Multiple myeloma: Symptoms, causes, and treatment

Multiple myeloma is a cancer of the plasma cells. Plasma is a type of white blood cell found in the bone marrow. The cancer affects the bones, immune system, kidneys, and red blood cell count.

Multiple myeloma is also known as myeloma or plasma cell myeloma.

The American Cancer Society (ACS) estimates the risk of developing multiple myeloma over a lifetime as 1 in 143 or 0.7 percent.

Fast facts on multiple myeloma

Multiple myeloma is a cancer of the blood plasma.

Symptoms include confusion, constipation, vomiting, and abdominal pain.

Age is a risk factor for myeloma, with 96 percent of people with myeloma aged over 45 years.

The cancer is treatable but not curable. It can be controlled using chemotherapy treatment and maintenance therapy.

Self-management techniques for myeloma include dietary and lifestyle changes.

The 5-year survival rate for multiple myeloma is 49 percent.

What is multiple myeloma?

Multiple myeloma
Multiple myeloma is a cancer of the blood plasma.

Multiple myeloma is a type of cancer. Cancer starts when the structure of the DNA in a cell changes. This is called a genetic mutation. The mutation can lead to rapid cell growth and can also stop unwanted cells from dying.

This leads to a buildup of mutated cells that form tumors.

Plasma cells are a type of white blood cell. White blood cells are produced in bone marrow, the soft, spongy tissue that is found in the middle of most bones. These white blood cells produce antibodies called immunoglobulin, which helps to fight off infections.

Multiple myeloma leads to the production of too many plasma cells inside the bone marrow. Normally, less than 5 percent of bone marrow consists of plasma cells, but in multiple myeloma, plasma cells can make up more than 10 percent of the marrow.

In this type of cancer, a group of abnormal white blood cells is produced, and they multiply in the body. These are called myeloma cells. They cause immunoglobin levels to become too high.

The abnormal myeloma cells start in the bone marrow of the spine. From there, they enter the bloodstream and travel to bone marrow in other parts of the body.

They collect in the bone marrow and the hard, outer part of the bones. As they collect in the different bones, they can cause multiple tumors. This is multiple myeloma.

Unlike many cancers, multiple myeloma is thought to spread via the bloodstream. It can reach different parts of the body quickly, making it very hard to cure.

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Symptoms

The signs and symptoms of multiple myeloma depend on the stage of the cancer and the general health of the patient. There may be no symptoms in the early stages.

If symptoms do occur, they can include bone pain, especially in the back, pelvis, ribs, and skull. High calcium levels in the blood can also indicate myeloma, as calcium from the bones dissolves into the bloodstream.

High calcium levels can cause:

excessive thirst and frequent urination

confusion

constipation

loss of appetite

nausea and vomiting

abdominal pain

Changes in red and white blood cell and platelet levels can cause:

fatigue, tiredness, and lethargy

breathlessness

repeated infections

easily bruised skin

nosebleeds, bleeding gums, or other unusual bleeding

Kidney damage and spinal cord compression may also occur, potentially leading to numbness, weakness, and tingling in the legs.

Biopsy
A biopsy can help to diagnose multiple myeloma.

To diagnose multiple myeloma, doctors use blood tests, urine tests, and X-rays.

They may request MRI or CT scans to check for bone damage. A biopsy of a sample of bone marrow will test for myeloma cells.

Sometimes a routine blood or urine test will show abnormal proteins, known as monoclonal proteins or M proteins. These can indicate multiple myeloma.

A staging system called the Durie-Salmon system is used to confirm the stage of the myeloma.

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