Multiple Myeloma

Overview

Multiple myeloma is a type of cancer that affects the plasma cells, which are a type of white blood cell that help the body fight infections. In people with multiple myeloma, the cancerous plasma cells crowd out healthy plasma cells.

Multiple myeloma almost always begins as monoclonal gammopathy of undetermined significance (MGUS), a condition that leads to M proteins in the blood.

Multiple myeloma causes

Multiple myeloma occurs when plasma cells develop a mutation (change) in their DNA. The mutated cells then multiply quickly, causing the cancer to grow out of control.

Multiple myeloma risk factors

The following factors may increase your risk for developing multiple myeloma:

• Being Black
• Being male
• Being older, especially older than age 60
• Having a family history of multiple myeloma
• Having a personal history of MGUS

Multiple myeloma symptoms

In its early stages, multiple myeloma usually doesn’t cause any symptoms. When they do occur, signs or symptoms of multiple myeloma can include:

• Confusion
• Constipation
• Decreased appetite
• Frequent, recurrent infections
• Nausea
• Numbness or weakness in the legs
• Pain in the bones, particularly in the spine or chest
• Trouble thinking clearly
• Unintentional weight loss
• Unusual and excessive thirst

Multiple myeloma diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam – including asking questions about your health history, your symptoms and related risk factors. Your doctor will check your lymph nodes for swelling.
• Blood tests – your doctor will send a sample of your blood to the laboratory for close analysis. The lab can determine if your blood has M proteins present, the sign of MGUS, leading to multiple myeloma. Your doctor can also use your blood test to determine how well your kidneys function, blood cell counts, calcium levels and uric acid levels.
• Bone marrow biopsy – in this test, your doctor removes a biopsy (small tissue sample) from your bone marrow (spongy material inside the bones). This sample is sent to the laboratory, where a specialist closely checks the biopsy for myeloma cells. 
• Imaging tests – your doctor may order imaging tests – such as X-ray, magnetic resonance imaging (MRI), computerized tomography (CT) scan or positron emission tomography (PET) scan – to help determine if you have multiple myeloma.

Multiple myeloma treatments

Depending on your personal health history, the extent of the multiple myeloma and other factors, your oncologist may recommend one or more of the following treatment options:

• Watchful waiting – if you are not experiencing any symptoms related to your multiple myeloma, you may not need to undergo treatment right away. In this case, you will see your specialist for regular visits and testing to monitor the condition.
• Bone marrow transplant – also known as a stem cell transplant, this treatment involves infusing your diseased bone marrow with healthy bone marrow. Doing so can help your body fight the cancer.
• Chemotherapy – during this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Corticosteroid medications – your doctor may prescribe this type of medication, which can help reduce inflammation in your body and regulate the immune system.
• Immunotherapy – this treatment uses your body’s immune system to fight the cancerous cells.
• Radiation therapy – this treatment uses high-powered energy beams to destroy cancerous cells.
• Targeted therapy – in this treatment, specialized medications kill cancerous blood cells. Targeted therapy may help preserve more surrounding healthy tissue than other treatment options.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.