiple Myeloma Treatment Decisions

How do men and women with relapsed or refractory multiple myeloma evaluate their treatment options, and are there differences between genders? 

In 2023 and 2024, HealthTree Foundation facilitated a Decision-Making Survey that included responses from 289 relapsed/refractory myeloma patients with a mean age of 66 years. Among respondents, 53% were female and 47% were male. 

The survey focused on three key domains: 

1. Treatment-Related Factors – Including potential side effects, supportive care needs, and medical efficacy.
2. Patient-Related Factors – The impact of emotional state, quality-of-life concerns, and physical condition.
3. Educational Resources – Sources of information that guide treatment decisions.

Treatment-Related Factors 

Both men and women cared most about efficacy, or how well a treatment was working. However, differences were seen for secondary priorities. 

• Potential Side Effects: Women were more likely than men to rate potential side effect severity as very or extremely influential (58% vs. 38%). 
• Supportive Care Needs: The burden of supportive care requirements, such as assistance with daily activities and caregiver support, was also more influential for women.

These findings show that women are more likely to weigh the practical implications of care and its impact on daily living. 

Patient-Related Factors

• Quality of Life: Women placed greater emphasis on how treatment impacts their quality of life, with 61% of women rating it as very or extremely influential, compared to 49% of men.
• Emotional Well-Being: At the first therapy change, women rated emotional state (anxiety, stress) as more influential than men. This difference widened for subsequent treatment changes, with women scoring 2.7±1.4 compared to men at 1.8±1.2 (p < 0.05).
• Physical Condition (Frailty): Women were also more likely to consider their physical condition when making treatment decisions. Frailty was rated as very or extremely influential by 37% of women compared to 21% of men.

These findings spotlight women’s emphasis on emotional and physical well-being more heavily in their decision-making than men. 

Educational Resources: Physician vs. Patient Advocacy Websites

Men and women both regarded their healthcare provider as their main source of information (89% of women and 92% of men). 

Women were more likely to use advocacy websites for information, which use increased for subsequent relapses while men’s usage remained relatively constant. 

Personalizing Myeloma Treatment Decisions

While all patients want optimal outcomes, women place more emphasis on emotional well-being, quality of life, and practical support needs, and rely more often on patient advocacy resources.  

During shared decision-making in relapsed or refractory myeloma, it would be helpful for clinicians to understand these key differences in gender. Individualizing treatment means accounting for these types of gender-specific preferences. 

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Source: 

• Exploring gender-based decision-making differences among patients with relapsed/refractory multiple myeloma