Multiple Myeloma

Cancer is made of changed abnormal cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to other parts of the body. This is called metastasis.

Multiple myeloma is a cancer that starts in plasma cells in your bone marrow. Plasma cells are part of your immune system. They normally make proteins called antibodies (immunoglobulins) that help fight infections. The bone marrow is the soft, inner part of some bones where all the different blood cells are made.

With multiple myeloma, the abnormal plasma cells grow out of control. These cells are called myeloma cells. They collect in the bone marrow and crowd out normal blood cells. They can form tumors in the bones called plasmacytomas. They damage and weaken the bone. A small number of people have only one tumor. This is called a solitary plasmacytoma. More often, people have tumors in many different bones. This is multiple myeloma.

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. Risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

The risk factors for multiple myeloma include:

• Being over age 65.

• Being African American.

• Being a man.

• Family history of multiple myeloma.

• Exposure to high levels of radiation.

• Exposure to certain chemicals, such as benzene and some pesticides.

• Obesity.

• A history of plasma cell diseases.

Talk with your healthcare provider about your risk factors for multiple myeloma and what you can do about them.

There’s no sure way to prevent multiple myeloma. Some risk factors can be controlled to help reduce your risk. For instance, limit exposure to and protect yourself from chemicals, and stay at a healthy weight.

Are there screening tests for multiple myeloma?

There are currently no regular screening tests for multiple myeloma. Screening tests are done to check for disease in people who don’t have symptoms.

Multiple myeloma often does not cause symptoms at first. When it does cause symptoms, the symptoms depend on where the tumor is or the problems it causes.

Myeloma cells can build up in the bone marrow and crowd out healthy cells. This can cause:

• Weakness, tiredness, or shortness of breath from having too few red blood cells.

• Frequent infections from having too few white blood cells.

• Easy bleeding or bruising from having too few platelets.

Myeloma cells make a lot of antibodies (M proteins) that make your blood very thick (hyperviscosity). This can cause:

• Dizziness.

• Confusion.

• Stroke-like symptoms, such as weakness on one side and slurred speech.

• Kidney damage.

Plasmacytomas in the bone can cause:

• Bone pain.

• Breaks or fractures in the affected bone.

• Numbness or weakness in your feet or legs, if the tumor affects the bones in your spine.

Plasmacytomas can also cause bone damage. This leads to having too much calcium in your blood (hypercalcemia). Too much calcium can cause:

• Feeling very thirsty.

• Urinating often.

• Constipation.

• Belly pain.

• Drowsiness.

• Confusion.

• Loss of appetite.

• Weakness.

• Nausea and vomiting.

Many of these may be caused by other health problems. It’s important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

Multiple myeloma may be diagnosed when you see your doctor because of symptoms. Sometimes it’s only found after abnormal blood or urine tests that were done for another reason, like a routine physical.

Your healthcare provider will ask you about your health history, symptoms, risk factors, and family history of disease. He or she will give you a physical exam.

You may also have one or more of these tests:

• Blood tests.

• Urine tests.

• X-rays.

• Bone marrow aspiration and biopsy.

After a diagnosis of multiple myeloma, you’ll likely need other tests. These help your healthcare providers learn more about the cancer. They can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It is one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

Your treatment choices depend on the number of plasmacytomas you have, where the tumors are, your symptoms, test results, and the stage of the cancer. The goal of treatment may be to control the cancer or help ease problems caused by cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy is a systemic treatment. You may have one treatment or a combination of treatments.

Multiple myeloma may be treated with:

• Active surveillance.

• Chemotherapy (chemo) and other medicines.

• Radiation therapy.

• Stem cell transplant.

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.

Cancer treatment such as chemotherapy and radiation can damage normal cells. This can cause side effects such as hair loss, mouth sores, and vomiting.

Talk with your healthcare provider about side effects you might have and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects.

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about problems or concerns you have. Work together to ease the effects of cancer and its symptoms on your daily life.

Here are tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse.

• Signs of an infection, such as a fever.

• Side effects of treatment that affect your daily function or don’t get better with treatment.