Multiple Myeloma

What is multiple myeloma?

  • Multiple myeloma is also called myeloma or plasma cell myeloma. It is a cancer of the plasma cell. Plasma cells are a type of white blood cell (WBC) present in your bone marrow. The bone marrow is the soft, spongy material in the center of bones where blood cells are made. Normally, your body makes more WBCs only when needed. Some of these WBCs become plasma cells which produce antibodies. Antibodies are proteins that help fight infections and diseases.

  • In myeloma, plasma cells become abnormal. These cells grow and divide without control or order, often making too much tissue (tumor). The abnormal plasma cells are called myeloma cells that produce an excess antibody called monoclonal protein or M protein. Myeloma cells may also grow into the bones and other nearby healthy tissues. The cells may also break away from the tumor and spread through the blood stream or lymphatic system to other parts of the body. Once cancer cells spread, the cancer is harder to control.

What causes multiple myeloma?

There is no known cause of multiple myeloma but you cannot catch it from someone else. The following may put you at higher risk for having myeloma:

  • Being older than 40 years.

  • Being overweight or weighing more than your caregiver suggests.

  • Being exposed to a lot of radiation or chemicals, such as arsenic, asbestos, lead, herbicides, or pesticides.

  • Having a parent, brother, or sister with myeloma.

  • Having other plasma cell diseases.

  • Infections caused by germs, such as viruses.

What are the signs and symptoms of multiple myeloma?

There are often no signs and symptoms in the early stages of myeloma. Sometimes, you may learn you have myeloma by having blood tests for another health problem. The most common symptom of myeloma is bone pain usually in the lower back, pelvis (hip area), or ribs. As myeloma becomes worse, you may have weak bones which break. You may also have one or more of the following:

  • Frequent signs and symptoms of an infection, such as fever, cough, or chills.

  • Nausea (upset stomach) or vomiting (throwing up).

  • Shortness of breath.

  • Tiredness or weakness.

  • Trouble urinating or having a bowel movement (BM).

  • Weight loss.

How is multiple myeloma diagnosed?

You may have one or more of the following tests:

  • Bone marrow biopsy: This is when a sample of bone marrow is removed and sent to a lab for tests. Bone marrow is the soft, spongy tissue inside the bone. The skin over your upper hipbone is first cleaned. Caregivers put numbing medicine into your skin so you will have little pain. A bandage is put on the biopsy area after the tissue sample is taken.

  • Imaging tests:

    • Chest and skeletal x-rays: These are pictures of the ribs and other bones in the body. Caregivers use these x-rays to see if other bones are affected by the cancer or if the cancer has spread to your lungs. Bone x-rays can also show if any of your vertebrae (bones in your spine) have collapsed onto one another.

    • Computerized tomography scan: This is also called a CT or CAT scan. An x-ray machine uses a computer to take pictures of a specific part of your body. It may be used to look at your brain, bones, muscles, and blood vessels.

    • Magnetic resonance imaging: This test is also called an MRI. MRI uses sound waves and strong magnets to take pictures of the brain, muscles, joints, bones, or blood vessels. Entering the MRI room with an oxygen tank, watch, or any other metal objects can cause serious injury. Tell your caregiver if you have any metal implants in your body.

    • Positron emission tomography scan: This is also called a PET scan. The test can find tumors by tracing the way your body cells act upon sugar.

  • Serum protein electrophoresis: This blood test uses electrical current to find and measure M proteins in the blood or serum. Finding M proteins confirms the diagnosis of myeloma. This test can also show the specific type of abnormal protein produced by the myeloma.

  • Urine electrophoresis: Your urine is collected in a container for 24 hours and then sent to the lab. Special tests are done to measure "M proteins". M proteins are found in the urine of people with myeloma. These proteins can damage the kidneys so this test helps caregivers know how much is in your body.

How is multiple myeloma staged?

The stage of myeloma describes how far it has spread. Stage I (one) is the earliest stage and stage III (three) is the most advanced. Myeloma is staged based upon the following:

  • Extent of bone damage.

  • Kidney involvement.

  • Levels of hemoglobin, calcium, and M proteins in your blood or urine.

How is multiple myeloma treated?

Treatment of myeloma depends upon what stage the cancer is in and the signs and symptoms present. You may have one or more of the following treatments:

  • Bone marrow transplant (BMT): This is when your diseased bone marrow is replaced with healthy marrow. You are usually given bone marrow from someone else (a donor). Sometimes your own marrow may be used if it is collected when your cancer is in remission (not active). The bone marrow transplant is given to you in an IV while you are in the hospital. A BMT may cure your illness, but it can cause other very serious health problems. You may be in the hospital for a month after your BMT.

  • Chemotherapy:

    • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.

    • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.

  • Radiation: Radiation shrinks tumors and kills cancer cells with x-rays or gamma rays. Radiation may be given after surgery to kill cancer cells that were not removed. It may also be given alone or with chemotherapy to treat cancer.

Where can I find support and more information?

Multiple myeloma is a life-changing disease. Accepting that you have myeloma is hard. You and those close to you may feel scared, depressed, angry, or sad. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group. This is a group of people who also have myeloma. Call or write one of the following organizations for more information:

  • American Cancer Society
    250 Williams Street
    Atlanta , GA 30303
    Phone: 1- 800 - 227-2345
    Web Address: http://www.cancer.org
  • National Cancer Institute
    6116 Executive Boulevard, Suite 300
    Bethesda , MD 20892-8322
    Phone: 1- 800 - 422-6237
    Web Address: http://www.cancer.gov

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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