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Vol 6, No 4 (2007)
Original articles
Published online: 2008-02-20
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Problems of palliative care in patients with multiple myeloma

Michał Graczyk, Anna Pyszora, Małgorzata Krajnik
Advances in Palliative Medicine 2007;6(4):137-146.

open access

Vol 6, No 4 (2007)
Original articles
Published online: 2008-02-20

Abstract

Background. In cases of multiple myeloma, palliative care includes patients who still undergo active oncological treatment and those who have discontinued it. The aim of the research is to present the difficulties which doctors of palliative care and others taking care of patients with multiple myeloma may face.
Material and methods. The trial included patients of home hospice care and the patients of a Palliative Care Ward. Retrospective analysis based on medical documentation was applied and, in patients that were still on treatment, prospective observation was conducted.
Results. The analysis included four patients on chemotherapy and two patients for whom intensive oncological treatment had been discontinued. The most frequent symptoms were afflictions connected to bone pain. These were often accompanied by secondary neurological symptoms of pathological bone fractures or compressions caused directly by the neoplastic tumour and symptoms of peripheral neuropathy. Secondary nephropathy (myelomic kidney) and a tendency to hypercalcaemia occurred. Various symptoms of blood hyperviscosity syndrome (dysfunctions of organs: kidneys, heart; bleeding gums and nose) were observed. Additionally during palliative care, it was essential to notice and counteract disease aggravations.
Conclusion. Patients with multiple myeloma constitute a great challenge in palliative care due to the changeable clinical course of the disease, repetitive relapses and remissions. Numerous symptoms of the disease require continuous observation and the proper treatment, which demonstrates that simultaneous multi-specialist care is essential.

Abstract

Background. In cases of multiple myeloma, palliative care includes patients who still undergo active oncological treatment and those who have discontinued it. The aim of the research is to present the difficulties which doctors of palliative care and others taking care of patients with multiple myeloma may face.
Material and methods. The trial included patients of home hospice care and the patients of a Palliative Care Ward. Retrospective analysis based on medical documentation was applied and, in patients that were still on treatment, prospective observation was conducted.
Results. The analysis included four patients on chemotherapy and two patients for whom intensive oncological treatment had been discontinued. The most frequent symptoms were afflictions connected to bone pain. These were often accompanied by secondary neurological symptoms of pathological bone fractures or compressions caused directly by the neoplastic tumour and symptoms of peripheral neuropathy. Secondary nephropathy (myelomic kidney) and a tendency to hypercalcaemia occurred. Various symptoms of blood hyperviscosity syndrome (dysfunctions of organs: kidneys, heart; bleeding gums and nose) were observed. Additionally during palliative care, it was essential to notice and counteract disease aggravations.
Conclusion. Patients with multiple myeloma constitute a great challenge in palliative care due to the changeable clinical course of the disease, repetitive relapses and remissions. Numerous symptoms of the disease require continuous observation and the proper treatment, which demonstrates that simultaneous multi-specialist care is essential.
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Keywords

multiple myeloma (plasmocytoma); palliative care; chemotherapy; rehabilitation

About this article
Title

Problems of palliative care in patients with multiple myeloma

Journal

Advances in Palliative Medicine

Issue

Vol 6, No 4 (2007)

Pages

137-146

Published online

2008-02-20

Bibliographic record

Advances in Palliative Medicine 2007;6(4):137-146.

Keywords

multiple myeloma (plasmocytoma)
palliative care
chemotherapy
rehabilitation

Authors

Michał Graczyk
Anna Pyszora
Małgorzata Krajnik

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