This summer I am sharing guest blogs from a variety of experts. This week’s blog is the fifth and final installment in a multi-part series about multiple myeloma from my colleague Dr. Margaret Henderson who has a Doctor of Pharmacy degree from the University of Colorado.
–Dr. Stephen Vogt
Welcome to the final part of the 5-part patient education series on multiple myeloma. Multiple myeloma, a form of cancer affecting the bone marrow, is diagnosed in approximately 30,000 Americans each year. In this disease, malignant plasma cells (which are a type of white blood cell) start growing out of control and can create multiple tumors in the bones. The cancerous plasma cells can also crowd out other cells in the bone marrow, leading to lower blood counts and anemia.
TREATMENT OF MULTIPLE MYELOMA COMPLICATIONS
Multiple myeloma does not only cause tumors, it may also cause a myriad of other complications, some of which can be life-threatening. Thus, when treating patients diagnosed with multiple myeloma, it is important to monitor and appropriately manage the multiple myeloma-related complications.
Elevated Serum Calcium Levels: This develops when bone is lost, and may require treatment with agents that act against bone loss.
- Zometa (zoledronic acid)
- Aredia (pamidronate)
- Oral bisphosphonates (e.g., Fosamax [alendronate]; Boniva [ibandronate], Actonel [risedronate])
Kidney Dysfunction: Effects of kidney dysfunction is one of the main reasons patients present to the healthcare system for treatment, resulting in a diagnosis of multiple myeloma. Treatment includes the following:
- Rehydration with IV fluids;
- Dialysis may be necessary in patients who have progressed to kidney failure
- It is important to note that advanced degrees of kidney dysfunction are not reversible, even if a patient begins and responds to treatment for multiple myeloma.
Bone Pain and Fractures: This is another reason patients present to the healthcare system for treatment, resulting in a diagnosis of multiple myeloma. Treatment may include the following:
- Analgesics may be used in patients with no evidence of bone loss
- Radiation therapy
- Bisphosphonates (both IV and oral)
Spinal Cord Compression: This complication requires prompt attention to prevent irreversible damage, such as paralysis. Treatments may include:
- Radiation and steroid therapy to reduce swelling around the spinal cord
- Surgery may be necessary in patients who don’t respond to radiation and steroid therapy
Anemia: This complication is characterized by fatigue and may require red blood cell transfusions. Debilitating fatigue that fails to improve over a specified amount of time, is another reason many patients present to their healthcare provider, resulting in a diagnosis of multiple myeloma.
I hope this blog series on multiple myeloma has been helpful to understanding the diagnosis and treatment of this form of cancer.