Multiple Myeloma

WHAT YOU SHOULD KNOW:

Multiple Myeloma (Inpatient Care) Care Guide

  • Multiple myeloma is also called myeloma. It is a cancer of the white blood cells (WBCs) which are called plasma cells. Normally, your body makes more WBCs and plasma cells only when fighting diseases and infections. Myeloma occurs when myeloma cells (abnormal plasma cells) grow and divide without control or order. These cells often make too much tissue (tumor). There is no known cause of multiple myeloma but you cannot catch it from someone else. You may be at higher risk if you are exposed to radiation and certain chemicals, such as herbicides or pesticides. The most common symptom of myeloma is bone pain, usually in the back or ribs. You may also have frequent infections, bone fractures (breaks), weakness, or trouble urinating or having a BM.

  • Myeloma is diagnosed by checking monoclonal (M) proteins in your blood or urine. Other tests may also be done, such as a computerized tomography (CT) scan or bone marrow biopsy. Treatment may include chemotherapy, radiation, or bone marrow transplant. Surviving myeloma depends upon how far it has spread when the cancer is found. The chances of controlling myeloma are better when it is found and treated early.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Treatment for multiple myeloma may cause unpleasant side effects. Radiation and chemotherapy can cause nausea, vomiting, hair loss, and diarrhea. In a bone marrow transplant, you may have infections or the new bone marrow cells may attack your tissues. Sometimes even with treatment, your cancer may spread or return. If the cancer is not treated, it may spread to other parts of your body. Once cancer spreads, it becomes more difficult to treat and other serious problems may develop. Ask your caregiver if you are worried or have questions about your disease, medicine, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Diet:

It is important that you get good nutrition when you have cancer. Eat a variety of healthy foods. Eating healthy foods may help you feel better and have more energy. If you have trouble swallowing, you may be given foods that are soft or in liquid form. Ask your caregiver about any extra nutrition you may need, such as nutrition shakes or vitamins. Tell your caregiver if you have problems eating, or if you are getting sick to your stomach.

Medicines:

You may be given the following medicines:

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Bisphosphonates: These medicines may strengthen your bones and decrease bone fractures (breaks ).

  • Immune globulins: This medicine is given as a shot or an IV infusion to make your immune system stronger. You may need immune globulins to treat or prevent an infection. It is also used when you have a chronic condition, such as lupus or arthritis. You may need many weeks of treatment. Each infusion can take from 2 to 5 hours.

  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Tests:

You may have one or more of the following tests:

  • Bone marrow biopsy: This is when a sample of bone marrow is removed and sent to a lab for tests. Bone marrow is the soft, spongy tissue inside the bone. The skin over your upper hipbone is first cleaned. Caregivers put numbing medicine into your skin so you will have little pain. A bandage is put on the biopsy area after the tissue sample is taken.

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Imaging tests:

    • Chest and skeletal x-rays: These are pictures of the ribs and other bones in your body. Caregivers use the x-rays to see if other bones are affected by the cancer. The x-rays will also tell caregivers if the cancer has spread to your lungs. Bone x-rays also show if any of your vertebrae (bone in your spine) have collapsed onto one another.

    • Computerized tomography scan: This test is also called a CT or CAT scan. An x-ray machine uses a computer to take pictures of a specific part of your body. It may be used to look at your brain, bones, muscles, and blood vessels.

    • Magnetic resonance imaging: This test is also called an MRI. MRI uses sound waves and strong magnets to take pictures of the brain, muscles, joints, bones, or blood vessels. Entering the MRI room with an oxygen tank, watch, or any other metal objects can cause serious injury. Tell your caregiver if you have any metal implants in your body.

    • Positron emission tomography scan: This test is also called a PET scan. The test can find tumors by tracing the way your body cells act upon sugar.

  • Serum protein electrophoresis: This blood test uses electrical current to find and measure M proteins in the blood or serum. Finding M proteins confirms the diagnosis of myeloma. This test can also show the specific type of abnormal protein produced by the myeloma.

  • Urine electrophoresis: Your urine is collected in a container for 24 hours and then sent to the lab. Special tests are done to measure "M proteins". M proteins are found in the urine of people with multiple myeloma. These proteins can damage the kidneys so this test helps caregivers know how much is in your body.

Treatment options:

You may have one or more of the following:

  • Bone marrow transplant (BMT): This is when your diseased bone marrow is replaced with healthy marrow. You are usually given bone marrow from someone else (a donor). Sometimes your own marrow may be used if it is collected when your cancer is in remission (not active). The bone marrow transplant is given to you in an IV while you are in the hospital. A BMT may cure your illness, but it can cause other very serious health problems. You may be in the hospital for a month after your BMT.

  • Chemotherapy:

    • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.

    • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.

  • Radiation: Radiation shrinks tumors and kills cancer cells with x-rays or gamma rays. Radiation may be given after surgery to kill cancer cells that were not removed. It may also be given alone or with chemotherapy to treat cancer.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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