{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Episode 398: An Overview of Multiple Myeloma for Oncology Nurses","description":"\u201c[Multiple myeloma] is very treatable, very manageable, but right now it is still considered an incurable disease. So, patients are on this journey with myeloma for the long term. It\u2019s very important for us to realize that during their journey, we will see them repeatedly. They are going to be part of our work family. They will be with us for a while. I think it\u2019s our job to be their advocate. To be really focused on not just the disease, but periodically assessing that financial burden and psychosocial aspect,\u201d Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University Medical Center in Neptune, NJ, told Lenise Taylor, MN, RN, AOCNS\u00ae, TCTCN\u2122, oncology clinical specialist at ONS, during a conversation about multiple myeloma. Music Credit: \u201cFireflies and Stardust\u201d by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 16, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center\u2019s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the pathophysiology and diagnosis of multiple myeloma. Episode Notes  Complete this evaluation for free NCPD. ONS Podcast\u2122 episodes: Episode 332: Best Nursing Practices for Pain Management in Patients With Cancer Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 192: Oncologic Emergencies 101: Hypercalcemia of Malignancy ONS Voice articles: AI Multiple Myeloma Model Predicts Individual Risk, Outcomes, and Genomic Implications Cancer Mortality Declines Among Black Patients but Remains Disproportionately High Financial Navigation During Hematologic Cancer Saves Patients and Caregivers $2,500 Multiple Myeloma: Detecting Genetic Changes Through Bone Marrow Biopsy and the Influence on Care Multiple Myeloma Prevention, Screening, Treatment, and Survivorship Recommendations Nurse-Led Bone Marrow Biopsy Clinics Truncate Time for Testing, Treatment Diagnose and Treat Hypercalcemia of Malignancy ONS books: BMTCN\u00ae Certification Review Manual (second edition) Multiple Myeloma: A Textbook for Nurses (third edition) Clinical Journal of Oncology Nursing articles: African American Patients With Multiple Myeloma: Optimizing Care to Decrease Racial Disparities Music Intervention: Nonpharmacologic Method to Reduce Pain and Anxiety in Adult Patients Undergoing Bone Marrow Procedures Other ONS resources: Financial Toxicity Huddle Card Hypercalcemia of Malignancy Huddle Card Hematology, Cellular Therapy, and Stem Cell Transplantation Learning Library American Cancer Society article: What Is Multiple Myeloma? Blood Cancer United educational resources page International Myeloma Foundation homepage Myeloma University homepage Multiple Myeloma Research Foundation (MMRF) article: Understanding Multiple Myeloma To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode \u201cEpidemiologically, myeloma is a cancer of older adults. The median age is about 69. It is more common in men than women. It\u2019s a ratio of about three men to two women that are diagnosed. It is much more common in people of African American descent with increasing global incidence linked to aging populations. Although, the highest rates are in high-income countries. So, if we look at some of the risk factors, and several have been identified, including MGUS. MGUS is a benign precursor of myeloma, and it stands for monoclonal gammopathy of undetermined significance. Older age is also a risk factor, although we do see patients that are younger who are diagnosed with myeloma.\u201d TS 1:54 \u201cBone pain, specifically in the back, and fatigue, are very common symptoms that relate to things that are going on behind the scenes with myeloma. But also, patients can be bothered by frequent and long-lasting infections. So, they find that they get sick more frequently than their family and friends, and they take a longer time to recover. That could also be a presenting sign. I think there can be some presenting signs and symptoms related to electrolyte abnormalities, especially in later stages. They might be nauseated, vomiting, or constipated. Also, signs and symptoms related to cytopenias. You have to remember that this is a bone marrow cancer. So, we do have some problem with development of normal blood cells. So, we can see not only infections, but bleeding issues related to thrombocytopenia and factors related to anemia from low red blood cell counts.\u201d TS 7:15 \u201cAbout 20%\u201325% of our patients who are diagnosed are asymptomatic. They have no symptoms. They\u2019re living their lives, they\u2019re going to work or they\u2019re traveling, playing golf on the weekends, taking care of their children or grandchildren. They are just living their lives. And at times, they go to the primary care physician and then they\u2019re referred to a hematologist-oncologist, and they\u2019re pretty surprised when they\u2019re sent to a cancer center. The way they are diagnosed in this matter is that their routine lab work, the complete blood cell count may be normal, there may be some slight differences in their hemoglobin. But what we see in the chemistry, the complete metabolic panel, is an elevation in their total protein and or an elevation of the total globulins.\u201d TS 9:22 \u201cThe bone marrow biopsy serves many purposes. You want to determine the percentage of bone marrow plasma cells. So, you want to get the degree of plasmacytosis. And then you want to do really specific tests on those plasma cells. So, you want to isolate the malignant plasma cells and determine, via analysis. So, we do the karyotype, chromosomal studies, fluorescence in situ hybridization (FISH) studies, immunohistochemistry studies, and molecular studies. All of these studies are looking for specific genetic changes in the myeloma cells\u2014looking for translocations or deletions. And it\u2019s very important to get that information because we can put patients in a category of having standard-risk disease versus high-risk disease. And that can give us a better picture of what this patient\u2019s journey with myeloma may look like.\u201d TS 13:41 \u201cWhen I used to work in lymphoma, I spoke with the physicians who were lymphoma specialists, and they said that they foresee a future in having these assays that detect circulating tumor cells actually take the place of imaging studies like restaging positron-emission tomography (PET), computed tomography (CT) scans. So, it\u2019s really amazing, these tests that are on the market now and maybe not as widespread as we\u2019d like, but there\u2019s a lot of nice assays out there that will become more popular and used more commonplace in the future that I think are going to help identify myeloma more precisely. ... If you think about myeloma, even with measurable residual disease (MRD), MRD for leukemia, for lymphoma, you take a blood sample, you test it for MRD. For myeloma, you need a bone marrow biopsy. You need a bone marrow sample. You can\u2019t do MRD on a blood sample for myeloma. Not yet. But if we perfect these assays and we can eventually detect this, then you\u2019re looking at a whole new ballgame. You can even perfect your MRD testing as well. So, it\u2019s a very exciting time for some of these heme malignancies.\u201d TS 28:09 ","author_name":"The ONS Podcast","author_url":"http:\/\/onsvoice.libsyn.com\/website","html":"