Treating myeloma symptoms

Kidney problems

Hypercalcaemia

Myeloma can cause too much calcium in your blood (hypercalcaemia). Your kidneys can get overworked trying to get rid of the calcium. Hypercalcaemia can cause symptoms like loss of appetite, thirst, nausea, vomiting, hazy vision, muscle weakness, depression and drowsiness. 

• Drink 2-3 litres of fluids (ideally water) every day to help protect your kidneys. 
• Talk to your doctor before taking any medication. For example, ibuprofen can affect your kidneys.
• Tell your hospital team if you have nausea, vomiting or diarrhoea. You may need fluids into a vein.
• If you need a CT or MRI scan tell the radiologist you have myeloma. You may not be suitable for the dye they use to show up parts of your body on the scan.

Read more about hypercalcaemia

Kidney damage

The abnormal proteins produced by myeloma cells can block tubes in your kidneys and stop them filtering your blood properly. This can damage your kidneys. 

If you have permanent kidney damage you may need to use a kidney dialysis machine once or several times a week. This filters your blood in the same way a healthy kidney does. 

Bone problems

Bone pain is a common problem with multiple myeloma, especially in the lower back, hips and ribcage. Myeloma can also weaken bones, making them more likely to break.

Weakened bones 

• Bisphosphonates drugs can reduce bone pain and damage and slow down further bone disease. This can make you feel much better. 
• Bisphosphonates are usually a long-term treatment. You may be given bisphosphonates before you develop symptoms, to try to reduce bone problems. 
• Bisphosphonates can reduce the amount of calcium in your blood to improve the symptoms of hypercalcaemia. They may also help to slow down the myeloma.
• Surgery can help to repair or prevent fractures and strengthen bone. If your doctor thinks surgery will help you, he or she will explain the options to you.

Read more about bone-strengthening drugs.

We also have information on how to look after your bones, to keep them as healthy as possible. 

Bone pain

Painkillers

• Regular painkillers will be given to help ease any bone pain you have. 
• Some painkillers, like ibuprofen, can cause kidney damage in people with myeloma. Check with your doctor or nurse before taking these.
• Always take painkillers as your doctor prescribes. If they aren’t controlling your pain well, go back to your doctor so they can try something else.
• We have more information on coping with pain and taking painkillers.

Radiotherapy

Radiotherapy can strengthen bone and reduce bone pain. 

• It involves aiming high-energy rays at an area of bone damage and pain. 
• It can also be used at the site where a myeloma tumour (plasmacytoma) has been removed to kill any myeloma cells that may remain.
• When radiotherapy is being used for pain relief it is called palliative radiotherapy. 
• You may have treatment every day for a week or 2, or less often. Sometimes you only need one treatment. 

Tips and hints on coping with bone pain

1. Sit comfortably. Get family or friends to help you move your position. Special v-shaped pillows are also helpful when in bed or sitting out.
2. Have a gentle massage as it can be a good way to relieve pain.
3. Relax as much as you can. Try visualisation or relaxation techniques to help you cope better with pain. Listen to music or watch your favourite TV programme.

Read more about bone pain.

Blood and bone marrow problems

Myeloma can stop you from making enough healthy blood cells. This can cause symptoms like:

• Fatigue, weakness, shortness of breath, dizziness and feeling lightheaded (not enough red blood cells - anaemia)
• Infections (not enough white blood cells)
• Bruising and bleeding, (not enough platelets)
• Increased risk of blood clots (abnormal proteins in the blood, which make it thicker)

Anaemia

• Blood transfusion. This can help to reduce symptoms from low red blood cells (anaemia). Blood will be given to you through a needle inserted into a vein like a drip. 
• Erythropoietin. This drug can help severe anaemia. It causes the bone marrow to make red blood cells more quickly. It is normally given by an injection under the skin. 

Read more about coping with anaemia. 

Abnormal bruising and bleeding

• Platelet transfusions. This is a fluid containing platelets which is given like a blood transfusion to prevent abnormal bruising and bleeding.

Increased risk of infection

Antibiotics

• If you get an infection, an antibiotic will be given to bring it under control quickly. 
• Intravenous antibiotics (antibiotics given into a vein) may be needed to help you fight off the infection if your immune system is low. 
• In special cases, you may be given antibiotics to prevent you from getting an infection or for emergency use. This may apply if you are at home or when travelling.

Growth factors and immunoglobulins

• Drugs called growth factors can help your bone marrow to make more white blood cells to prevent infection. 
• Growth factors are special proteins normally made in your body but which can now be made in the laboratory. A common one used to boost white cells is called G-CSF. 
• If you get serious recurrent infections, your doctor may decide to give you immunoglobulins into your vein.

Vaccinations

• You will probably be advised to get the flu vaccine every year and the pneumonia vaccine every 5 years. 
• Check with your doctor about which vaccinations are recommended for you and make sure you get them. 
• Shingles (herpes zoster virus) can also be a common complication and you may be given anti-viral drugs to prevent this infection.

Read more about infections – how to avoid them, treatment and signs to look out for.

Increased risk of blood clots

Plasmapheresis

If you have kidney damage, your kidneys may not be able to get rid of any abnormal proteins from your blood quickly enough. Your blood may become thick because of the abnormal proteins. Plasmapheresis may be done to thin your blood. It involves filtering your blood to remove the unwanted protein and replacing it with normal fluid. This fluid is called plasma or albumin and is given the same way as a blood transfusion.

Blood thinners

Drugs (usually tablets) to treat or prevent blood clots.