Steroid-Associated Side Effects: A Symptom Management Update on Multiple Myeloma Treatment

Abstract

Identifying the side effects of steroids and managing them promptly contribute to the success of steroid-containing regimens for patients with MM.

Using nominal group technique to compare patients’ and clinicians’ perspectives on symptoms in multiple myeloma to inform the development of a self management tool for patients with relapsed myeloma

“…Their mechanism is complex; however they are thought to modify the body's immune system and produce powerful anti-inflammatory properties. In contrast to their ability to help in the control of MM they are known to cause intense adverse effects including elevated blood sugars, increased risk of infection, mood swings and insomnia, which are often long term and not widely described or documented despite the common use of steroids 21 . Phase 1 of our study iterated these adverse events with patients describing hyperactivity, the "let down" effect and excessive diaphoresis as having a significant impact on their health related quality of life 18 .…”

Patient-Reported Outcomes and Assessment of Quality of Life: A Focus on Multiple Myeloma

“…Reduction in a patient’s HRQoL may be the reason for treatment discontinuation and consequently disease progression, particularly when physiologic or psychologic side effects are inappropriately managed ( Amgen, 2015 ; Faiman, 2016 ; Faiman, 2017 ; King & Faiman, 2017 ). It is important for advanced practitioners to explore which factors impact the patient most.…”

Distress, Fatigue, and Sexuality: Understanding and Treating Concerns and Symptoms in Patients With Multiple Myeloma

“…The results of a meta-analysis found that yoga had little benefit in managing symptoms in patients with hematologic cancers, including MM (Felbel, Meerpohl, Monsef, Engert, & Skoetz, 2014). If corticosteroids, often used with MM, are causing moderate to severe mood swings, reviewing disease status and adjusting the dosage of corticosteroids may be warranted (King & Faiman, 2017). Anxiolytics and antidepressants can be effective in treating anxiety and distress, but their side effect profiles must also be considered (Jacobsen, Donovan, Swaine, & Watson, 2006;Pirl, 2004;Williams & Dale, 2006).…”

“…Side effects of corticosteroids, many of which contribute to CRF, are discussed in Figure4. Although steroids are associated with improved energy, this experience is followed by intense fatigue, called a "let-down effect," for several days after steroid administration (King & Faiman, 2017). Steroids affect numerous body systems.…”