Managing myeloma symptoms

In the early stages, myeloma may not cause any symptoms. Some people may only have mild symptoms. Myeloma can cause symptoms if it affects areas of the body such as the bones, kidneys, blood or nerves. Symptom control is important for everyone diagnosed with myeloma.

You will see your doctor regularly for blood tests and x-rays, and to talk to you about how the myeloma is affecting you. Always tell your doctor and nurse about any problems you may have. There are different ways that symptoms can be managed.

Myeloma may cause problems such as:

• bone problems and bone pain
• high calcium levels in the blood (hypercalcaemia)
• pressure on the spine (spinal cord compression), causing leg weakness or numbness, bladder problems or bowel problems
• infection
• tiredness (fatigue)
• anaemia (low number of red blood cells)
• kidney problems
• numb or tingling hands or feet (peripheral neuropathy)
• eating problems
• blood clots
• high levels of paraprotein in blood affecting blood flow (hyperviscosity syndrome).

The paraprotein and light chains produced in myeloma can damage the kidneys. Calcium may also leak out of damaged bones and build up in the blood. This can also cause kidney problems.

Kidney problems can cause symptoms such as:

• passing less urine (pee) than usual
• tiredness
• reduced appetite
• feeling sick (nausea) or being sick (vomiting).

Not everyone has symptoms. But you will have regular blood tests to check for kidney problems.

You can help protect your kidneys by drinking plenty of fluids. Try to drink at least 3 litres (5 pints) each day. Always check with your doctor or nurse before taking painkillers called anti-inflammatory drugs, such as ibuprofen. These can cause kidney problems.

If your kidneys are affected, you may have fluids through a drip (infusion). This helps your body to flush the waste products out of your kidneys into your urine. Treatment for myeloma usually reduces the amount of paraprotein in the blood. This helps with kidney problems.

Sometimes kidney damage is severe, and the kidneys stop working altogether. This is called kidney failure or renal failure. If you have kidney failure, blood is not filtered properly and you do not produce any urine. Excess fluid and waste products, which are usually passed as urine, begin to build up in the body. If this happens, you may need to have your blood artificially filtered. This is called kidney dialysis.

Some people who need kidney dialysis only have it for a short period of time. Other people need long-term dialysis.

You can contact our cancer support specialists on 0808 808 00 00 to talk about dialysis. You may also find our Online Community a helpful place to get support.

Myeloma, and some treatments for it, can affect your ability to fight infections. Your doctor or nurse will talk to you about infections and possible signs of an infections to be aware of. Your doctor may give you drugs to help prevent an infection (prophylactic drugs). They may also recommend you have vaccines such as the flu or coronavirus vaccination, if you have not already.

If you are getting a lot of infections, your doctor may give you a regular infusion (drip) of immunoglobulins. You have this into a vein. It can help to improve your immune system. Most people feel fine when having an immunoglobulin infusion, but sometimes it can cause an allergic reaction. This is most likely to happen during or after the first infusion.

To reduce the chance of a reaction, the first infusion is given slowly.

Myeloma and its treatment can affect the nerves in your hands or feet. This can cause tingling, numbness, or a feeling like pins and needles. This is called peripheral neuropathy. You may find it hard to fasten buttons or do other fiddly tasks. Your doctor or nurse will tell you if you are having a treatment that may cause this side effect.

Tell your doctor or nurse if this happens. If it is caused by your treatment, they may need to lower the dose. Or your doctor may talk to you about whether you could have a different treatment. Usually, peripheral neuropathy gets better when treatment is over, but it can sometimes be permanent.

Myeloma, and some treatments for it, can increase your risk of developing a blood clot. Symptoms of a blood clot include:

• pain, redness or swelling in a leg or an arm
• breathlessness
• chest pain.

Blood clots can be very serious. Tell your doctor straight away if you have any of these symptoms. Most blood clots can be successfully treated with drugs that thin the blood.

Sometimes doctors may give you drugs to reduce the risk of a blood clot.

Your doctor or nurse can give you more information about blood clots. We also have more information on blood clots.

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We want our information to be as clear as possible. To do this, we try to:

• use plain English
• explain medical words
• use short sentences
• use illustrations to explain text
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• make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

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