Understanding pain in early multiple myeloma

On November 10, 2022, the Multiple Myeloma Hub held a virtual symposium on the topic of holistic pain management in multiple myeloma, with three established leaders in the field talking on different elements of pain management.
Here, we share the first presentation by Professor Heinz Ludwig, Wilhelminen Cancer Research Institute, Vienna, AT, on the management of pain in early multiple myeloma.
In this presentation, Professor Ludwig discusses the symptoms of pain at presentation and early in the course of MM, as well as the common sites of bone lesions.
[Disclaimer: All content produced by the Multiple Myeloma Hub is intended to adhere to the Centers for Disease Control and Prevention (CDC) Clinical Practice Guideline for Prescribing Opioids for Pain, issued in November 2022. Opioids are a class of highly addictive prescription painkillers; therefore, all information regarding their use must accurately describe the benefits and serious risks of misuse and abuse. The CDC recommendations do not apply to pain management related to sickle cell disease, cancer-related pain treatment, palliative care, or end-of-life care. Key principles to be taken into consideration include: i) nonopioid therapies are at least as effective as opioids for many common types of acute pain and are preferred for subacute and chronic pain; ii) before starting opioid therapy, clinicians should discuss with patients the realistic benefits and known risks; iii) when opioids are used, clinicians should prescribe immediate-release opioids at the lowest possible effective dosage; and iv) clinicians should regularly reevaluate with patients the benefits and risks of continued opioid therapy and when changing the dosage].

[@doctork1708]

I don’t have any desire to please anyone especially a physician, but I’m sick of being ignored and gaslit by physicians. It took years for a correct diagnosis b because of incompetent and uncaring physicians. They stole my quality and duration of my life.

[@emmanuelking9988]

I have multiple myeloma...thank you for mentioning cancer patients wanting to "make their doctor happy" by not fully disclosing their symptoms and going along the "everything is going well" theater. I sometimes do this because it actually makes my life easier, it's more of a mental health protection for me because doctors can start gaslighting you or pressure you on treatments you don't understand or are ready for. Anyway, this is why it's very important to educate yourself on your diagnosis and treatment and be your own advocate, do your own research and follow up that research with lots of questions. May God grant all those with cancer healing and health 🙏

[@timlittle1286]

Sometimes diet can increase the intensity of pain if something in the diet causes inflammation.

[@emmanuelking9988]

Agree 🎯

[@elainerobertson1988]

Excellent - thank you Sir.

[@justincase1575]

I am experiencing pain with treatment that no one wants to admit that I have. I am told how well I’m responding and should feel ok. I also have a bad heart with a 30 year old bypasses all but one plugged. I know everyone wants to make me feel better but I’m the one in pain!

[@marywilliams9858]

Speak up dear. I wrote up a doctor twice for withholding pain medication and now I am handled with kid gloves. Put your concerns in writing. Wrote to his boss or to the hospital where he works. One doctor told me: "You are very smart...." He looked nervous.

[@marywilliams9858]

He made me so desperate I overdosed.