What is Multiple Myeloma?
Cancer is caused by malignant (cancerous) cells that grow and multiply without control. Multiple myeloma is a relatively rare cancer that affects plasma cells, a type of white blood cell.
Plasma cells, which are part of the immune (disease-fighting) system, produce antibodies — proteins that attack bacteria and viruses. With diseases known as plasma cell neoplasms, the body makes too many plasma cells. These abnormal plasma cells, called myeloma cells:
- Build up in the bone marrow
- Produce proteins (monoclonal protein) that may damage the kidneys
- Weaken the bone, leading to fractures
- Can cause tumors (abnormal growths) to form in the bone or soft tissue in various parts of the body, also known as plasmacytomas
The following types of plasma cell neoplasms are cancerous:
- Multiple myeloma occurs when there are two or more plasma cell tumors
- Plasmacytoma occurs when there is only one plasma cell tumor
Another plasma cell neoplasm, monoclonal gammopathy of undetermined significance (MGUS), is not cancerous but in rare cases may develop into multiple myeloma.
Multiple myeloma and other plasma cell neoplasms can also cause amyloidosis. This rare disease occurs when amyloid proteins slowly deposit in normal tissue, affecting the function of the affected organ.
The American Cancer Society estimated that about 26,850 new cases of multiple myeloma would be diagnosed in the United States in 2015, and that the disease would cause about 11,240 deaths.
Multiple Myeloma Symptoms
The symptoms of multiple myeloma may look like those associated with other bone disorders or medical problems. Some people with early multiple myeloma have no symptoms, in which case it is found during routine blood or urine tests.
Talk to your doctor if you notice any of the following:
- Bone pain, particularly in the back, hips or ribs, that does not go away
- A tendency to break bones
- Weakness or numbness, especially in the feet or legs
- Nausea and vomiting
- Weight loss for no clear reason
- Frequent infections
- Loss of appetite
- Mental confusion
Diagnosing Multiple Myeloma
The first step in diagnosing any disease is to complete a medical history and physical examination. In order to diagnose multiple myeloma, your doctor may also order tests and procedures such as:
- Blood and urine tests: These tests can detect proteins or other substances (such as monoclonal proteins) that are more likely to be seen in the blood or urine of people with multiple myeloma
- Bone marrow aspiration and/or biopsy: A small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (biopsy) is taken, usually from the back of the hip bone. A pathologist checks the sample(s) for abnormal cells that may signal multiple myeloma
- X-rays: Electromagnetic energy beams produce images of tissues, bones and organs. These images can show areas where myeloma cells have caused bone damage
- Skeletal bone survey: A series of X-rays are taken of all of the major bones in the body to detect where myeloma cells may have caused bone damage
- Magnetic resonance imaging (MRI): A magnetic field and computer assistance are used to produce detailed pictures of various organs and structures. This test can show areas where myeloma cells are involving the bone
- Computed tomography (CT) scan: A series of X-ray images are combined to produce cross-sectional views of the body and show where myeloma cells have caused bone damage
- Positron emission tomography (PET) scan: A radioactive glucose (sugar) tracer is injected to create pictures of inside the body and highlight cancer cells. A computer puts these images together to show where cancer cells are located. This scan is generally combined with a CT scan
Treating Multiple Myeloma
If you are diagnosed with multiple myeloma, your care team will work with you to develop a treatment plan that is right for you. Multiple myeloma prognosis (chance of recovery) and treatment options depend on factors such as stage (extent) of the disease along with your age and general health.
Treatment for multiple myeloma may involve one or more of these options:
- Watchful waiting for patients with smoldering myeloma (myeloma without symptoms) involves careful monitoring of the disease until it progresses or symptoms emerge. You may also hear this called active surveillance
- Chemotherapy kills myeloma cells through the use of intravenous (IV), subcutaneous, or oral drugs
- Corticosteroids may be used alone or in combination with other drugs to kill myeloma cells. They may also help treat common multiple myeloma symptoms such as nausea and vomiting
- Radiation therapy uses high-energy radiation beams to kill or shrink a tumor while saving healthy tissue. The radiation source generally comes from outside the body (external radiation therapy). Radiation therapy can also help control pain, prevent fractures and allow bone lesions to heal in multiple myeloma patients
- Targeted therapy uses drugs that attack specific parts of cancer cells without damaging normal cells
- Stem cell transplantation (autologous) or bone marrow transplant involves collecting and storing stem cells from the patient's bone marrow, administering high-dose chemotherapy, and then returning the stem cells to the patient's body through an infusion. This generally occurs in the hospital. The stem cell collection process is similar to donating blood and occurs after a period of time when a patient receives medications to help "mobilize" the stem cells. Stem cell transplantation aims to help the bone marrow recover faster from the effects of the high-dose chemotherapy
Some hospitals also offer clinical trials that may provide access to new and promising therapies for multiple myeloma.