Supportive care treatments

Supporting your immune system

Because myeloma cells and treatments reduce your immune system’s ability to fight infections, you and your doctor will need to take extra steps to help prevent infections and support your immune system.

Ways of preventing infection and supporting your immune system may include:

• General steps to help prevent infections (washing your hands, avoiding crowds or family/friends who have recently been unwell or wearing gloves when gardening)
• Preventative medicines Some treatments for myeloma can increase the risk of serious infections. Your treating team will usually prescribe medicines to reduce this risk during treatment or after a stem cell transplant. 
• Vaccinations can be an effective way to protect you from certain types of serious infections.
• Immunoglobulin therapy, Immunoglobulin is part of the blood’s plasma which contains antibodies that help to fight infections. If you‘re experiencing recurrent infections and your doctor discovers you have low levels of immunoglobulin IgG, you may be able to access immunoglobulin therapy.

To read more about preventing and treating infections in myeloma see our Infection prevention webpage.

Supporting your bones

In myeloma, the balance of breaking down old bone and building new healthy bone is disrupted, and this can result in thinner, weaker bones which can break more easily.

While existing bone damage from myeloma can’t be undone, new symptoms can be prevented by using bisphosphonate therapy alongside your other treatments for myeloma. 

In Australia, there are two different types of bisphosphonates available to treat myeloma bone disease. These are called zoledronic acid (or Zometa®) and pamidronate disodium (or Aredia®) which are both given as an infusion into the vein.

To read more about bisphosphonates and managing myeloma bone disease see our Managing myeloma bone disease webpage.

Preventing blood clots

Anticoagulants

People with myeloma have an increased risk of developing blood clots, called venous thromboembolism, both because of myeloma itself and some of its treatments.

Your treating team may prescribe anticoagulant medicine to help prevent a clot from forming. 

This is usually given either as a daily tablet or subcutaneous injection (injection under the skin). Your treating team will let you know if you need this preventative medicine and will give you more information.

Supporting your bone marrow

Transfusions

People with myeloma may need blood transfusions from time to time. This is because both myeloma and its treatments can affect your bone marrow’s ability to make enough red blood cells and platelets. 

Signs you may be low in red blood cells (anaemia) are shortness of breath and fatigue. A blood test to check your haemoglobin will determine if you need a blood transfusion. 

Signs you may be low in platelets (thrombocytopenia) include bruising and bleeding easily. A blood test to check your platelet level will determine if you need a platelet transfusion. 

Always let your treating team know if you have any signs of low red blood cells or platelets.

Growth factor injections 

Myeloma and its treatments can also affect your bone marrow’s ability to make enough white blood cells, which your immune system needs to help fight infections. 

If your white blood cells have fallen below a level that is safe for you, your doctor may prescribe an injection to help. Granulocyte-colony stimulating factor (G-CSF) is a protein used to promote white cell production in your bone marrow. It is given as an injection into the skin (subcutaneously).

G-CSF is also given before stem cell collection to ensure you have a strong enough blood count for the stem cells to be collected.

Pain management

Pain is a very common symptom experienced by people with myeloma. It can be acute (comes on quickly and lasts for a relatively short period of time) or chronic (does not go away or comes back often). 

In myeloma, pain can be caused by bone disease, peripheral neuropathy, infections, and side effects of treatment. 

Pain can have a big impact on your quality of life, which is why having an individual pain management plan is such an important part of your myeloma treatment.

This begins with communicating openly with your treating team and then working with them to find the right combination of medicines, treatments, tools and lifestyle adjustments to help manage your pain so you can experience an improved quality of life. 

In some cases, the palliative care and pain teams might be included to help develop your pain management plan.

To read more about managing myeloma pain see our page Managing myeloma pain webpage.

Complementary and alternate therapies

Complementary medicines and therapies are ones that are used in addition to prescribed treatments for myeloma. 

Examples of complementary medicines include: vitamin, mineral and herbal supplements, and complementary therapies include acupuncture, massage and reiki.

Many people look to complementary medicines to support them through their time on and off treatment for myeloma. They may be looking to control a side effect, gain better overall health, or they may be hopeful that there will be some antimyeloma effects

Alternative medicines and therapies are treatments that are promoted instead of conventional treatments. 

Conventional treatments for myeloma have been well-tested in clinical studies, we have a clear understanding of how they work, and they have been approved as safe and effective for use by the Australian Therapeutic Goods Administration (TGA).

By comparison, alternative medicines and therapies have not been rigorously tested, and are not endorsed by the TGA.

Some complementary or alternate therapies can be helpful for these symptoms, while others may interact with your myeloma treatment, causing it to be less effective or cause more side effects.

It’s really important to talk to your treating team about any complementary or alternate therapies you’re interested in trying. Your treating team will provide you with evidence-based advice that’s tailored to your unique situation.

To read more about complementary therapies see our Complementary therapies and myeloma webpage.