Long Term Care Planning

With the advent of novel therapies, patients with multiple myeloma are living longer. Even though the disease is incurable, the depth of response, overall survival, and progression-free survival have improved dramatically with the combination of autologous stem cell transplant and drug regimens with novel agents.

According to the National Cancer Institute, survivorship includes physical, psycho-social, and economic issues of cancer from diagnosis until the end of life. With the improvement in treatment modalities for multiple myeloma in particular, the intent of therapy has shifted from a goal of palliation to a goal of finding a cure.

Despite the approach of treatment, patients must have continued access to healthcare, treatment of related toxicities, maintenance of disease-specific comorbidities, and assessment of their overall quality of life.

According to the National Institute of Aging, many commonly observed illnesses in the MM patient population include heart disease, endocrine disorders, sensory defects, and bone loss. In Routine Health Screenings, learn about the need for screening and education to help prevent the onset and decrease the severity of comorbid conditions. Provided are evidence-based screening recommendations to identify risk factors of comorbid conditions, whether from therapy or from disease , as well as recommendations on how to manage such conditions.

Furthermore, a safety survivorship care plan is also necessary for patients who are living longer with multiple myeloma. An estimated 35% of older adults will experience a fall that puts their well-being at risk. Because the majority of patients diagnosed with multiple myeloma are older adults (age 65 and older), the risk of falling already exists and is enhanced by complications of the disease, such as bone loss, pain, neurologic compromise, fatigue, and weakness. Mobility and Safety gives tips on how to minimize risks of falls and also how patients can maintain their functional status.

Other issues related to survivorship are distress, fatigue, and sexuality issues, which are covered in that section of this website.

Finally, palliative care may be needed at any time during treatment, but is most often needed at the end of the disease course. When a patient has tried and exhausted the full range of approved and experimental treatments that are available to him or her, and the myeloma has become refractory to each of those approaches, it’s time to weigh the possible benefits of continuing treatment against the reality of stopping. Each patient must make this decision for him or herself. If you or a loved one is considering such a decision, visit Palliative Care.

 


Source URL: http://www.myeloma.org/long-term-care-planning