Treating Symptoms of Multiple Myeloma During Treatment

Possible Multiple Myeloma Symptoms

Multiple myeloma may cause no symptoms or mild symptoms at first. When symptoms are present, they often mimic those of other illnesses. This makes it difficult to distinguish multiple myeloma from other health conditions.

The most common symptoms of multiple myeloma include:

• Bone pain: Because cancerous cells affect the health of the bones, many experience bone pain as a result of bone damage or tumors. This may involve pain in the spine or other areas of the body. Some describe the pain as a dull ache, while others feel sharp and stabbing sensations.
• Osteoporosis: Bone lesions and damage to healthy bone tissue can lead to osteoporosis. This condition decreases bone mass and is marked by an increased risk of fractures.
• Fatigue: The multiple myeloma disease process can cause changes in blood cell counts, which contribute to fatigue.
• Kidney trouble: Sometimes the disease can cause kidney problems due to the excess accumulation of abnormal proteins in the blood. Your kidneys may become overworked, leading to damage or kidney failure. Signs of kidney trouble include back pain or flank pain, changes in the amount of urine you produce, and increased blood creatinine levels.
• Anemia: A low red blood cell count results from cancerous cells interfering with the maturation of red blood cells in the bone marrow. Symptoms include fatigue, shortness of breath, lightheadedness, and paleness.
• Elevated blood calcium levels (hypercalcemia): When multiple myeloma causes bone destruction, the calcium that was stored in those bones releases into the blood. Symptoms of elevated blood calcium include bone pain and/or weakness, abdominal pain, nausea, and confusion.
• Weakened immune system: A lower than normal white blood cell count (leukopenia) can contribute to a decrease in immune function, making you susceptible to serious infections.
• Increased bleeding: Changes in your blood platelet count (thrombocytopenia) can cause problems with normal blood clotting, leading to easy bruising and bleeding. This can be seen as petechiae (flat red or purple spots under the skin) and purpura (red, purple, or brown spots on the skin).

Managing Multiple Myeloma Symptoms

You can manage many of these symptoms by working closely with your health care team. Your doctors will determine whether they’re related to the disease's progress or to the treatment.

"It's nice to have a medical team of doctors, nurses, and pharmacists that are comfortable treating multiple myeloma and can help you as a patient, parse out what symptom is from the illness and what symptom is from which medication so adjustments can be made," adds Dr. Hoffman.

As the induction phase progresses and your multiple myeloma responds to treatment, many of the symptoms related to the myeloma will decrease. While side effects related to the actual treatment process are still common, the actual symptoms of disease progression should be lessening.

"By assessing the myeloma, how active is it at a given point in time, and by carefully listening to the patient about the nature and intensity and pace of their symptoms, you can parse out the cause and help improve the symptoms with appropriate adjustments," concludes Dr. Hoffman.

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