Supportive care to alleviate symptoms and reduce adverse effects
Supportive care is tailored for each patient and for their unique situation. In addition to medication
it may also include dietary changes and psychological support.
Patients with myeloma often receive the following supportive treatments:
- Bisphosphonate (BP) prevents fractures and skeletal changes caused by myeloma. It also prevents and reduces elevated blood calcium levels (hypercalcaemia). A rare adverse effect of bisphosphonate treatment is osteonecrosis of the jaw, i.e. localised degeneration of the jaw bone. For this reason, your doctor may order a dental examination and any necessary dental procedures to be done before starting treatment.
- Myeloma is associated with a risk of venous thromboembolism (VTE). The risk is increased further by infections, overweight, some medications, renal impairment or older age, for example. To reduce this risk, myeloma medication can be paired with blood thinning (anticoagulant) medication such as low molecular weight heparin (LMWH).
- The skeletal pain caused by myeloma is treated with strong painkillers. Many different medications for pain relief are available, and they can be administered orally or as injections, depending on the intensity of your pain.
- If necessary, radiation therapy may be given for the treatment of skeletal pain.
- Myeloma or its treatment may cause painful neuropathy. This can be treated with
antidepressants or other medications to alleviate the symptoms of neuropathy.
- Infections can be treated or prevented with antibiotics.
- Red blood cell transfusions can be given for the treatment of anaemia. The growth hormone that stimulates production of red blood cells, erythropoietin, is used for the treatment of symptomatic anaemia. If the number of platelets decreases, bleeding tendency increases. This risk can be reduced by platelet transfusions.
Another important factor in the treatment of myeloma is medication to prevent constipation and the treatment of dry mouth symptoms.