You may receive supportive care to prevent or treat myeloma symptoms and therapy side effects. It's used for conditions such as:
- Treating Anemia. Fatigue is one of the most common complaints reported by myeloma patients. It can be caused by many factors, including disease-related anemia. In some patients with severe anemia due to the effects of chemotherapy, the administration of an engineered form of the red cell growth factor erythropoietin (EPO) may alleviate the anemia or decrease the need for blood transfusions. However, some studies suggest that correcting anemia too vigorously may increase the risk for blood clots. Also, in some forms of cancer, the use of EPO may be associated with a worse outcome, although this may not be the case in myeloma. Patients should discuss the risks and benefits of EPO therapy with their doctors.
- Treatment of bone pain. Bone pain may occur because the growth of myeloma cells in the bone causes bone thinning and lesions. Patients may also experience pain that radiates from the back when the back bones (vertebrae) collapse and press on the nerves. Fractures of bones may also result in pain.
- Vertebroplasty and kyphoplasty are surgical techniques that may be used to help myeloma patients who have back pain. With vertebroplasty, a chemical cement is inserted into the damaged or broken vertebrae through a catheter. Kyphoplasty involves inflating a balloon before stabilizing the area with the chemical cement. These procedures relieve bone compression and may alleviate pain and reduce the amount of pain medication that the patient needs.
- The use of bisphosphonates (pamidronate [Aredia®] and zoledronic acid [Zometa®]) can help reduce bone pain and the risk of bone fractures. These drugs also prevent the high levels of calcium in the blood that are the result of bone destruction.
- Denosumab (Xgeva®) is approved for the prevention of skeletal-related events in patients with multiple myeloma.
- Preventing Infections. Myeloma and its treatment can suppress parts of the immune system. To prevent infection
- IV immunoglobulin therapy should be considered for frequent and life-threatening infections.
- Pneumococcal and influenza vaccine should also be considered.
- Pneumocystis carinii pneumonia, herpes and antifungal prophylaxis is recommended if a high-dose regimen has been given.
- Bortezomib treatment is associated with an incidence of herpes zoster. Herpes prophylactic treatment should be considered in patients who are receiving bortezomib therapy.
- Maintaining Kidney Function. Myeloma patients may have serious problems with their kidney function. Timely, adequate treatment of myeloma can improve kidney function and, potentially, even return it to normal in most cases. When this is not the case, some patients may end up needing dialysis support. In rare cases, when patients present with very recent or acute kidney failure, a procedure known as “plasmapheresis and exchange” may be helpful in limiting kidney damage, though this approach is controversial. The most important and successful treatment for kidney failure secondary to myeloma is to treat the myeloma itself without delay. Drinking adequate amounts of water and other healthy fluids can flush the kidneys and help them filter impurities from the blood.
Some patients may need only supportive care for their myeloma if it's in an early stage, such as smoldering myeloma or asymptomatic myeloma, causing few or no symptoms. In this case, you may receive supportive care to prevent or treat any symptoms, but you won't receive treatment for the myeloma itself during this period. Instead, your doctor closely monitors you. This approach is called watch and wait.
- Disease Complications
- Watch and Wait
- Managing Side Effects
- Integrative Medicine and Complementary and Alternative Therapies
Download or order The Leukemia & Lymphoma Society's free booklet, Myeloma.