We’ve seen data before by the Mayo Clinic and the University of North Carolina showing that multiple myeloma patients who are seen by a myeloma specialist live longer. A new, recent study  supports these findings. 

A state cancer registry linked to public and private insurance claims was used to identify 1029 myeloma patients from 2006 – 2012. The study evaluated the difference in overall survival between:

1. NCI-designated cancer centers
2. Primary oncologists’ volume of patients with myeloma
3. Patient sharing between local oncologists and myeloma specialists

The study found that:

• Patients treated at an NCI Cancer Center lived longer than those who did not.
• Patients treated at an NCI Cancer Center lived longer than those treated by low-volume and high-volume community providers.
• No difference was seen between treatment by myeloma specialists and the highest-volume community oncologists in the ninth and tenth deciles (eg. the same approximate number of patients seen by the NCI Cancer Centers).
• Patients treated by community oncologists had a higher risk of death regardless of patient-sharing with myeloma specialists, compared to those only treated by myeloma specialists.

Reasons why patients didn’t obtain treatment from NCI designated Cancer Centers included older age, governmental insurance (eg. Medicaid), not being married and increased distance from the NCI center.

There is solid evidence that patients who have multiple myeloma should be seen by a myeloma specialist, especially at diagnosis and relapse. If patients are seen in the community setting, it should be only by oncologists or hematologists who have extremely high myeloma patient volumes (as much as an NCI Cancer Center which is typically 500-2000 myeloma patients per year). Experience matters!