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Q. I am 66 years old, was diagnosed with multiple myeloma 2005, and have been in remission for 40 months on Velcade infusion maintenence. I've had tendinitis and bursitis developing over the past 6 months, and increasing 4 weeks ago. In the past four weeks it got to the point where I could not stand or walk, and had to stop working. MRI and then PET scans showed a lesion in the femur (no impending fracture). It was treated with 5 days of radiotherapy at that point. The restaging work up of my myeloma was stable. The problem is that the oncologist is saying the bursitis and tendinitis, is unrelated to that lesion or the multiple myeloma, or the drug. Pain is still leaving me incapacitated despite cortisone injections last week. I see my doctor in 2 weeks, who is letting the local oncologist manage the case until then. This is causing a lot of anxiety with my wife (my caregiver) and decisions about work and finances. There does appear to be much available info that I can find, and my "care team" is not regularly providing anything other than analgesics.

A.

It sounds like you have been faced with a lot of uncertainty and confusion since the development of your bursitis and tendonitis. Compounded with the overall uncertainty of cancer, this can undoubtedly be unnerving.

Pain can often become so severe that it impacts your daily routine, and can interfere with work and family life. Having been diagnosed with multiple myeloma, it is understandable that you may correlate this pain with your diagnosis, as one of the most common symptoms of multiple myeloma is bone pain. However, as your medical team has indicated, the pain may be unrelated.

It is understandable that you are feeling frustrated by the lack of explanation and the inability to determine a cause for your pain. This frustration can even overshadow the positive news of your stable test results. As this pain is continuing to impact your daily life, ask your doctor for a referral to a pain management specialist who can work closely with you to help you find relief.

More information can be found in our publications, Controlling Cancer Pain: What You Need to Know to Get Relief and Opening the Door to Effective Pain Management: Getting the Facts and Getting Help.

You may also be interested in registering for our upcoming CancerCare Connect Education Workshop™ featuring the topic, Managing Cancer Pain: What You Need to Know.

More information on locating a pain specialist can be found at www.americanpainsociety.org.

Q. My sister has been diagnosed with multiple myeloma and I'd like to share info and services that might be helpful to her. Could you please give me recommendations?

A.

Learning about a new diagnosis can be extremely difficult and overwhelming both for the patient as well as loved ones. Gathering information and resources is certainly an important step. Beginning to form a foundation of knowledge can help alleviate some of the stress and anxiety.

Multiple myeloma is a blood cancer that begins in white blood cells called plasma cells. Over time these abnormal plasma cells may collect in the bone marrow and bones. While some individuals may not experience any symptoms, some common symptoms of multiple myeloma may include bone pain or broken bones, fatigue and infection. Doctors often do a bone marrow biopsy to determine the staging of the cancer which can range from smoldering (asymptomatic) to stage three. Learning the stage of the disease can help doctors determine the best treatment plan. It is important to ask questions and have open communication with your treatment team in order to better understand treatment choices, expected results and any possible side effects. More information can be found in our booklet, Communicating With Your Health Care Team.

Coping with a new diagnosis can also be emotionally challenging for both the patient and loved ones. CancerCare offers a number of free support services including individual counseling and telephone and online support groups for anyone that has been affected by cancer. For more information, you may speak with one of our oncology social workers by calling 1-800-813-HOPE (4673), or visit the multiple myeloma section of our website.

As cancer treatments may also impose financial burdens, many organizations also have financial assistance programs. CancerCare’s Door to Door Program offers a reimbursement grant to help cover travel-related expenses. The following organizations also offer co-payment assistance: Chronic Disease Fund, Patient Advocate Foundation and Patient Access Network. Funding may change, so please check each organization’s website for up-to-date financial assistance information.

You may also be interested in registering for our upcoming CancerCare Connect Education Workshop: Progress in the Treatment of Multiple Myeloma.

Additional resources include International Myeloma Foundation, Leukemia & Lymphoma Society and Multiple Myeloma Research Foundation.

Q. My father has multiple myeloma and it is disheartening to see to him lose weight. He is 74 years old and I wish I could do much more for his pain. Can you recommend nutritional and pain resources?

A.

Caring for a loved one with cancer can be difficult. It is admirable and not uncommon to want to ease your loved ones pain. As physical changes occur, it can be especially overwhelming and may bring up feelings of helplessness. Reaching out and gathering information as you have done is an important and helpful step.

Many patients do experience changes in weight, including weight loss. These changes are common and can be caused by a number of factors including poor appetite, fatigue or treatment side effects. It is important to talk with your father’s medical team so that the weight loss may be evaluated. You can also request a referral to meet with a dietician who can work closely with your father to maintain a healthy weight. The following CancerCare fact sheets offer additional information on nutrition: Coping With Caner-Related Weight Changes and Muscle Loss and Tips for Managing Nausea and Increasing Appetite During Cancer Treatment. More information on locating an oncology dietician can be found at www.oncologynutrition.org.

Bone pain is another common side effect of multiple myeloma. Again, communicating with your father’s medical team will be an essential component to managing his pain. Remember, your father is the expert in what he is feeling; informing his doctors about the severity, location, and type of pain he is experiencing can help determine an appropriate approach to pain relief or reduction. Doctors may recommend managing bone pain by: wearing a brace, having radiation therapy or taking pain medications. If pain persists he may also consider consulting with a pain specialist. To locate a pain specialist, you may visit www.americanpainsociety.org.

More information on pain can be found in our publications, Controlling Cancer Pain: What You Need to Know to Get Relief and Opening the Door to Effective Pain Management: Getting the Facts and Getting Help. You may also be interested in registering for our upcoming CancerCare Connect Education Workshop™ featuring the topic, Managing Cancer Pain: What You Need to Know.