What is multiple myeloma?
Multiple myeloma is a type of blood cancer that begins in the bone marrow and represents a cancer of the plasma cell, a particular type of blood cell. Healthy plasma cells are like small factories that produce antibodies – and lots of them! In myeloma, there is an abnormal proliferation of plasma cells, clogging the circulation with excess antibodies. Multiple myeloma is not a very common cancer; approximately 20,000 people are diagnosed with multiple myeloma each year in the United States.(Source: LLS).
Some myelomas, called smoldering myelomas, do not have symptoms and may not need immediate treatment. If treatment is delayed, careful follow-up is important so that treatment can be started as soon as significant progression or symptoms become apparent. While multiple myeloma is not curable, treatment can often control disease progression and symptoms.
Multiple myeloma can interfere with production of new blood cells in the bone marrow, which can result in anemia, increased risk of infection, and easy bruising and bleeding. It also produces a substance that weakens bones and abnormal proteins that can cause kidney damage and other problems.
The cause of multiple myeloma is not known, but it is most common in people over the age of 50 and in African Americans.
Because multiple myeloma can decrease production of new blood cells, people who have it can have problems with bleeding and serious infections. Seek immediate medical care (call 911) if you, or someone you are with, have uncontrolled bleeding, severe sweating, severe difficulty breathing, pale or blue lips, fast heart rate, confusion, or loss or change in level of consciousness.
What are the symptoms of multiple myeloma?
Multiple myeloma may produce a variety of symptoms or none at all.
Common symptoms of multiple myeloma
Symptoms that can be experienced with multiple myeloma include:
Easily broken bones
Fatigue and weakness
Fever and chills
Holes in the skull bones (lytic bone lesions)
Pain or numbness of the fingers or surface areas when exposed to cold
Pale skin or pallor
Serious symptoms that might indicate a life-threatening condition
In some cases, multiple myeloma or its complications can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:
Bluish coloration of the lips or fingernails
Change in level of consciousness or alertness, such as passing out or unresponsiveness
High fever (higher than 101 degrees Fahrenheit)
Rapid heart rate (tachycardia)
Uncontrolled or heavy bleeding, hemorrhage
What causes multiple myeloma?
The specific cause of multiple myeloma is not known, but there are a number of factors associated with its development. Multiple myeloma is more common among older adults, African Americans, and men.
A number of factors increase the risk of developing multiple myeloma. Not all people with risk factors will get multiple myeloma. Risk factors for multiple myeloma include:
How is multiple myeloma treated?
Goal of cancer treatment
The goal of multiple myeloma treatment is to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in the body, although it may recur or relapse later.
It is important to continue regular visits with your medical care team so that significant progression or relapse can be identified early and to watch for and treat any complications that might result from the disease or its treatments.
Common treatments for multiple myeloma
There are many approaches to treating multiple myeloma; the specific approach taken will depend on the stage of the disease, what symptoms are present, whether kidney damage has occurred, and whether any other health problems exist. Treatment approaches include:
Biologic therapy to enhance the immune system’s ability to fight cancer
Chemotherapy to attack cancer cells
Immunomodulators to help reduce the production of abnormal proteins by cancer cells
Participation in a clinical trial testing promising new treatments for multiple myeloma
Stem cell transplant to provide healthy stem cells that can make new blood cells
Steroids to slow growth of cancer cells and enhance other therapies
Targeted therapy to limit the production of new cancer cells
Watchful waiting to identify when to start treatment
Other treatments for multiple myeloma
Other therapies may be added to help with your general state of health and any complications of the cancer or its treatment including:
Antinausea medications if needed
Bisphosphonates to help strengthen bones
Blood transfusions to temporarily replace blood components (such as red blood cells or platelets) that have been reduced or lost
Dietary counseling to help maintain strength and nutritional status
Intravenous fluids to help flush excess calcium out of the bloodstream
Pain medications if needed to increase comfort
Plasmapheresis to remove excess proteins from the blood
Surgery to support weakened bones or treat bone fractures
Vaccinations to prevent diseases like the flu and pneumonia
Some complementary treatments may help some people to better deal with multiple myeloma and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.
Complementary treatments may include:
Nutritional dietary supplements, herbal remedies, tea beverages, and similar products
In cases in which multiple myeloma has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift away from controlling the disease and focus on measures to keep a person comfortable and maximize the quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support the patient’s family.
Complications of untreated or poorly controlled multiple myeloma can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of multiple myeloma include:
Adverse effects of multiple myeloma treatment
Amyloidosis (rare immune-related disorder characterized by protein buildup in organs and tissues that can cause serious complications)
Anemia (low red blood cell count)
Hypercalcemia (increased calcium in the blood)
Hyperviscosity syndrome (thickened blood that is difficult for the heart to pump)
Immune deficiency and frequent infections
Spinal cord compression, which can cause paralysis and loss of sensation
Spread of cancer