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Treatments are available to alleviate the physical and emotional impact of myeloma. Early use of supportive care measures is just as important as initiating frontline therapy.

Myeloma Symptoms Requiring Supportive Care

Cancer or cancer treatment fatigue is a distressing, persistent, subjective sense of tiredness or exhaustion that is not proportional to recent activity and interferes with usual functioning. Three common causes of fatigue in myeloma patients are:

  • myeloma-induced anemia
  • high levels of cytokines
  • persistent pain

All can result in weight loss, decreased appetite, and fatigue and weakness. If your fatigue is the result of a source other than anemia, there are no laboratory tests that can be used to diagnose it. Your healthcare team will need to evaluate your situation and try to identify the source or sources of your fatigue and find ways to manage it most effectively.

Patients need to openly discuss their feelings of fatigue and weakness with members of their healthcare team. Do not think that feeling tired and weak is not important enough to mention at your appointments. Do take note of the following:

  • Time when fatigue is most noticeable
  • Medications that you are taking
  • Emotional stress, anxiety, or depression
  • Presence and location of physical pain
  • Existence of other conditions or illnesses
  • Sleep disturbances
  • Dietary changes
  • Changes in weight
  • Changes in activity or daily routine
  • Changes in health.


Anemia is very common in patients with multiple myeloma. In fact, at least 60%-70% of patients with multiple myeloma have anemia at the time they are diagnosed with the disease. Some of the therapies that successfully kill myeloma cells suppress the bone marrow’s ability to make needed blood cells.

If your doctor suspects you have anemia, a physical examination will be performed and your blood will be drawn for lab tests. Be sure to report to your healthcare team any of the following symptoms:

    • Shortness of breath
    • Lack of energy and motivation
    • Rapid heartbeat
    • Swelling in the legs, especially in the ankles
    • Dizziness
    •  Headache
    • Chills
    • Change in appetite
    • Decreased libido

Bone Disease
Multiple myeloma is characterized by a unique form of destructive bone disease which occurs in the majority of patients. Since patients may survive for many years post-diagnosis, clinicians have attempted to devise therapeutic approaches in myeloma that would relieve disabling symptoms, in particular severe bone pain, thereby improving quality of life. New therapies are still needed for myeloma bone disease. New targets have been identified and are being addressed in clinical trials.

Bone Lesions and Bone Loss: Up to 90% of myeloma patients develop bone lesions during the course of their dis­ease; 70% have bone loss in the spine. A vertebral compression fractures (VCF) occurs when the vertebra fractures or collapses because the bone is too weak to withstand the pressure or stress placed upon it. With multiple fractures, the spine shortens and becomes misaligned, causing a curvature of the spine known as “kypho­sis.” Pain occurs both suddenly, as a result of the movement of the fracture fragments, and often secondarily, as a result of the deformity, causing a chronic dull ache in the facet joint of the vertebra.

Choices that Support Ongoing Health

Your diet is an important part of your treatment for cancer. Eating the right kinds of foods before, during, and after treatment can help you feel better and stay stronger. While no specific diet has been developed for myeloma patients, this is an area of ongoing research.

Caution should be used in two areas:

  • Vitamin C: High doses (> 1000 mg/day) may be counter-productive in myeloma and increase the risk of kidney damage.
  • Herbal and vitamin supplements: Talk to your doctor about using supplements at the same time as chemotherapy or other drug treatment. Drug/supplement interactions can create medical problems. Most pharmacies have systems that identify potential interactions with medications and/or supplements.

Here are some additional resources:



©2015 International Myeloma Foundation


Bone Disease
Multiple myeloma is characterized by a unique form of destructive bone disease which occurs in the majority of patients. The bone destruction, which is progressive, is responsible for the most prominent and distressing clinical features of this disease, namely intractable bone pain, fractures occurring either spontaneously or following trivial injury, and hypercalcemia with its attendant symptoms and signs.

Management of Side Effects of Novel Therapies
Written by the IMF Nurse Leadership Board, made up of experienced specialty oncology nurses, these are the first comprehensive guidelines for managing side effects from lenalidomide, thalidomide, and bortezomib used in the treatment of multiple myeloma.

According to the National Cancer Institute, "healthy eating habits and good nutrition can help patients deal with the effects of cancer and its treatment. Some cancer treatments work better when the patient is well nourished and gets enough calories and protein in the diet. Patients who are well nourished may have a better prognosis (chance of recovery) and quality of life."

Anemia and Fatigue

Learn about what you can do and which medications are available to help you better manage your fatigue and enable you to feel better and participate in more activities.

Complementary and Alternative Medicine
Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine.