Taking Control of Relapsed/Refractory Multiple Myeloma

Medically Reviewed by Brunilda Nazario, MD on August 25, 2023
5 min read

Relapsed/refractory multiple myeloma (RRMM) is an ongoing condition with no cure. But there are many treatments and steps you can take to help you live well. Here are some of the more common symptoms of RRMM and tips on how to manage them.

Anemia is a blood disorder that happens when the bone marrow doesn’t make enough red blood cells to carry oxygen to the organs. It can cause you to feel short of breath, dizzy, and very tired.

What can help: 

  • Iron-rich foods. Red meat, chicken, turkey, and fatty fish are good choices. So are dark green leafy vegetables, tofu, beans and lentils, fortified cereals, and enriched pasta and rice.
  • Extra iron. Your doctor may suggest you start taking iron pills. If your red blood cell count is too low, a large dose of iron through an IV could ease your symptoms.
  • Erythropoietin. This hormone, which is created mainly in the kidneys, helps the bone marrow make red blood cells.
  • Blood transfusion. Your doctor may recommend a transfusion to treat anemia.

RRMM weakens your bones, which can cause pain and raise your risk for broken bones. Your spine, pelvis, and ribs tend to be the areas most likely to hurt.

What can help:

  • Pain-relief drugs. Your doctor can suggest over-the-counter pain medicines or prescribe something stronger based on your health, overall medical history, and any other medicines you might take. If your pain is really bad, your doctor may prescribe opioids – strong prescription painkillers. 
  • Radiation. Intense beams of energy can help manage bone pain. You might start to feel better in the first 2 weeks of treatment.
  • Surgery. Several types of surgery can safely ease pain from compression fractures to help stabilize your bones. For instance, surgeons can add a special cement into your spinal bones to help you regain your range of motion and stop any breaks from getting bigger.

You may have nerve pain as a possible side effect of chemotherapy (called neuropathy).

What can help:

  • Medicines. Several types of medicines, such as antidepressants and anti-seizure drugs, can sometimes ease nerve pain.
  • Pain patches. A skin patch may be able to soothe your pain by numbing the area. 
  • Acupuncture. In some cases, very thin needles placed under your skin at certain parts of your body can help nerve pain. Check with your doctor to see if acupuncture might help you.

RRMM damages your immune system, making it harder for your body to fight germs. You’re 15 times more likely to catch an infection than people who don’t have RRMM.

What can help:

  • Try to stay healthy. Wash your hands often, avoid people who might be sick, and stay up to date with your vaccines. If you get a cut or scrape, wash it well and cover it to protect it from germs.
  • Take care in the kitchen. You can catch some infections from the foods you eat. Wash fresh fruits and vegetables well, and use a food thermometer to make sure dishes you prepare are fully cooked.

RRMM can make it hard for bleeding to stop once it starts (a condition called thrombocytopenia). Some cancer treatments can make this condition worse. Your gums might bleed a lot when you brush your teeth, your skin might bruise easily, or your pee or poop might have blood in it. 

What can help:

  • Limit alcohol. If you drink, check with your doctor to see if any amount is safe for you to have. Your doctor may suggest you stick to nonalcoholic drinks.
  • Avoid over-the-counter products. Some drugs, like aspirin and ibuprofen, make your blood very thin, which could cause you to bleed more. Certain herbal remedies and supplements may also have this effect.
  • Take care of your teeth. Careful brushing and flossing helps prevent bigger dental issues that can trigger bleeding.
  • Skip activities that put you at risk. Any sport that puts you in contact with another person, like basketball or football, raises your risk of bruising and bleeding. Check with your doctor to confirm which activities are safe for you to do.

Because of  RRMM, your kidneys, which clean toxins from your blood, may not work well anymore. 

What can help:

  • Drink enough water and stay hydrated. Your pee should look clear. If it’s dark yellow, drink more fluids. If you feel you’re drinking enough fluids but peeing less, let your doctor know right away. 
  • Manage high blood pressure. Kidneys that aren’t working well, along with some cancer treatments and their related side effects, can raise your blood pressure. Try to limit the sodium in the foods you eat. Packaged and canned foods often contain large amounts. Lowering your stress levels with yoga, meditation, or deep breathing could also help.
  • Follow through with any treatments. If your kidney damage is very bad, you may need to have some of your blood cleaned with a process called plasmapheresis to stop the damage from becoming permanent. Another treatment called dialysis can help remove waste or extra myeloma proteins from your blood when your kidneys can’t.

Bone loss can push too much calcium into your blood. If not treated right away, this condition, which is called hypercalcemia, can sometimes be fatal.

What can help:

  • Know the symptoms. If you experience any of the following, call your doctor right away:
    • Not wanting to eat
    • Feeling very thirsty
    • Peeing more than usual
    • Having upset stomach
    • Throwing up
    • Finding it hard to sit still
    • Feeling confused
  • Bisphosphonates. These strong drugs can quickly lower your calcium levels. You can get the medicine through an IV at least once a year. If your calcium levels are very high, you may need to get other fluids or medicines in the hospital.

Let your doctor know which symptoms you have and how well your treatment and lifestyle changes work for you. You can also join a support group for people who live with RRMM. Talking to others who are dealing with some of the same symptoms you have may help you feel less alone.