How a Nutritious Diet Can Help During Myeloma Treatment

Although it is sometimes overlooked, nutrition is a central element of a patient’s medical plan.

Proper nutrition before, during and after treatment can help reduce side effects, quality of life, strength, fatigue, healing, treatment toxicities and more.

Depending on the cancer diagnosis and treatment plan, nutritional recommendations may change. Common symptoms of multiple myeloma can directly affect nutrition, before and after diagnosis.


About one in three people with cancer have high levels of calcium, known as hypercalcemia. High calcium levels are common in patients with multiple myeloma. The high levels are usually not due to the consumption of large amounts of milk or calcium-rich foods, but rather the effect of cancer on the bones. If the calcium level is high, the patient can be told not to consume a lot of dairy products. At the same time, it’s important to take in enough fluids to help the kidneys remove excess calcium from your body.


Multiple myeloma can also affect kidney or kidney function. Kidney damage is common in patients with multiple myeloma and can lead to high potassium and/or phosphorus levels. Patients should contact their medical team to stay aware of potassium and phosphorus levels when having their blood drawn.

If lab results show elevated levels, a patient may need to reduce their intake of foods high in potassium and/or phosphorus. In the ingredient list, look for words such as “dicalcium phosphate”, “disodium phosphate” and others to identify additives.

Potassium-rich foods include bananas, oranges, cantaloupe, apricots, prunes, raisins, dates, potatoes, and avocados. Foods high in phosphorus include black colas and dairy products like milk, ice cream and pudding.


During treatments, a patient may experience a wide range of side effects that affect nutrition, such as nausea, constipation, loss of appetite, fatigue, weight loss, and excessive thirst. These can affect everyday life, but there are ways to combat them.


Having nausea can greatly affect nutritional status. Identifying patterns can help guide treatment, so patients should keep their medical team informed. For example, if a patient has nausea every night before treatment, this may be caused by anxiety, as opposed to post-treatment nausea, which may be caused by the drug.


Constipation can also be a sign of high calcium levels, as well as dehydration, thirst, confusion and worsening underlying bone pain – so this is worth pointing out. Fiber, or roughage, can help prevent constipation, but that’s only part of the story. Eating fiber-rich foods like spinach, whole grains, and beans can help bulk up, but adequate hydration is also essential. Consuming enough fluids helps move bulk throughout the body and rid the body of waste. Drinking warm liquids in the morning can help relieve constipation. A patient should let their medical team know how often they have a bowel movement, in case a bowel diet is needed.


More often than not, the number on the scale doesn’t tell the whole story. If a patient tires during daily activities, such as opening a jar or going to the mailbox, they may show signs of muscle wasting. Patients should tell their medical team if they feel like they have lost muscle mass and/or lost weight without trying. A dietitian can demonstrate how to add nutrient-dense foods to the diet and explain ways to rebuild or preserve muscle mass, such as strength training and adequate protein intake.


Neutropenia is a term used to describe weak neutrophils, a type of white blood cells. Neutropenia can increase the risk of infection. Because of this risk, a medical team may discuss specific dietary guidelines to avoid harmful organisms from food and drink. Safe food handling is especially important if a patient is receiving chemotherapy or radiation therapy, or has had a stem cell transplant.


Patients should bring a notebook to appointments. Their medical team can

mention certain foods or beverages that should be avoided with medication, such as grapefruit or green tea. They may also give instructions on taking medication on an empty stomach or with food. All of this information can seem overwhelming. It may be helpful to bring a support partner for a second pair of ears or to take notes.

Nutrition should be part of a patient’s treatment plan and should be tailored to their lab results, medications, and condition. Ask to speak to a Registered Dietitian for advice on the best way to fuel the body

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