What to know about multiple myeloma in older adults

Plasma cells normally help make antibodies. In myeloma, abnormal plasma cells build up in the marrow and can interfere with healthy blood-cell production. They may also affect bones, kidneys, or the body’s handling of calcium. Possible symptoms include persistent bone or back pain, fractures after minor injury, tiredness, repeated infections, thirst, constipation, or changes in urination. These signs have other possible causes and do not confirm myeloma.

Assessment may include blood and urine tests, imaging, and a bone-marrow examination. In older adults, clinicians also consider kidney function, frailty, mobility, memory, other illnesses, and current medicines. Treatment can include combinations of anti-myeloma medicines, steroids, supportive bone care, or other approaches suited to the person’s health and preferences.

Keep a record of pain, infections, falls, appetite, drinking, bowel changes, and medicines. Ask whether you need advice about hydration, activity, dental care, calcium or vitamin supplements, and preventing falls. Report new pain rather than masking it with over-the-counter medicines, particularly if kidney problems are possible.

When treatment is offered, ask about its purpose, timing, monitoring, side effects, and effect on independence. Tell the team about all prescribed and non-prescribed medicines. A carer or family member can help with appointments, transport, medicines, and noticing changes between visits.

Seek urgent care for sudden severe back or neck pain, new weakness or numbness in the legs, loss of bladder or bowel control, confusion, fainting, severe dehydration, chest pain, breathlessness, or a suspected fracture. Contact the care team promptly for fever, chills, a new infection, worsening pain, repeated vomiting, or much less urine than usual. These symptoms can signal complications requiring quick assessment.

Ask: Which tests confirm the diagnosis and assess bone or kidney effects? What is the aim of treatment? How will we protect mobility and independence? Which medicines or supplements should I avoid? What symptoms require an urgent call? Can supportive care address pain, fatigue, mood, and practical needs?