Multiple Myeloma

Follow-Up Care

Whether you are still receiving treatment or have finished, you will be checked at regularly scheduled follow-up appointments to gauge how your multiple myeloma is responding to treatment and identify any signs of a relapse.

Follow-up appointments also give you the opportunity to keep the lines of communication open with your health care team and to address any new symptoms or concerns. Multiple myeloma treatments often result in side effects that should be addressed as part of your supportive care.

It is important to discuss how you’re feeling physically, mentally and emotionally at these appointments — or sooner if something changes. Specific information to share includes the following.

  • New or ongoing physical symptoms that aren’t adequately relieved, including pain, gastrointestinal problems, nausea and vomiting, signs of infection, bone pain and blood clots.
  • Cognitive (thinking-related) symptoms, such as difficulties with memory, concentration, processing information, word-finding or completing tasks
  • Emotional issues, such as depression, anxiety, fear, anger, grief, hopelessness, emotional numbness, feeling overwhelmed or other concerns
  • Visits to the emergency room, urgent care or other doctors, even if not cancer-related

You may also receive instructions for maintenance medications; referrals for cancer rehabilitation services, such as physical or occupational therapy; information about your risk of a recurrence or second cancer; and recommended screening guidelines for other types of cancer.

Symptom & Side Effect Managment

Your doctor may recommend one or more of the following medications to alleviate symptoms from side effects or the multiple myeloma:


  • Antacids and/or acid reducers
  • Antidepressants
  • Antiemetics (anti-nausea medicines)
  • Antimicrobials (antibiotics, antivirals and antifungals)
  • Blood thinners
  • Bone-modifying agents
  • Corticosteroids
  • Erythropoiesis-stimulating drugs for stimulating the bone marrow to produce more red blood cells
  • White blood cell growth factors to help your body make more white blood cells

These procedures and therapies used alone or in combination may also be part of your treatment plan:

Intravenous fluids for dehydration caused by vomiting, diarrhea or mild hypercalcemia.

Intravenous immunoglobulin (IVIG), which is an infusion of antibodies, may be given to prevent or treat infections.

Kyphoplasty and vertebroplasty are surgical procedures that may be used if a weakened vertebra collapses. They involve inserting bone cement into a fractured vertebra to help stabilize it and prevent it from moving.

Occupational therapy (OT) may be helpful if physical activity and/or daily routines need to be modified due to pain or other limitations.

Physical therapy (PT) can help build and maintain muscle strength, improve balance and increase coordination.

Plasmapheresis treats blood that has become too thick from an overabundance of M-proteins, slowing circulation and increasing the risk of blood clots.

Transfusions inject blood, plasma or platelets intravenously (IV) and may be used for severe cases of anemia.

Healthy Lifestyle

Leading a well-balanced lifestyle may help you tolerate treatment better, lower the risk of a recurrence or the risk of other chronic diseases, and help protect against secondary cancers. Following are suggestions for healthy ways to approach your everyday life.

Exercise and physical activity are effective for managing fatigue and may also reduce pain from peripheral neuropathy. Weight-bearing exercise helps strengthen damaged bone. Improving your strength, flexibility and balance through targeted exercise helps reduce your risk of falls.

Good nutrition gives your body essential nutrients to improve your health, better tolerate treatment-related side effects and help ward off additional illnesses. Total parenteral nutrition (TPN), a type of intravenous feeding, may be necessary to help prevent malnutrition for stem cell transplant patients who have acute Graft-versus-Host Disease.

Hydration is the adequate intake of liquids. Multiple myeloma can lead to dehydration, as can treatments causing vomiting and diarrhea. Staying well-hydrated is essential.

Medication Adherence

Some multiple myeloma treatments are pills that can be taken orally from the convenience of home. Other treatments are given by injection or infusion at a cancer center or medical office. Regardless of how you receive your treatment, it is crucial to take it exactly as prescribed. Taking the right drug in the right dose at the right time – every time – is referred to as medication adherence.

Getting off schedule, missing doses or taking an incorrect dose can lead to increased side effects, treatment delays or hospitalization. The most serious consequences include cancer progression and recurrence.

Many tools are available to help you stay on track. Set alarms or phone reminders, make a daily medication schedule, ask loved ones to remind you, track medications on a calendar or use a smartphone app.

Support Your Emotional Health

A cancer diagnosis can affect your mental health as much as your physical health, and it is crucial to address your feelings. Ask your nurse navigator to recommend a multiple myeloma support group. Other myeloma survivors will understand what you’re going through because they have been in a similar position.

Don’t hesitate to ask for a referral to a patient counselor or mental health professional. Contact your doctor about continued feelings of hopelessness or despair. Get immediate medical attention for thoughts of suicide.

Research studies have shown that various holistic approaches, such as journaling, meditation and guided imagery (visualization), may reduce feelings of depression and increase the overall sense of well-being.


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