Multiple myeloma is when plasma cells become cancerous and produce bone tumors called plasmacytomas. This type of cancer is called multiple myeloma because a person has more than one plasmacytoma.
Multiple myeloma is uncommon with a lifetime risk of 1 in 132 people or 0.76 percent, according to the American Cancer Society (ACS). The ACS estimate there will be 30,770 new cases and 12,770 deaths in 2018.
It is unknown what exactly causes multiple myeloma, but it is more common in older adults and African-Americans than others. It also runs in families.
There is no cure for multiple myeloma, but the prognosis can be good if doctors catch it early.
It is essential to recognize the symptoms of this type of cancer so doctors can start treatment early, if necessary.
Symptoms of multiple myeloma vary, and many people do not experience symptoms at all in the initial stages of the disease.
When symptoms are present they may include:
- extreme weakness and fatigue
- weakness and numbness in the legs
- weight loss
- frequent infections, fevers, and illness
- increased thirst
- frequent urination
- shortness of breath
As symptoms of multiple myeloma increase and worsen, people may develop one or more related conditions.
These conditions are a consequence of the early symptoms of multiple myeloma and include:
Hypercalcemia is when a person has high levels of calcium in their blood.
People may experience extreme thirst, confusion, loss of appetite, and gastrointestinal symptoms, including constipation and nausea as a result of hypercalcemia.
Anemia is when a person's red blood cell count is low.
Myeloma cells push out red blood cells from the blood, causing anemia.
Reduced kidney function
Multiple myeloma may affect kidney function and cause kidney damage.
Advanced multiple myeloma may eventually cause fractures, pain, and bone thinning.
Myeloma cells weaken the immune system and inhibit the body's ability to fight infections.
Lab work, imaging, and bone marrow testing are used to reach a diagnosis of multiple myeloma.
Blood work might reveal the abnormal cells that myeloma produces, including M proteins and beta-2-microglobulin.
The type of proteins found in the blood can also confirm the aggressiveness of the myeloma.
In addition, doctors can use blood work to check for blood cell counts, kidney function, and calcium levels. Urine tests are another way of detecting M proteins, too.
Bone marrow testing
Drawing off a sample of bone marrow from a person's bone tissue allows technicians to carry out tests.
The sample is taken using a long needle inserted into the bone. This procedure is called a bone marrow aspiration and biopsy.
A pathologist will then examine the sample of bone, blood, and bone marrow under a microscope to look for abnormal myeloma cells.
Fluorescence in situ hybridization (FISH)
The FISH test analyzes myeloma cells, looks for genetic defects, and determines how fast myeloma cells are multiplying.
How does staging work?
The doctor will look at the tests to determine disease stage, from stage I to stage III, once testing has confirmed multiple myeloma.
Stage I means the disease is less aggressive, while stage III indicates the most aggressive disease, which may affect organs and bones.
Staging myeloma is done to help the person, and the doctor, determine prognosis and treatments.
What treatment doctors give will depend on how far advanced the disease is, whether the individual has symptoms, and the severity of those symptoms.
As there is no cure for multiple myeloma, the goals of treatment are to slow the disease's progression, reduce complications, and manage pain and symptoms.
Doctors will usually not suggest treatment if a person has no symptoms. If they have symptoms but are not getting worse, and testing indicates the disease is not advancing, treatment may not be recommended either.
Routine monitoring of someone who is not receiving treatment is done to check for symptoms and signs that indicate the disease may be advancing. This usually involves doing regular blood work and urine tests.
Doctors may suggest the following therapies:
Targeted therapy medications
These medications destroy myeloma cells by blocking specific chemicals in the cells, causing the cancerous ones to die. Giving these medications by intravenous (IV) means, through a vein in the arm, is the usual method.
These medications help the immune system fight myeloma cells. They are available in pill form and are designed to boost the immune system's ability to tackle cancer.
Chemotherapy drug treatment is a potent therapy, given in high doses to kill cancer cells aggressively and rapidly. These drugs are available in pill form or given as an IV treatment.
Radiation therapy uses energy beams to destroy myeloma cancer cells in specific areas of the body. Receiving this treatment may mean a person's cancer will not return.
Bone marrow transplants
Bone marrow transplant treatment is when a person is given healthy marrow from a donor. Before the transplant, the cancer cells must be treated with radiation or chemotherapy.
The healthy bone marrow can be transplanted into the body once the diseased cells are destroyed. The hope is that healthy cells will move into bone tissue and start creating healthy bone marrow.
Alternative therapies include acupuncture, massage, meditation, and relaxation breathing. People may find that using these techniques helps them cope with symptoms of multiple myeloma and the side effects of treatments.
Each person should discuss alternative therapies with their doctor to make sure they do not interfere with treatments and are safe.
While there is no cure for multiple myeloma, it is a manageable condition.
It is possible for a person not to experience symptoms for many years. Even when there are symptoms, for most people the treatments are helpful in slowing down the disease's progression and reducing symptoms.
The outlook is different for everyone and depends on various factors, including a person's age, overall health, and how the disease responds to treatment.
People should speak to their doctor to learn more about their prognosis and long-term outlook.