Shortness of breath, also called dyspnea, is a common symptom of multiple myeloma, a type of cancer that forms in blood cells.
Feeling like you can’t catch your breath — or, in severe cases, feeling like you can’t breathe at all — can be extremely worrying. Fortunately, there are things you can do to ease this symptom of multiple myeloma and the anxiety and fear that it causes.
Multiple myeloma originates in bone marrow — the spongy tissue in the center of bones that creates red blood cells, white blood cells, and platelets. Myeloma forms in a type of white blood cell in the bone marrow known as a plasma cell. Healthy plasma cells produce proteins known as antibodies. Malignant (cancerous) cells — called myeloma cells — produce abnormal proteins known as monoclonal proteins or M proteins.
These cancerous plasma cells and M proteins can cause complications, including kidney problems and low blood cell counts, which can result in breathing problems.
Your kidneys typically help filter and remove waste from your blood. Damage to the kidneys can result in breathing problems such as shortness of breath as waste and excess fluid builds up in the lungs.
Kidney (renal) impairments and kidney failure are common for people who have been diagnosed with multiple myeloma — that’s because bone destruction related to multiple myeloma often results in hypercalcemia. Hypercalcemia is a buildup of calcium in your blood. These high levels of calcium in the blood can harm the kidneys and cause kidney problems as well as kidney failure.
Myeloma protein and other toxins caused by multiple myeloma can also build up in the body, causing thickening of the blood (hyperviscosity) and kidney damage. The myeloma protein can affect the kidney’s ability to filter waste products from the blood and remove harmful chemicals from the body.
When myeloma forms in the plasma cells, myeloma cells eventually crowd out the healthy red blood cells, white blood cells, and platelets. Having too few of each type of blood cell causes its own specific blood issue. Thrombocytopenia occurs when the blood platelets are low, leukopenia occurs when the white blood cells are low, and anemia — which causes shortness of breath — is caused by low red blood cells.
Red blood cells contain an iron-rich protein called hemoglobin that allows the cells to carry oxygen from the lungs to the rest of the body. Anemia is the result of the body lacking these oxygen-carrying red blood cells. Poor oxygen circulation caused by anemia can make it feel like you’re struggling to catch your breath.
One of the most common causes of breathing problems in MyMyelomaTeam members is anemia. “My wife doesn’t seem to be getting any strength back,” wrote one member. “Her medications are causing anemia, and I don’t think she’s getting the oxygen she needs.”
Living with multiple myeloma is challenging, and it can be especially difficult when complications like breathing problems arise. Many members of MyMyelomaTeam experience shortness of breath. “It’s a beautiful day! I want to get some things done, but the fatigue and shortness of breath make it hard,” wrote one member. Another member reached out to others for a solution, asking, “I was just diagnosed last week, and I am having shortness of breath. Does this get better over time?”
Many MyMyelomaTeam members have shared what has worked for them when they’ve experienced shortness of breath. If you experience breathing problems or pulmonary (lung-related) symptoms like chest pain, talk to your doctor. The doctor can help identify the cause and work with you to find the best ways of managing your symptoms.
To help address anemia, many members recommend a change in diet. “Try organic baby spinach omelets for breakfast,” suggested one member. Another added, “Eat foods rich in iron. Red meats, beets, dark, leafy vegetables, all of these have iron!”
If a nutritional deficiency is an underlying reason for your anemia, your doctor can also recommend supplements. One member mentioned that they take daily calcium and vitamin D3 supplements. Consult your doctor before trying any new vitamins or dietary supplements.
When myeloma or myeloma treatment is causing the anemia, treating the underlying myeloma appropriately is the only sure way to treat the symptom. Proper treatment for multiple myeloma should increase your red blood cell count, and, in turn, lessen your anemia and help relieve anemia-related breathing problems.
Do not stop any treatment for myeloma without your doctor’s advice, even if the medication is causing breathing problems. If you’re experiencing symptoms like shortness of breath while undergoing treatment for myeloma, ask your doctor about ways of managing this symptom. The doctor may recommend adjusting your dosage or trying different treatment options to help alleviate breathing problems.
If your breathing problems are a side effect of myeloma-related kidney impairment, you may have different management options depending on the severity of the kidney problem. If you are in kidney failure, for example, your doctor will likely put you on dialysis — a medical procedure that filters your blood as healthy kidneys would.
Severe kidney damage will also likely require frequent testing for hypercalcemia. Medications, intravenous fluids (fluids delivered through a vein), and treatment of hypercalcemia can all be expected for anyone who has kidney problems.
Treating multiple myeloma will also likely have a positive impact on breathing problems related to kidney problems. In some cases, treating multiple myeloma can reverse the damage to the kidneys, which will relieve your symptoms.
Kidney damage is a serious and dangerous condition, so if you start to experience breathing problems or any other symptom of renal failure, consult your doctor right away.
While you work with your doctor to address the cause of your breathing difficulties, there are ways you can help relieve shortness of breath as needed.
If you are experiencing shortness of breath or some other kind of breathing problem, try to focus on your breathing pattern. Take slow, even breaths. Breathe in through the nose and out through the mouth. When you exhale, form your lips like you are about to blow out a flame. This technique can help calm you and help improve your shortness of breath.
You can also practice other breathing exercises. When practicing these breathing exercises, you should start with your lips pursed. This ensures that you can control your rate of breathing and encourages the airways to stay open. Inhale slowly through your nose, hold it in for one to two seconds, and gently exhale through your pursed lips. Repeat this 10 times per exercise as needed throughout the day.
Try to remain relaxed and plan out your day according to your symptoms. If you know that you are likely to experience shortness of breath, keep your day limited to only necessary activities and take frequent rests. Limiting the number of times you go up and down the stairs in your home is also a useful way to limit shortness of breath.
If you aren’t overly active and you’re still experiencing breathing problems, there are positions you can sit in that should make breathing easier. If you are lying in your bed, try to avoid lying completely flat. Prop your head up with enough pillows so that you are almost in a sitting position. If this position is not comfortable for you, try to lie with your knees bent or with pillows propped underneath them. If you are sitting in a chair, sit upright and lean far enough forward that your arms are resting on a solid surface in front of you.
Trying these tips, following your doctor’s orders, and making sure that you are surrounded by clean air should all help you manage breathing problems or make it easier for you to catch your breath.
MyMyelomaTeam is the social network for people with myeloma. On MyMyelomaTeam, more than 16,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple myeloma.
Have you experienced breathing problems with multiple myeloma? How have you managed them? Share your experience and tips in the comments below or by posting on MyMyelomaTeam.