Multiple myeloma is one type of cancer where thalidomide is now being used and further tested. Early results have shown some benefit in people who have not responded to normal chemotherapy.

Thalidomide became notorious in the 1960s when it was used to treat morning sickness during pregnancy and was found to cause birth defects. The birth defects occurred because thalidomide interferes with the growth and development of new blood vessels, and did so in the developing babies.

Cancers also need to produce a network of new blood vessels in order to grow. Without forming these blood vessels cancers cannot grow and so thalidomide is being looked at in clinical trials to see if it can be used as a treatment for some types of cancer. Researchers are hoping to use it to prevent myeloma growing by preventing the development of new blood vessels and possibly also reducing the supply of oxygen and nutrients. Drugs that interfere with blood vessel growth in this way are called angiogenesis inhibitors or anti-angiogenics.

At the present time it is not certain how many people with myeloma are likely to benefit and how long such improvements might last. It is not even certain what the best dose of thalidomide is for myeloma. These results are encouraging in that they offer the possibility of a new approach to treatment in myeloma but the work is still very much at a research stage and clinical trials are continuing to decide whether the treatment is worthwhile, how it is best given and which patients which myeloma should receive it.

Because thalidomide can cause birth defects, its use is strictly controlled. It can only be prescribed by a hospital specialist and you will receive no more than 4 weeks supply at a time which means that you will need to see the specialist more frequently. You will need to sign a consent form and may have to be registered with the drug company that produces thalidomide. Registration will involve a confidential telephone survey.

Women taking thalidomide should not become pregnant and they will have to undergo a pregnancy test before starting treatment. If women are able to get pregnant they must use two methods of contraception at the same time, every time they have sex, and men taking thalidomide must use a condom. These precautions are advised for 4 weeks before starting treatment, during treatment and for 4 weeks after treatment has finished.