Multiple Myeloma and Palliative Care
Multiple myeloma is a hematologic cancer. In other words, it grows in the blood. Damaged blood plasma cells start to rapidly reproduce and grow out of control. These cancerous cells then crowd out other blood cells and interfere with the immune system and bones.
The human blood system contains several types of cells that are necessary for a healthy immune system to protect the body from infection. Plasma cells are a type of white blood cell that are made in the soft and spongy bone marrow located at the center of large bones. They make the antibodies that help the body recognize, attack and kill germs.
Understanding Palliative Care
Palliative (pronounced “pal-lee-uh-tiv”) care is specialized medical care for people with serious illness. It focuses on providing you with relief from the symptoms, pain and stress of a serious illness like multiple myeloma. The goal is to improve quality of life for both you and your family.
Palliative care is provided by a team of doctors, nurses, social workers and other specialists who work alongside your other doctors to provide an extra layer of support. It is appropriate at any age and at any stage of your illness. You can have it together with curative treatment.
Treating the Symptoms of Multiple Myeloma—How Palliative Care Can Help
Although typically the disease cannot be cured, patients can live with multiple myeloma for years. Recent advances in treatment have turned it into a chronic, long-term illness that is manageable with good care.
Symptoms of multiple myeloma, however, start to build up over time. These can include pain, fatigue (feeling weak or tired) and bone fractures. And that’s where palliative care can make a big difference.
Typical treatment for multiple myeloma includes chemotherapy, a common therapy to kill cancerous cells. Other multiple myeloma treatments include bisphosphonates, which are drugs used to strengthen bones in arthritis patients. Steroids are often used to reduce inflammation and pressure in the bones, which can help with pain. Thalidomide may also be used to strengthen your immune system.
The most common complaint for people facing multiple myeloma is pain. Sometimes you may experience bone pain from lesions that make holes in the bone. These lesions can get into the bone marrow and leave you prone to fractures.
Bone pain is also related to nerve pain. It does not always respond as well to the standard pain drugs used for other forms of cancer. Often, treating this pain calls for the advice of a specialist in complex pain disorders and in the different drugs that are most effective with bone pain.
Other symptoms of multiple myeloma include anemia (low red blood cell count) and extreme fatigue—the kind of terrible tiredness that drains quality of life. There are good treatments available for both anemia and fatigue, including blood transfusions and psychostimulants.
While chemotherapy helps your body to fight cancer, the side effects of chemotherapy can damage normal cells. You may experience infection, bleeding, nausea and vomiting, loss of appetite and hair loss. Your damaged immune system may also leave you at risk for infections such as pneumonia, shingles and urinary tract infections. Additional symptoms may include depression and anxiety.
The symptoms and side effects of multiple myeloma tend to make life harder for you and your family.
Palliative care specialists have particular expertise in treating the symptoms of multiple myeloma. They help you to understand complex medical information, and to match your treatment choices to your personal needs and goals. In all ways, your palliative care team helps you to better cope with the challenges of multiple myeloma.
Your team will be your sounding board and your first line of defense against any symptoms of pain, discomfort, depression or anxiety.
The team specialists will help you and your loved ones make both large and small decisions. They will enhance communication between you, your family and your other doctors, and help you to clarify your goals for care.
Because the disease often has a longer course, it is possible to develop a long-term relationship with your palliative care team. You can look to the team specialists for guidance on any tough questions and important decisions that lie ahead. No matter what direction your disease takes, palliative care will be with you every step of the way.
Debbie’s Palliative Care Story: Living Well with Multiple Myeloma
How to Get Palliative Care
If you or a loved one is facing multiple myeloma, ask your doctor for a referral to palliative care—the earlier the better. You can receive palliative care in the hospital, at an outpatient clinic and sometimes at home.
Although living with multiple myeloma is a difficult journey, your burden may be eased and the best possible quality of life achieved when palliative care is involved.