Life-quality concerns for multiple myeloma survivors

Aug 22 2012

By Lynda Williams, Senior medwireNews Reporter

Care of patients with multiple myeloma (MM) should not end with the achievement of long-term survival, suggests research indicating many experience poor health-related quality of life (HRQoL) in the decade after diagnosis.

Compared with 500 healthy population controls, the 156 Dutch patients diagnosed with MM between 1999 and 2010 had significantly poorer scores on the physical, role, cognitive, emotional and social functioning, and global health/QoL scales of the 30-item self-report European Organization on Research and Treatment of Cancer (EORTC) QLQ_C30 assessment.

At baseline assessment, a median of 2 years after diagnosis, MM patients also had significantly higher levels of fatigue, nausea and vomiting, and pain, as well as dyspnea, insomnia, loss of appetite, constipation, diarrhea, and financial impact.

EORTC QLC_C30 scores did not significantly differ between patients who had survived for less than or more than 5 years, say Floortje Mols (Tilburg University, the Netherlands) and co-authors.

Of the 80 patients who completed the 1-year follow-up assessment, the majority experienced significant deterioration for scores in terms of overall QoL (74%), nausea and vomiting (71%), pain (59%), dyspnea (66%), and half of the patients had greater fatigue.

When patients were asked about bothersome symptoms in the past week, the most common complaints were tingling hands or feet (32%), back pain (28%), bone ache or pain (26%), shoulder or arm pain (19%), and feeling drowsy (18%).

A significant proportion of patients expressed concern about their future health (37%), their MM diagnosis (34%), and worried about dying (21%).

"The improved survival of MM has resulted in an increased symptom burden, not only caused by the disease itself, but also because of aggressive MM treatments," with pain and fatigue associated with multifactorial causes explain the researchers.

"Healthcare providers should pay specific attention to these symptoms and low HRQOL and refer their patients to specific cancer survivorship care programs if possible and available," recommend Mols et al.

They add: "Future studies should focus on the possible mechanisms that can predict low HRQOL and high symptom burden in patients with MM and should investigate the optimal way to alleviate these."

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