Supportive care in multiple myeloma: Current practices and advances.

Supportive care in multiple myeloma (MM) can have a major impact on quality of life and the survival outcomes of MM patients. In this review, we will focus on disease and treatment related toxicities experienced by MM patients and what are the best approaches to date to help mitigate the effects. We will specifically focus on a practical approach to managing bone disease, thrombosis, infection risk, peripheral neuropathy, dermatologic complications, gastrointestinal and ocular toxicities, and fatigue in MM.

Survey of experiences of an e-mentorship program: Part II.

Nurse educators (NEs) are responsible for providing continuing education to nurses, who are expected to remain knowledgeble in the diagnosis and management strategies of a range of cancers. Remaining abreast of up-to-date information can be a challenge. Part I of the e-mentorship program was developed in 2009 to provide NEs with the latest updates and educational materials to enhance multiple myeloma (MM) nursing knowledge. The second phase was completed in January 2011. Faculty developed four modules: overview of MM, peripheral neuropathy, bone health, and overview of transplantation. Seventeen MM nurses were identified to participate as mentors and partner with 34 mentees. Mentees were trained through monographs, journal articles, webcasts, and telephone communication, and then they presented the modules to their nurses. All mentees were asked to participate in voluntary pre- and post-test assessments to measure improved knowledge and clinical competence in the management of patients with MM. A significant improvement in post-test scores, as compared to pretest scores, was seen; therefore, nurses who participated in the e-mentorship program demonstrated improved knowledge. In the future, this type of educational program should be expanded to other cancer types.

Survivorship care guidelines for patients living with multiple myeloma: consensus statements of the International Myeloma Foundation Nurse Leadership Board.

Novel therapies approved over the past decade for the management of multiple myeloma have contributed to improved overall survival in patients with newly diagnosed and relapsed disease. Nurses play a key role in educating, advocating for, and supporting patients throughout the continuum of care. Identifying potential and actual comorbid conditions associated directly with multiple myeloma and its treatment is important, as is confirming those that are patient specific so that prompt intervention can take place; therefore, the International Myeloma Foundation Nurse Leadership Board identified the most significant needs of patients diagnosed with multiple myeloma as bone health, health maintenance, mobility and safety, sexual dysfunction, and renal health. The Nurse Leadership Board then developed a survivorship care plan to assist healthcare providers and patients with multiple myeloma, their partners, and their caregivers to identify these needs.

Maintaining bone health in patients with multiple myeloma: survivorship care plan of the International Myeloma Foundation Nurse Leadership Board.

About 90% of individuals with multiple myeloma will develop osteolytic bone lesions from increased osteoclastic and decreased osteoblastic activity. Severe morbidities from pathologic fractures and other skeletal events can lead to poor circulation, blood clots, muscle wasting, compromised performance status, and overall poor survival. Supportive care targeting bone disease is an essential adjunct to antimyeloma therapy. In addition, the maintenance of bone health in patients with multiple myeloma can significantly improve quality of life. Oncology nurses and other healthcare providers play a central role in the management of bone disease and maintenance throughout the course of treatment. Safe administration of bisphosphonates, promotion of exercise, maintenance of adequate nutrition, vitamin and mineral supplementation, scheduled radiographic examinations, and monitoring of bone complications are among the important functions that oncology nurses and healthcare providers perform in clinical practice.