Multiple Myeloma is a type of plasma cell cancer. In multiple Myeloma, a white blood cell proliferates rapidly, crowding out healthy blood cells in the bone marrow. These cancerous cells then produce proteins that don’t kill pathogens, making patients susceptible to diseases. According to a study published in 2022, 188,000 people died from multiple Myeloma, where the majority of them were elderly. Patients with Myeloma experienced chronic bone pain, particularly in the spine, chest, hips, ribs, and legs. The importance of pain management in Multiple Myeloma patients is essential because the pain results in patients’ poor sleep, depressed mood, and poor daily activity.
Understanding Pain in Multiple Myeloma
Multiple sources may trigger pain in multiple myeloma. Accurate pain assessment in multiple myeloma is a challenge due to the nature of the disease and patients’ difficulties in expressing the complexity of the pain. Chronic pain linked to multiple myeloma, for example, often affects patients with varying intensity. Assessment tools like the pain management index are used to determine the intensity of the pain. However, only measuring the intensity of pain in multiple myeloma is not enough to manage the pain. A comprehensive evaluation of the pain is required to lessen it. A leading cause of pain in multiple myeloma is bone diseases.
Bone Diseases
Patients may experience any of the following pain causing bone diseases, which include Osteoporosis, lytic bone lesions, pathologic fractures, and vertebral compression fractures. The painful neuropathy could be another reason for pain in multiple Myeloma. The disease happens when monoclonal proteins affect the nerve tissue. Treatments’ side effects may also cause neuropathic pain.
Pain Management Strategies
Pain management in multiple Myeloma involves multiple approaches which include medications, procedures, and the use of anti-depressants. For bone pain, both opioids and non-opioids medications and radiotherapy are effective. For the bone fracture procedures, applied are vertebroplasty, and kyphoplasty, while the neuroplastic pain is managed with anti-depressants, and anti-convulsants.
Opioids are quite effective in treating severe pain in multiple myeloma. However, physicians also need to be cautious of potential side-effects of the routine administration of opioids which include dependency, respiratory depression, and opioid-induced hyperalgesia. They need to use the proper dose of these medications, which alleviate pain, and minimize side effects, .
Pain in multiple myeloma is manageable with multi-disciplinary approaches. While choosing a particular method, potential side effects associated with the method must also be taken into account.
Non-Pharmacological Approaches
Depending on the physical state of the cancer patients, some physicians may incorporate non-pharmacological methods to manage the pain of suffering patients. These non-pharmacological approaches include physical therapy, exercise, massage, relaxation techniques, acupuncture, and mind-body practices.
Palliative Care and Support
Palliative care may play a role in treating patients with multiple Myeloma. It is not a core type of cancer treatment process, instead, it helps to ease pain associated with the disease and provide mental support to boost patients’ confidence. In simple words, palliative care acts like a support system of cancer treatment. This treatment is available at hospitals, clinics, or even at home.
