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Palliative Care for Multiple Myeloma

Medically Reviewed by Neha Pathak, MD on April 07, 2021

If you or a loved one has multiple myeloma, you may want to think about palliative care. Although it’s often mistaken for “end-of-life” care, palliative care simply means treating the symptoms, pain, and stress of a disease along with the disease itself.

Think of palliative care as a support system. You’ll see a team of doctors, nurses, and other specialists who work with your current doctors. They’ll help lessen side effects of your cancer treatment, ease symptoms of the disease itself, and offer emotional support.

You can get palliative care at a clinic, hospital, or sometimes even at home. Learn about some of the problems that palliative care can address.

Bone Damage and Pain

Multiple myeloma can weaken or break your bones. Bisphosphonates, a type of drug that helps strengthen the bones of people living with arthritis, can ease bone pain and reduce the risk of fractures. Steroids can relieve inflammation and pressure in your bones.

Palliative care providers might sometimes recommend radiation therapy (high energy X-rays) to provide quick relief from bone pain.

Spinal Fractures

The bone damage in multiple myeloma can include breaks in your spine. You can get a surgery for this called vertebroplasty or balloon kyphoplasty. The surgeon injects a special type of cement into your spine to help reduce spinal pain and make it easier for you to move around.

Kidney Damage

Kidney damage is common in multiple myeloma. If your kidneys aren’t working as they should, doctors can prescribe a diuretic (a drug that makes you pee more) to reduce the work your kidneys have to do. In some cases, you may also get dialysis -- a treatment that cleans waste from your blood when your kidneys can’t do the job themselves.

IV fluids can keep you hydrated and help you feel better, too.

Anemia

When myeloma cells crowd red blood cells out of the bone marrow, this can lead to anemia. Medications can help your body make enough red blood cells to carry oxygen throughout your body.

Iron, folate, and vitamin B12 can also help treat anemia. If your doctor doesn’t think you get enough through your diet, they may suggest a supplement.

In some cases, doctors recommend a blood transfusion to treat anemia.

Nerve Pain

Several drugs, including certain kinds of antidepressants, can lessen the painful “pins and needles” sensation that can come with multiple myeloma treatment. If your nerve pain is in one area, a numbing agent like lidocaine or a capsaicin patch can give short-term relief.

Some nutrients, like B vitamins and folic acid, help protect your nerves. Your care team may suggest a supplement if you don’t get enough from the food you eat.

Blood Clots

Some multiple myeloma medications raise your risk for blood clots. Blood thinners, like aspirin and heparin, can help keep blood clots from forming during your treatment. Your palliative care team may also suggest some things you can do to lessen your risk of clots, like wearing compression stockings.

Infections

Multiple myeloma damages your immune system, which can raise your risk for infections. You could get antibiotics by IV to treat an infection, or your doctor may give you a vaccine to prevent you from getting sick in the first place. In some cases, you may get immunoglobins (antibodies) from a donor to help your body fight off infections.

Fatigue

Feeling tired, even when you’re rested, is a common side effect of cancer treatment. Since physical activity can help, a physical therapist on your team can come up with an exercise plan to help you safely regain your strength and balance and prevent muscle wasting.

Stress, Anxiety, Sadness

Your palliative care team can also help you deal with the feelings you have as you go through cancer treatment. They can teach you new ways to cope with stress and other tough emotions. You can also ask them to refer you to a counselor or help you find a support group.

WebMD Medical Reference

Sources

SOURCES:

GetPalliativeCare.org: “Multiple Myeloma and Palliative Care.”

Multiple Myeloma Research Foundation: “Supportive Care: Living with Multiple Myeloma.”

Multiple Myeloma Hub: “Palliative Care in Patients with Multiple Myeloma.”

International Myeloma Foundation: “Multiple Myeloma and Anemia,” “Multiple Myeloma Pain.”

Cancers: “Pain Management in Patients with Multiple Myeloma: An Update.”

National Organization for Rare Diseases: “Multiple Myeloma.”

MyelomaCrowd.org: “Palliative Care in Hematologic Malignancies.”

Cochrane Database of Systematic Reviews: “Bisphosphonates in multiple myeloma: an updated network meta-analysis.”

Canadian Cancer Society: “Multiple Myeloma.”

Seattle Cancer Care Alliance: “Multiple Myeloma Treatment,” “What is Palliative Care?”

Memorial Sloan Kettering Cancer Center: “Managing Cancer-Related Fatigue with Exercise.”

Sports Medicine and Health Science: “Exercise as a therapy for cancer-induced muscle wasting.”

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