Multiple myeloma is a type of cancer that originates from white blood cells called plasma cells. Many factors affect the outlook for a person with this disease, including their age, overall health, and kidney function, as well as the stage of cancer at diagnosis.
Multiple myeloma can lead to organ damage that affects the kidneys, the bones, and the overall immune system.
In this article, we look at the outlook for people with different stages of multiple myeloma. We also look at the symptoms and treatment of multiple myeloma and what can affect a person’s outlook.
The American Cancer Society (ACS) estimates that doctors will diagnose 34,920 new cases of multiple myeloma in 2021 and that there may be 12,410 deaths from the disease.
When a person receives a multiple myeloma diagnosis, the doctor will use the Revised International Staging System (RISS) to determine the stage of the cancer. This staging system is based on:
- the amount of albumin present in the blood
- the levels of beta-2 microglobulin
- the levels of lactate dehydrogenase (LDH) present in the blood
- the genetic features of the cancer
A person will receive a diagnosis of either stage 1, 2, or 3 multiple myeloma. There is also a stage 0, a slow-growing type of multiple myeloma that is called smoldering myeloma.
However, survival rates are based on summary staging, which the Surveillance, Epidemiology and End Results (SEER) program developed. This staging system groups cancers into:
- in situ, which is only applicable to epithelial tissue
As multiple myeloma does not spread to the lymph nodes, the regionalized stage is not relevant to this cancer.
The 5-year relative survival rate for multiple myeloma is as follows:
|SEER stage||What this means||5-year relative survival rate|
|Localized||There is only one tumor growing in or outside the bone. Doctors refer to this as a solitary plasmacytoma.||75%|
|Distant||Many tumors have appeared inside or outside the bones.||53%|
These statistics mean that a person with localized multiple myeloma is 75% as likely as someone without multiple myeloma to live for 5 years after receiving the diagnosis.
People who receive a smoldering myeloma diagnosis can live for years without any treatment. Additionally, beginning treatment early does not appear to affect the outlook.
The stage of multiple myeloma is among the factors that can affect a person’s outlook.
Other factors include:
- Kidney function: The creatinine levels in the blood provide an indication of how well the kidneys are functioning. The kidneys usually remove creatinine from the body. Damage to these organs causes creatinine levels to rise, which indicates a less positive outlook.
- Age: The ACS notes that older adults do not generally live as long with the condition.
- Overall health: Those who have been unable to manage underlying health conditions, such as heart disease or diabetes, may have a less positive outlook.
Additionally, changes in chromosomes and genetic abnormalities can affect a person’s outlook. The specific chromosomal abnormalities that doctors consider high risk affect chromosomes 4, 14, 16, and 17.
The treatment for smoldering myeloma typically consists of watchful waiting, as this stage is slow growing.
Drug therapy for multiple myeloma consists of:
- immunomodulating agents
- proteasome inhibitors
- histone deacetylase inhibitors
- monoclonal antibodies
- antibody-drug conjugates
- nuclear export inhibitors
Other treatment options include:
- radiation therapy
- stem cell transplants, which involve replacing the cancerous cells with healthy new ones
- CAR T-cell therapy, which is a type of immunotherapy
Multiple myeloma can cause:
- bone pain and weakness
- high blood levels of calcium, known as hypercalcemia
- back pain, numbness, and muscle weakness
- infections, such as pneumonia
A doctor may recommend supportive therapies to help manage these side effects. These may include surgery to help support weakened bones and prevent fractures.
A person may find support from the following organizations:
People may also find it helpful to talk with a mental health professional.
A person should contact a healthcare professional if they notice any symptoms of multiple myeloma.
After receiving a multiple myeloma diagnosis, a person may want to ask the following questions:
- What is the location of the cancer?
- Has the cancer spread?
- What stage is the cancer at, and what does this mean?
- What are the recommended treatment options, and why?
- What are the steps to prepare for treatment?
- How will the treatment affect daily life?
Multiple myeloma is a type of cancer that affects the blood. The outlook for people with multiple myeloma depends on the stage of the cancer at the time of diagnosis. It also depends on how well a person’s kidneys are functioning and their age and overall health.
However, different treatment options are available. A person should talk with a healthcare professional about which treatment options would best suit them.