Although patients with multiple myeloma (MM) experience many different symptoms while undergoing treatment, researchers identified worry as a core symptom in a study published in Supportive Care in Cancer.

For this study, a group of researchers conducted a cross-sectional survey of 177 patients with MM in China with the goal of identifying their core symptom.

They used a questionnaire with established reliability and validity to measure symptoms of chemotherapy-treated multiple myeloma, including pain, fatigue, nausea, vomiting, and worry. As data collection occurred during the COVID-19 pandemic, both online and offline methods were used to collect data.

Continue Reading

At the end of data collection, the researchers had received 170 completed questionnaires for analysis. Of those patients, 51.8% were aged 60 years or younger, and 48.2% were older than 60.

The “most prevalent and distressing” symptom for patients with MM was pain, which was reported by 71.76% of participants, followed by lack of energy (67.06%) and trouble sleeping (63.53%). Bone disease, peripheral neuropathy, and procedural pain were cited as contributing factors to the pain. The participants reported experiencing pain throughout all stages of disease, which affected their quality of life.

Additionally, the analysis revealed that the most severe symptoms were problems with sexual interest or activity, and lack of energy, as well as pain. The symptoms with the strongest correlation were nausea and vomiting.

However, worry was determined to be a core symptom, or the one symptom with the greatest effect on other symptoms. Worry was reported by 54.1% of the participants, a higher rate than reported in previously conducted studies. Worry can be in regard to the cancer itself, financial pressures, and the effectiveness of treatment.

The researchers suggested that interventions to address worry could relieve other symptoms. Potential interventions include health education, physical activity, aromatherapy, and cognitive behavioral therapy.

An understanding of the correlation between symptoms could improve symptom management in chemotherapy-treated patients with MM. “By focusing on worrying while managing symptoms in a clinical setting, interventions would have maximal effectiveness due to a chain reaction,” they wrote in their conclusion.


Zeng L, Huang H, Liu Y, et al. The core symptom in multiple myeloma patients undergoing chemotherapy: a network analysis. Support Care Cancer. Published online April 25, 2023. doi:10.1007/s00520-023-07759-7