With current treatment advances in multiple myeloma, people are living with the disease longer than ever before. However, in order to maintain quality of life, the long term side effects of multiple myeloma must be recognized and managed properly, which ultimately requires a team of physicians, nurses, and other clinicians. According to Dr. Sid Ganguly, a multiple myeloma specialist at the University of Kansas, “It takes a village to help a patient.”
Some of the long term side effects for multiple myeloma are:
Neuropathy normally occurs either from the disease or from treatment with proteasome inhibitors. About two-thirds of patients stop experiencing neuropathy once they stop treatment with these inhibitors. An additional 20% of patients at least improve their neuropathy over time. About 15% of patients with multiple myeloma, however, experience long-term disabling neuropathy, which must be managed by a team of pain doctors, anesthesiologists, psychologists, and oncologists over time.
Bone damage is caused because myeloma resides in the bone marrow. It can be alleviated by biphosphonates, a drug given orally or intravenously to prevent loss of bone density, as well as vitamin D and calcium supplements.
Dangerous blood counts can be a long term consequence of bone marrow damage caused by stem cell transplant and chemotherapy. Periodic blood transfusions can be given to resolve low blood counts.
Development of second cancer may result from damage and transformation of the bone marrow caused by transplant, chemotherapy, and long term lenalidomide use. Also, people who have developed one type of cancer are at risk for development of others.
Proper treatment for multiple myeloma takes years and sometimes decades, so consistent communication with your physicians is key to maintaining a high quality of life. Ganguly advises that patients remain vigilant and air on the side of caution in managing their long-term side effects. “An informed patient is always the best patient…If you see a new mole, get it checked out. If you see a new lump, get it checked out. If your counts are low, get it checked out.”
In some cases, multiple myeloma patients will be put on something called maintenance therapy after initial treatment, in order to “maintain” myeloma in a depleted state.
The maintenance phase of multiple myeloma treatment aims to “maintain” the cancer in its depleted state after other treatments. We asked some of the top doctors in the field to explain how it works.
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Continuous Use of Lenalidomide
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