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.