‘Like a sieve’: an exploratory study on cognitive impairments in patients with multiple myeloma

Abstract

The aim of this study was to obtain a more in-depth understanding of cognitive impairments and concerns as described by patients with multiple myeloma and the strategies used to cope with them. Semi-structured qualitative interviews were undertaken with 15 multiple myeloma patients of differing age ranges and at various stages of their disease. Various cognitive impairments, such as problems with short-term memory, poor recall and lack of concentration were observed and/or expressed in at least 10 out of 15 patients, all of them long(er)-term survivors. In some patients cognitive impairments significantly interfered with their personal and professional lives, and for some patients these were described as permanent. The patients used various coping strategies, from denial, taking notes, writing diaries, reading simpler texts, using talking books and videos, to using systems for counting medication to cope with the results of their cognitive impairment. Our findings differ from much of the contemporary literature which states that if cognitive impairments in cancer patients occur, they are mostly mild and transient. More proactive supportive care is needed to help patients with multiple myeloma to cope with poorer cognitive functioning.

Living with multiple myeloma: experiences of patients and their informal caregivers

“…A sample of the patients' partners (n=93) was also assessed, and it was shown that the partners/ informal caregivers had considerably lower psychological functioning and higher unmet supportive care needs than the patients [17]. Furthermore, in an interview study of 15 myeloma survivors, various cognitive impairments, such as problems with short-term memory, poor recall and lack of concentration, were observed and/or expressed in at least two thirds of the sample, impairments that significantly interfered with personal and professional lives [20]. The low public recognition of this disease, which is diagnosed predominantly in older people coupled with the use of intensive treatments, frequent relapses and poor prognosis, suggest that this group may have different issues and difficulties from other haematological cancers such as lymphomas and leukaemias.…”

Review paper. Chemobrain in patients suffering from cancer based on the example of multiple myeloma

“…The disorders of cognitive processes have already been noted in research on a group of patients with a diagnosed multiple myeloma [27,28]. In case of this cancer, a target therapy can be directed at cytokines, such as interleukin 6, tumor necrosis factor or BDNF neurotrophin, since a crucial part of these biological factors has been observed in tumor progression [23].…”

“…These compounds turned out to be crucial in development of cancer among the patient with multiple myeloma [29][30][31]39]. Potrat's research from 2010 [28] shows that the incidence of chemobrain phenomenon was observed in case of patients with MM. Then, is it possible to present the connection between particular biochemical factors (TNF-α, IL-6, BDNF) and the changes in the functioning of patients with multiple myeloma?…”

“…Zaburzenia procesów poznawczych zostały już odnotowane w badaniach na grupie osób ze zdiagnozowanym szpiczakiem mnogim [27,28]. Terapia celowana w przypadku tego nowotworu może być skierowana na cytokiny, takie jak interleukina 6, czynnik martwicy nowotworu, czy neurotrofinę BDNF, ponieważ obserwuje się istotni udział tych czynników biologicznych w progresji nowotworu [23].…”

“…Związki te okazały się również kluczowe w zaawansowaniu procesu nowotworowego u pacjentów ze szpiczakiem mnogim [29][30][31]39]. W badaniach Potrata z 2010 roku [28] występowanie zjawiska chemobrain zostało zaobserwowane w przypadków pacjentów z MM. Czy można zatem wskazać na powiązanie wybranych czynników biochemicznych (TNF-α, IL-6, BDNF) ze zmianami w funkcjonowaniu chorych ze szpiczakiem mnogim?…”