What To Expect With Relapsed/Refractory Myeloma
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If you or a loved one has multiple myeloma, you might worry about how the cancer may affect the way one’s organs function. In rare cases, people with this condition may have symptoms that seem related to the central nervous system (CNS), which includes the brain and spinal cord. Could symptoms like confusion or trouble thinking (sometimes called cognitive decline) be linked to multiple myeloma?
While it’s uncommon for multiple myeloma to reach the brain, the disease can still impact thinking, memory, and problem-solving. Additionally, the physical symptoms, treatment side effects, uncertainty, isolation, and life changes caused by multiple myeloma can affect your mood.
Read on to learn more about how multiple myeloma can affect the brain and nerves.
Multiple myeloma can spread to the brain, but this is very rare. About 0.7 percent of people with the condition develop problems because of multiple myeloma cells reaching the brain. People with multiple myeloma in their CNS typically experience headaches, dizziness, and vision issues. In some cases, the symptoms might be similar to those of a stroke.
You may have heard that multiple myeloma causes lesions (areas of damage) on your skull. While the disease often spreads to the skull, it usually doesn’t affect the brain directly.
However, if you notice new or worsening symptoms, always talk to your oncologist (cancer specialist) or healthcare team. Figuring out the cause of these symptoms is important for improving your quality of life and overall well-being, whether or not they’re related to multiple myeloma.
Most people with multiple myeloma won’t develop brain tumors, but your blood cancer can still cause cognitive or neurological symptoms in other ways.
Possible neurological or cognitive symptoms of multiple myeloma include:
If you have sudden, severe back pain, numbness, or muscle weakness without a clear cause, it could be due to multiple myeloma in your spine. The disease can create destructive spots in your bones, known as lytic lesions. These spots can weaken your spine so much that the bones may collapse onto each other, pressing on the spinal cord. This is called spinal cord compression.
In rare cases, the excessive buildup of plasma cells in multiple myeloma can form a mass called a plasmacytoma, which may press on the spinal cord. This pressure on the spinal nerves can cause back pain and paresthesia (unusual sensations like tingling, numbness, or weakness in the hands and feet).
If you notice these symptoms, get emergency medical treatment right away. Severe cases can result in permanent paralysis.
Multiple myeloma and its treatments can both affect the nerves. This can lead to symptoms including tingling, numbness, and weakness in different parts of the body.
In multiple myeloma, the body may produce abnormal antibodies (immune proteins) that can damage nerves, leading to peripheral neuropathy. This can cause symptoms such as numbness, weakness, or a “pins-and-needles” sensation, typically in the hands and feet.
Neuropathy can range from mild to severe. One member of MyMyelomaTeam said, “Today is a good day! Only numb feet from neuropathy, but no pain.”
If you’re experiencing peripheral neuropathy, your oncology team can help you manage these uncomfortable symptoms.
Multiple myeloma tumors can also put pressure directly on nerves, causing similar symptoms. As one team member explained, “About six weeks ago, my right lower lip and chin went numb. My oncologist said I have bone lesions on both sides of my jaw, skull, upper spine, and sternum.”
Some treatments for multiple myeloma can also affect nerve health as well. For example, thalidomide (Thalomid) is known to worsen peripheral neuropathy as a side effect. Other drugs that may cause neuropathy in some people, include:
Multiple myeloma can cause abnormalities in the way your plasma cells produce antibodies, which can make you end up with more immune proteins in your blood than your body can handle. This can lead to hyperviscosity — when your blood becomes thicker than normal. Hyperviscosity makes it harder for your body to move blood around, which can reduce blood flow to your brain or other parts of your CNS.
People with hyperviscosity may have symptoms similar to those of a stroke, such as:
If you or your loved one has these symptoms, see a doctor right away. A treatment called plasmapheresis can remove the extra proteins from the blood, providing temporary relief.
Multiple myeloma can lead to mental health issues like depression and anxiety. Worrying about cancer can make these feelings worse. One MyMyelomaTeam member shared, “I’m feeling depressed. I have to go in for a bone marrow test … . I’m worried my cancer is coming back.”
Another noted, “I’m feeling a little anxious about the results of next week’s blood draw.”
Pain (including bone pain) from multiple myeloma or associated treatments is also a risk factor for both depression and anxiety.
It’s important to treat depression and anxiety. When someone with cancer faces mental health challenges, they may be less likely to stick with their treatment. There are many ways to treat depression and anxiety and improve your quality of life with multiple myeloma.
People with certain types of cancer, including multiple myeloma, often experience a decline in cognitive function. Researchers aren’t sure whether this decline is caused by the cancer itself, cancer treatment, or simply because older adults are more likely to experience cognitive decline. The longer someone lives with multiple myeloma, the more likely they are to notice these changes.
Cognitive skills include:
If you or a loved one notice a decline in these skills, talk to a doctor as soon as possible. There may be treatments or strategies to help manage these effects. Your doctor can guide you to the right resources and help you make the most out of your treatment options
If you notice any new or worsening symptoms that might be related to multiple myeloma, talk to your doctor right away. Your quality of life matters, and your medical team is there to help.
On MyMyelomaTeam — the social network for people with multiple myeloma and their loved ones — more than 48,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple myeloma.
Have you experienced cognitive symptoms with multiple myeloma? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.
Leonora Valdez Rojas, M.D.
received her medical degree from the Autonomous University of Guadalajara before pursuing a fellowship in internal medicine and subsequently in medical oncology at the National Cancer Institute.
Learn more about her here.
Sarah Winfrey
is a writer at MyHealthTeam.
Learn more about her here.
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What To Expect With Relapsed/Refractory Myeloma
11 Articles
A MyMyelomaTeam Member
Pomalyst made me fill the way, disoriented, severe muscles pain and dizzy..my Dr took me off the drug .