Managing symptoms and complications of myeloma
Myeloma can cause symptoms if it affects areas of the body such as the bones, kidneys, blood or nerves. Controlling these symptoms is often an important part of your treatment.
Your doctor will see you regularly for blood tests and x-rays, and to talk to you about how the myeloma is affecting you. Not everyone has symptoms, and some people may only have mild symptoms. Always tell your doctor and nurse about any symptoms or problems you may have. There are different ways that symptoms and possible complications can be managed.
Myeloma, and some treatments for it, can affect your ability to fight infections. Your doctor or nurse will talk to you about infections and possible signs of an infection to be aware of. They may give you drugs to help prevent an infection (prophylactic drugs). They may also advise you to have vaccines such as the flu vaccine.
If you are getting a lot of infections, your doctor may give you a regular infusion (drip) of immunoglobulins. This is given into a vein and can help to improve your immune system.
Most people feel fine when having an immunoglobulin infusion, but sometimes it can cause an allergic reaction. This is most likely to happen during or after the first infusion. To reduce the chance of a reaction, the first infusion is given slowly.
Myeloma or its treatment can reduce the number of red blood cells in your blood. This is called anaemia. This can make you feel tired and breathless.
Your doctor may suggest that you have a blood transfusion. The blood is given into a vein in your arm. Some people have a drug called erythropoietin (EPO) instead of a blood transfusion. This drug encourages your bone marrow to make more red blood cells. It is usually given as an injection under the skin (subcutaneously).
The paraprotein and light chains produced in myeloma can damage the kidneys. Calcium may also leak out of damaged bones (hypercalcaemia) and build up in the blood. This can also cause kidney problems.
Kidney problems can cause symptoms such as:
- passing less urine (pee) than usual
- reduced appetite
- feeling sick or being sick.
Not everyone has symptoms. But you will have regular blood tests to check for kidney problems.
You can help protect your kidneys by drinking plenty of fluids. Try to drink at least 3 litres (5 pints) each day. Always check with your doctor or nurse before taking painkillers called non-steroidal anti-inflammatory drugs (such as ibuprofen). These can cause kidney problems.
If your kidneys are affected, you may have fluids given through a drip (infusion). This helps your body to flush the waste products out of your kidneys into your urine. Treatment for myeloma usually reduces the amount of paraprotein in the blood and helps with kidney problems.
Sometimes kidney damage is severe and the kidneys stop working altogether. This is called kidney or renal failure. It means the blood is not filtered properly and you do not produce any urine. Extra fluid and waste products, which are usually passed as urine, begin to build up in the body. If this happens, you may need to have your blood artificially filtered. This is called kidney dialysis.
Some people who need kidney dialysis only have it for a short period of time. Other people need long-term dialysis. Your doctor and nurse will talk this over with you and you will be given lots of support.
Myeloma and its treatment can affect the nerves in your hands or feet. This can cause tingling, numbness, or a feeling like pins and needles. This is called peripheral neuropathy. You may find it hard to fasten buttons or do other fiddly tasks. Your doctor or nurse will tell you if you are having a treatment that may cause this side effect.
Let your doctor or nurse know if this happens. If it is caused by your treatment, they may need to lower the dose. Or your doctor may talk to you about whether you could have a different treatment. Usually, peripheral neuropathy gets better when treatment is over, but it can sometimes be permanent.
Myeloma, and its treatment can cause sickness and problems with appetite. Your doctor can prescribe anti-sickness (anti-emetic) drugs for you. Let them know if your anti-sickness drugs are not helping as there are different types you can take.
We have more information about nausea and vomiting.
Myeloma, and some treatments for it, can increase your risk of developing a blood clot. Symptoms of a blood clot include:
- pain, redness or swelling in a leg or an arm
- chest pain.
Blood clots can be very serious. Tell your doctor straight away if you have any of these symptoms. Most blood clots can be successfully treated with drugs that thin the blood.
Sometimes doctors may give you drugs to reduce the risk of a blood clot. We have more information about blood clots.
Rarely, myeloma causes a very high level of paraprotein in the blood. This means the blood can become thicker than normal. This is called hyperviscosity syndrome. It can cause symptoms such as:
- blurred vision
- abnormal bleeding
You may need a plasma exchange (plasmapheresis). This is a procedure that removes the abnormal paraprotein from the blood.