Description

Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Healthy plasma cells help you fight infections by making proteins called antibodies. The antibodies find and attack germs.

In multiple myeloma, cancerous plasma cells accumulate in the bone marrow. The bone marrow is the tissue of matter in the interior of the bone where blood cells are made. In the bone marrow, cancer cells crowd healthy blood cells. Instead of making the helpful antibodies, the cancer cells of proteins that do not function well. This leads to complications of multiple myeloma.

The treatment of multiple myeloma is not always needed right away. If multiple myeloma is of slow growth, and it is not causing symptoms, about to see could be the first step. For people with multiple myeloma who need treatment, there are a number of ways to help to control the disease.

Symptoms

Early in multiple myeloma, there may be no symptoms. When signs and symptoms do occur, they can include:

  • Pain in the bones, especially in the spine, the chest or hips.
  • Nausea.
  • The constipation.
  • Loss of appetite.
  • Mental fogginess or confusion.
  • Fatigue.
  • Infections.
  • The loss of weight.
  • The weakness.
  • Of thirst.
  • Need to urinate frequently.

When to see a doctor

Make an appointment with a doctor or other health care professional if you have symptoms that concern you.

Causes

It is not clear what causes myeloma.

Multiple myeloma begins with one of the plasma cells in the bone marrow. The bone marrow is the tissue of matter in the interior of the bone where blood cells are made. Something happens that makes the plasma cells in a cancerous tumor of myeloma cells. The myeloma cells begins to make much more of myeloma cells quickly.

Healthy cells grow at a pace and die at a set time. Cancer cells do not follow these rules. They do a lot of extra cells. The cells continue living when healthy cells would die. In myeloma, cancer cells build up in the bone marrow and crowd out the healthy blood cells. This leads to fatigue and not being able to fight infections.

Myeloma cells continue trying to make antibodies, such as healthy plasma cells do. But the body can't use these antibodies, called monoclonal proteins or M proteins. In contrast, the M proteins accumulate in the body and cause problems, such as damage to the kidneys. Myeloma cells can harm the bones and increase the risk of bone fractures.

A connection with MGUS

Multiple myeloma starts as a condition called monoclonal gammopathy of undetermined significance, also called MGUS. In MGUS , the level of M protein in the blood is low. The M proteins do not cause damage in the body.

Risk factors

Factors that may increase the risk of multiple myeloma include:

  • Aging. Most people are diagnosed in their late 60's.
  • The fact of being a man. Men are more likely to develop the disease than women.
  • Be Black. Black people are more likely to develop multiple myeloma than are people of other races.
  • Having a family history of multiple myeloma. Having a brother or a father with multiple myeloma increases the risk of the disease.
  • To have monoclonal gammopathy of undetermined significance, also calledMGUS. Multiple myeloma is started as MGUS , so having this condition increases the risk.

There is no way to prevent multiple myeloma. If you get multiple myeloma, not to do anything because of it.

Complications

Complications of multiple myeloma include:

  • Infections. Have multiple myeloma reduces the body's ability to fight infections.
  • Problems in the bones. Multiple myeloma can cause bone pain, bone thinning and fractures of bones.
  • Kidney problems. Multiple myeloma can cause problems with the kidneys. This can lead to kidney failure.
  • Low count of red blood cells, called anemia. As the myeloma cells crowd healthy blood cells, multiple myeloma can also cause anemia and other blood problems.

Diagnosis

Sometimes a health care professional is multiple myeloma during a blood test for another condition. Other times, symptoms may lead to your health professional to test for multiple myeloma.

Tests and procedures of diagnosis of multiple myeloma include:

  • Blood tests.The M proteins produced by myeloma cells can be displayed in a blood sample. Blood tests also can find another protein in myeloma cells, called beta-2-microglobulin. Other blood tests give your health care team clues about your diagnosis. These tests can include tests that are seen in the renal function, blood cell counts, levels of calcium and uric acid levels.
  • Urine tests. M proteins can be displayed in the urine samples. In the urine, the proteins are called Bence Jones proteins.
  • The bone marrow test.Bone marrow biopsy and bone marrow aspiration are used to collect bone marrow samples for the test. The bone marrow has a solid and a liquid. In a bone marrow biopsy, a needle is used to collect a small amount of solid tissue. In a bone marrow aspiration, a needle is used to remove a sample of fluid. The samples are usually taken from the hip bone. Samples of going to a lab for analysis. In the laboratory, tests to look for myeloma cells. Other special tests to give to your health care team for more information about their myeloma cells. For example, the fluorescence in situ hybridization of the test looks for changes in the cells, the genetic material called DNA.
  • Imaging tests. Imaging tests can show the bones of the problems associated with multiple myeloma. The tests may include a chest x-ray, magnetic resonance imaging, computed tomography, or positron emission tomography scan, also called a PET.

Blood tests. The M proteins produced by myeloma cells can be displayed in a blood sample. Blood tests also can find another protein in myeloma cells, called beta-2-microglobulin.

Other blood tests give your health care team clues about your diagnosis. These tests can include tests that are seen in the renal function, blood cell counts, levels of calcium and uric acid levels.

The bone marrow test. Bone marrow biopsy and bone marrow aspiration are used to collect bone marrow samples for the test. The bone marrow has a solid and a liquid. In a bone marrow biopsy, a needle is used to collect a small amount of solid tissue. In a bone marrow aspiration, a needle is used to remove a sample of fluid. The samples are usually taken from the hip bone.

Samples of going to a lab for analysis. In the laboratory, tests to look for myeloma cells. Other special tests to give to your health care team for more information about their myeloma cells. For example, the fluorescence in situ hybridization of the test looks for changes in the cells, the genetic material called DNA.

Stages

Your test results help your healthcare team to decide their myeloma of the stage. In multiple myeloma, the stages in the range of 1 to 3. The scenario tells your health care team how quickly your myeloma is growing. Stage 1 multiple myeloma is growing little by little. As the stages higher, the myeloma becomes more aggressive. Stage 3 multiple myeloma is quickly getting worse.

Multiple myeloma can also have a level of risk. This is another way of saying how aggressive the disease.

Your health care team uses multiple myeloma stage and the level of risk to understand their prognosis and treatment plan.

Treatment

The treatment of multiple myeloma is not always needed right away. If there are no symptoms, you may have tests to see myeloma, to see if it gets worse. When the multiple myeloma causes of the symptoms, the treatment often begins with medication. The treatment can help to relieve the pain, the control of complications and slow down the growth of myeloma cells.

The treatment may not be needed immediately

Sometimes multiple myeloma does not cause symptoms. Doctors call this smoldering multiple myeloma. This type of multiple myeloma may not need treatment right away.

If the myeloma is at an early stage and is growing little by little, you could have regular check-ups to monitor the cancer. A health care provider may do a blood test and a urine test to look for signs that the myeloma is getting worse.

You and your health care team might decide to start the treatment if you develop multiple myeloma symptoms.

Treatments for myeloma

Treatments may include:

  • The targeted therapy. Targeted therapy uses drugs that attack specific chemicals in cancer cells. By blocking these chemicals, specific treatments can cause cancer cells to die.
  • Immunotherapy. Immunotherapy is a treatment with a medication that helps the body's immune system to kill cancer cells. The immune system fights diseases by attacking the germs and other cells that should not be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the cells of the immune system find and kill cancer cells.
  • CAR-T cell therapy.Chimeric antigen Receptor T cell therapy, also called CAR-T cell therapy, train your immune system cells to fight against multiple myeloma. This treatment begins with the removal of some white blood cells, including T cells, in your blood. The cells are sent to a lab. In the laboratory, the cells are treated in such a way that they have special receptors. The receptors help the cells to recognize a marker on the surface of myeloma cells. Then, the cells were placed back in her body. Now they can find and destroy multiple myeloma cells.
  • Chemotherapy. Chemotherapy uses strong drugs to kill cancer cells. The drugs kill fast-growing cells, including myeloma cells.
  • Corticosteroids. Corticosteroids are medications to help control the swelling and irritation, called inflammation in the body. Also work against myeloma cells.
  • Bone marrow transplant.A bone marrow transplant, also known as stem cell transplant replaces diseased bone marrow with healthy bone marrow. Before a bone marrow transplant, the blood-forming stem cells are collected from your blood. High-dose chemotherapy is then given to destroy your diseased bone marrow. Then, the stem cells are put into your body. Travel to the bones and begin the reconstruction of the bone marrow. This type of transplant, using their own cells is called an autologous bone marrow transplant. Sometimes, the stem cells come from a healthy donor. This type of transplant is called an allogeneic transplant of bone marrow.
  • The radiation therapy. Radiation therapy uses high-energy rays to kill cancer cells. The energy can come from X-rays, protons or other sources. Radiation can quickly reduce a growth of myeloma cells. It can be used if the myeloma cells form a mass called a plasmacytoma. The radiation can help control a plasmacytoma that is causing the pain or the destruction of a bone.

CAR-T cell therapy. Chimeric antigen Receptor T cell therapy, also called CAR-T cell therapy, train your immune system cells to fight against multiple myeloma. This treatment begins with the removal of some white blood cells, including T cells, in your blood. The cells are sent to a lab. In the laboratory, the cells are treated in such a way that they have special receptors. The receptors help the cells to recognize a marker on the surface of myeloma cells.

Then, the cells were placed back in her body. Now they can find and destroy multiple myeloma cells.

Bone marrow transplant. A bone marrow transplant, also known as stem cell transplant replaces diseased bone marrow with healthy bone marrow.

Before a bone marrow transplant, the blood-forming stem cells are collected from your blood. High-dose chemotherapy is then given to destroy your diseased bone marrow. Then, the stem cells are put into your body. Travel to the bones and begin the reconstruction of the bone marrow. This type of transplant, using their own cells is called an autologous bone marrow transplant.

Sometimes, the stem cells come from a healthy donor. This type of transplant is called an allogeneic transplant of bone marrow.

How are the treatments used

Your treatment plan will depend on if it is likely that you will have a bone marrow transplant. When deciding if a bone marrow transplant is the best for you, your health care team takes into account many factors. These include if your multiple myeloma is likely to worsen, your age, and your health in general.

  • When bone marrow transplantation is an option.If your health care team thinks bone marrow transplant is a good option for you, the treatment often begins with a combination of drugs. The mixture may include targeted therapy, immunotherapy, corticosteroids and, in some cases, chemotherapy. After a few months of treatment, blood stem cells are collected from your blood. The bone marrow transplant can occur shortly after collection of the cells. Or would you wait until after a relapse, if there is one. Sometimes, doctors suggest two bone marrow transplants for people with multiple myeloma. After the bone marrow transplantation, it is likely that the targeted therapy, or immunotherapy. These can help keep the myeloma of return.
  • When bone marrow transplantation is not an option. If you choose not to have a bone marrow transplant, the treatment may include a combination of medications. The mixture may include targeted therapy, immunotherapy, corticosteroids and, in some cases, chemotherapy.
  • When the myeloma comes back or does not respond to treatment.The treatment may involve having another course of the same treatment. Another option is to try one or more of the other available treatments for multiple myeloma. The research on new treatments in the course. You may be able to join a clinical trial. A clinical trial may allow you to test new treatments that are being tested. Ask your health care team about what clinical trials are available.

When bone marrow transplantation is an option. If your health care team thinks bone marrow transplant is a good option for you, the treatment often begins with a combination of drugs. The mixture may include targeted therapy, immunotherapy, corticosteroids and, in some cases, chemotherapy.

After a few months of treatment, blood stem cells are collected from your blood. The bone marrow transplant can occur shortly after collection of the cells. Or would you wait until after a relapse, if there is one. Sometimes, doctors suggest two bone marrow transplants for people with multiple myeloma.

After the bone marrow transplantation, it is likely that the targeted therapy, or immunotherapy. These can help keep the myeloma of return.

When the myeloma comes back or does not respond to treatment. The treatment may involve having another course of the same treatment. Another option is to try one or more of the other available treatments for multiple myeloma.

The research on new treatments in the course. You may be able to join a clinical trial. A clinical trial may allow you to test new treatments that are being tested. Ask your health care team about what clinical trials are available.

The treatment of the complications

The treatment might include the treatment of the complications of multiple myeloma. For example:

  • Pain in the bones. Pain medications, radiation therapy, and surgery can help control the pain in the bones.
  • The kidney damage. People with severe kidney damage may need dialysis.
  • Infections. Vaccines can help prevent infections, such as influenza and pneumonia.
  • The loss of bone. The bone-building drugs could help prevent the loss of bone.
  • Anemia. The medication can increase the number of red blood cells in the blood. This can help alleviate the course of the anemia.

Alternative medicine

There are alternative medicines that have been found to treat multiple myeloma. But alternative medicine may help deal with the stress and the side effects of myeloma and myeloma treatment.

The options may include:

  • Art therapy.
  • Exercise.
  • Meditation.
  • Music therapy.
  • The relaxation exercises.
  • Spirituality.

Talk with your doctor before trying any of these techniques to make sure that it has no risks.

Coping and support

A cancer diagnosis can be a shock. With time, you will find ways to cope with the stress of living with cancer. Until you find what works best for you, try:

  • Learn enough to help guide your care.Learn about multiple myeloma, so that you feel comfortable in making decisions about your care. Ask your health care team about your treatment options and their side effects. Ask your health care team to recommend good sources of information. You could start with the National Cancer Institute and the International Myeloma Foundation.
  • They have a strong support system.This can help you to deal with the problems and concerns that may arise. Ask your friends and family. A support group of people who are dealing with cancer might be useful. People gather in support groups can offer tips on how to cope with the day-to-day problems. You can join some support groups on-line.
  • Set goals that you can achieve. Having goals helps you feel in control and can give you a sense of purpose. But don't choose goals that you can't reach. You might not be able to work full-time, for example. But maybe you can work part-time. Many people find that the work during cancer treatment can help your mood.
  • Take time for yourself. Eat well, relax and get plenty of rest can help to combat the stress and fatigue that causes cancer. Plan for times when you need to rest more or less.

Learn enough to help guide your care. Learn about multiple myeloma, so that you feel comfortable in making decisions about your care. Ask your health care team about your treatment options and their side effects.

Ask your health care team to recommend good sources of information. You could start with the National Cancer Institute and the International Myeloma Foundation.

They have a strong support system. This can help you to deal with the problems and concerns that may arise. Ask your friends and family.

A support group of people who are dealing with cancer might be useful. People gather in support groups can offer tips on how to cope with the day-to-day problems. You can join some support groups on-line.

Preparing for your appointment

If you have symptoms that worry you, make an appointment with a doctor or other health care professional.

If you have multiple myeloma, it is likely that you will be referred to a specialist. This could be:

  • A doctor who specializes in the treatment of blood and bone marrow disorders. This doctor is called a hematologist.
  • A doctor who specializes in the treatment of cancer. This doctor is called an oncologist.

Here's some information to help you prepare for your appointment.

What you can do

A family member or friend who goes with you can help you remember the information they give you.

Make a list of:

  • The symptoms, when they started and if they have changed over time.
  • Other medical conditions you have, especially plasma conditions, such as monoclonal gammopathy of undetermined significance, also called MGUS.
  • All the medications, vitamins and supplements, including doses.
  • Questions to ask your health care provider.

Questions to ask at your first appointment could include:

  • What can be causing my symptoms?
  • There are other possible causes?
  • What tests do I need?
  • What should I do to find my diagnosis and treatment?

Questions to ask if you see a specialist include:

  • Do I have multiple myeloma?
  • At what stage of myeloma have?
  • Does my myeloma have any high-risk characteristics?
  • What are the goals of treatment for me?
  • What treatment do you recommend it?
  • I have these other health problems. How can I better manage with multiple myeloma?
  • What are the possible side effects of treatment?
  • If the first treatment does not succeed, what will be the next option?
  • I am likely to have a bone marrow transplant?
  • I need a medication to strengthen bones?
  • What is the outlook for my condition?

Be sure to ask all the questions you have about your condition.

What to expect from your doctor

Be prepared to answer some questions about your symptoms and your health, including:

  • Do you have bone pain? Where?
  • You are nausea, more tired or weaker than usual, or have you lost weight?
  • Can you keep getting infections, such as pneumonia, sinusitis, bladder, or kidney infections, infections of the skin, or shingles?
  • Have you noticed changes in your bowel habits?
  • Do you have a family history of plasma disorders such as MGUS ?
  • Do you have a history of blood clots?
Symptoms and treatment of Multiple myeloma