If you think of multiple sclerosis as a disease that severely handicaps patients, you have an outdated impression.
It used to be the case that there were no good treatments for multiple sclerosis, an autoimmune disease that attacks the central nervous system (the brain, spinal cord, and optic nerve), causing symptoms like blurry vision, numbness, weakness, and difficulty walking, to name a few.
And it’s highly likely that when you think of a patient with MS, you think of someone with a case that’s progressed to the point that they may use a cane or walker or wheelchair to get around. Their disease had a huge impact on their mobility and quality of life.
“A lot of people do know people in their community, family members, who had MS before it was treatable and so a lot of people think of that as MS and of course that is MS, but that is untreated MS,” says neurologist Michelle Fabian, MD, an assistant professor of neurology at The Mount Sinai Hospital. “Now that we have treatments, we think the condition has significantly changed and that most people, if we diagnose them with MS and we put them on a treatment, they will stay steady, and that they will not develop progressive MS.”
While there is no cure for MS, a comprehensive treatment approach can slow the disease progression, treat relapses, and manage symptoms, according to the National Multiple Sclerosis Society.
Newer medications, developed over the last two decades, have changed the game for many multiple sclerosis patients. In the days before such immune-modifying drugs were available, patients with relapsing remitting MS—the most common kind, in which patients experience MS flares where symptoms get worse, then periods of remission—would develop progressive MS within 10 to 20 years of being diagnosed. (In progressive MS, symptoms develop gradually and get worse over time, without any periods of remission.)
“But we truly think now with our treatments, that that’s flipped, that most people now will not develop progressive MS,” says Dr. Fabian.
In her practice, Dr. Fabian says she now diagnoses patients with MS with a message of hope.
“It’s a very different diagnosis than it was 30 years ago when we didn’t have treatments,” she says. “So now what I tell patients is, you know, we’ve listened to your story. We’ve looked at your MRIs and they are consistent with having multiple sclerosis, but this is a treatable condition, and I expect that you’re going to continue to live your life and it might not actually change much from before you knew you had the diagnosis.”
Dr. Fabian is the assistant professor of neurology at The Mount Sinai Hospital in New York City.
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I think that people,
when they're first diagnosed,
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they do assume that their life is gonna
have to very significantly change.
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It does for some, so I don't wanna
discount that, but for most people,
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they will just continue
to do what they're doing.
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They don't have to severely limit
themselves in their goals for
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the future, or what they thought
their life was gonna be like.
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A lot of people do know
people in their community,
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family members who have MS
before it was treatable.
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a lot of people think of that as MS.
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And of course that is MS,
but that is untreated MS.
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Now that we have treatments, we think
the condition has significantly changed.
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And that most people,
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if we diagnose them with MS, we put them
on a treatment, they will stay steady.
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And that they will not
develop progressive MS.
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When I tell somebody that
they have a diagnosis of MS,
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I always give that message with
a message of hope as well,
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because we have really good treatments for
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And so, it's a very different
diagnosis than it was 30 years ago
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when we didn't have treatments.
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So now what I tell patients is,
we've listened to your story,
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we've looked at your MRIs and they are
consistent with having multiple sclerosis.
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But this is a treatable condition and
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I expect that you're gonna
continue to live your life.
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And it might not actually change much
from how it was before you knew you had
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I do have many patients who tell me,
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the only reason I remember I have
MS is because I take treatment.
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But, of course,
other people do have daily symptoms.
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And so that's a kind of
a patient to patient thing.
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But most patients find that they can't
continue go on living their life with it.
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Comprehensive care. New York, NY: National Multiple Sclerosis Society. (Accessed on December 20, 2017 at https://www.nationalmssociety.org/Treating-MS/Comprehensive-Care.)
Patient education: multiple sclerorsis in adults (the basics). Waltham, MA: UpToDate. (Accessed on December 20, 2017 at https://www.uptodate.com/contents/multiple-sclerosis-in-adults-the-basics.)