Multiple Myeloma

What is multiple myeloma?

Multiple myeloma is a cancer of plasma cells. Plasma cells are white blood cells made in the bone marrow, which is the spongy tissue inside bones. Normal plasma cells make proteins called antibodies to fight infection. In multiple myeloma, abnormal plasma cells grow quickly and uncontrollably to form tumors in bone. They make a lot of abnormal antibodies. As a result, you have too many antibodies that are not useful. There may be so many of these proteins in your blood that your blood becomes too thick.

The plasma cell tumors interfere with the growth and function of normal cells made by the bone marrow. This results in anemia (too few red blood cells, which carry oxygen) and lowered resistance to infection. Fewer blood platelets are produced, so your blood clots more slowly than normal and bleeding may occur.

The uncontrolled production of plasma cells in the bone marrow also causes pain in the bones. Bone tissue may be destroyed, and the bones may break more easily. Calcium from destroyed bone tissue can accumulate in the blood. This condition, called hypercalcemia, can affect many organs in the body, such as the kidneys, nerves, heart, muscles, and digestive tract. The damage to these organs can cause serious health problems. Collapsed bones in the spine may compress nerves, causing numbness or paralysis. If it is not treated, multiple myeloma can spread throughout your body and be fatal.

How does it occur?

The cause of multiple myeloma is not known. It affects mainly people who are middle-aged or older. It affects more men than women and affects African Americans twice as often as Caucasians.

What are the symptoms?

Sometimes it may not cause any symptoms. When it does, symptoms it may cause are:

bone pain, especially in the back or ribs
fever for no known reason or frequent infections
tiredness, weakness, drowsiness
easy bruising or bleeding
trouble breathing
bones that break easily.

How is it diagnosed?

Your health care provider will ask about your symptoms and do a physical exam. He or she may order the following tests:

blood and urine tests
a bone marrow biopsy, a procedure in which a needle is used to take a sample of bone marrow to look for myeloma cells
x-rays of bones.

How is it treated?

The goals of treatment are to decrease the number of the abnormal plasma cells, reduce pain, correct anemia, combat infection, and relieve any other problems caused by the disease. Your health care provider will determine your treatment plan based on the extent of the cancer, your symptoms, your age, and your general health.

Your provider may recommend a combination of the following therapies:

anticancer drugs (chemotherapy) to destroy cancer cells and slow their growth (A number of new drugs have become available recently that are very effective.)
a single or double bone marrow transplant
radiation treatments to relieve bone pain and help control the growth of the cancer
antibiotics to treat infections, which can occur more often during chemotherapy
blood transfusions, if needed, for anemia
medicines to relieve pain
corticosteroid drugs (steroids) to make chemotherapy more effective
medicines to strengthen your bones
biologic therapy (also called immunotherapy), which uses your body's immune system to fight the cancer.

These steps may slow or temporarily stop the growth of the cancer and ease the symptoms. The disease may go away completely for a time (go into remission) but then return.

How long will the effects last?

You may enjoy periods of normal health, though relapses of multiple myeloma will occur. About 20% of people live more than 4 years after diagnosis. Some can even be cured. Rarely, the disease is so mild that treatment is not necessary.

How can I take care of myself?

Follow these guidelines:

Complete the full course of recommended treatment.
See your provider right away if you notice a return of any previous symptoms or if you develop new ones.
Learn about the side effects you may have from radiation or chemotherapy. It may help to be prepared for severe or distressing side effects, such as baldness.
Avoid unproven cancer treatments without discussing them first with your provider. Besides costing money, unproven therapies may delay or interfere with possibly life-saving, conventional treatment.

You may also find it helpful to join a cancer support group during your illness and recovery.

For more information, contact organizations such as:

American Cancer Society, Inc.
Phone: 800-ACS-2345 (800-227-2345)
Web site: http://www.cancer.org
AMC Cancer Research Center and Foundation
Phone: 800-525-3777
Web site: http://www.amc.org
National Cancer Institute Cancer Information Service
Phone: 800-4-CANCER (1-800-422-6237)
Web site: http://cis.nci.nih.gov

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File CNC3531F.HTM Release 9.0/2006