How Do Myeloma Patients Die?
The outlook for people with multiple myeloma depends on many factors. The age of the patient, how fast the cancer is growing, and whether they have any other health conditions can all impact their chances of survival.
Fortunately, there are more treatment options than there were when I was diagnosed with myeloma and many of them can help put patients into long-term remission. These new drugs are based on different approaches to the immune system and the body’s ability to fight back.
If they work, patients can stay in remission and have no abnormal cells left in their bodies. However, myeloma can recur and patients need to stay on treatment if they want to stay alive.
Relapses can happen at any time. They may be symptomatic, meaning they cause pain or discomfort or they may just cause blood or urine tests to show certain abnormalities that doctors don’t recognize. If relapses do occur, doctors will update their plan and treat them as necessary.
Infections are another major problem for myeloma patients. They are 7 to 10 times more likely to get an infection than someone who has no myeloma. They are especially prone to pneumonia, which can be deadly. This is why it’s important to get vaccinated for the flu, shingles, and pneumococcal pneumonia when you have myeloma.
Getting the right vaccinations helps protect patients from infection and can extend their life. For example, the CDC recommends people who have myeloma get the influenza vaccine and the shingles vaccine after diagnosis to protect against these infections.
The CDC also recommends that people who have myeloma be vaccinated for COVID-19, which is the coronavirus disease that first appeared in 2019. This virus causes severe illness and deaths in people who are unvaccinated.
Early death in myeloma is uncommon but is still a possible outcome for some patients. In one study, patients who died before 5 years from their myeloma diagnoses had an early mortality rate of 12 percent. This was compared to an early mortality rate of less than 20 percent for non-early-mortality patients (see fig.).
Most people with myeloma will eventually relapse. They will have a cancerous growth in the bone marrow that produces abnormal plasma cells. In some cases, the tumor can spread to other parts of the body, including the lungs or liver.
Some of these relapses will be accompanied by other symptoms, such as bone pain or shortness of breath. They can also be caused by other complications such as kidney failure and other chronic illnesses.
The relapses may last for weeks or months. If relapses are followed by complete remission, the myeloma is usually considered “cured.” Relapses can be painful, but they can also be very difficult for patients to cope with.
Using palliative care during myeloma can help improve quality of life and reduce distress. Most large academic hospitals have palliative care teams made up of doctors, nurses, social workers, and psychologists to whom patients can be referred. These specialists can help patients understand their condition and make treatment decisions as well as provide support for families.
