Cancer, Multiple Myeloma

Multiple myeloma is a type of blood cancer that starts in a specific white blood cell called a plasma cell. Plasma cells are important because they make antibodies, which are proteins that help our bodies fight off infections by identifying and attacking germs.

In multiple myeloma, these plasma cells become cancerous and multiply in the bone marrow. Bone marrow is the soft, spongy tissue inside our bones where new blood cells are created. When cancerous plasma cells take over the bone marrow, they crowd out the healthy blood cells that are supposed to be there. Instead of producing helpful antibodies, these cancerous cells make faulty proteins. This disruption in the body's functions leads to the various problems associated with multiple myeloma.

Treatment for multiple myeloma isn't always needed right away. If the cancer is growing slowly and isn't causing any noticeable symptoms, doctors might decide to monitor the situation closely first. For people who do need treatment, there are several different approaches to help manage the disease.

For help finding a doctor specializing in multiple myeloma, contact one of our clinics below:

Arizona: 520-675-7496 Florida: 904-850-5836 Minnesota: 507-792-8718

Multiple myeloma, a type of blood cancer, can sometimes have no noticeable symptoms at first. However, as the disease progresses, several signs and symptoms may appear. These include:

• Bone pain: This is a common symptom, often felt in the spine, chest, or hips. The pain can range from mild to severe. It might be constant or come and go.

• Upset stomach (nausea): Feeling nauseous can be a sign of the disease.

• Trouble with bowel movements (constipation): Having difficulty passing stool is another possible symptom.

• Loss of appetite: A reduced desire to eat might occur.

• Brain fog or confusion: Some people experience mental fuzziness or difficulty concentrating.

• Fatigue (tiredness): Feeling unusually tired and drained is a common complaint.

• Frequent infections: The immune system may be weakened, making you more susceptible to infections like colds or the flu.

• Weight loss: Unintentional weight loss is a possible symptom.

• Muscle weakness: Feeling weaker than usual in your muscles can be a sign.

• Increased thirst: You might feel more thirsty than usual.

• Frequent urination: Having to urinate more often than usual can be a symptom.

It's important to note that these symptoms can also be caused by other health problems. If you experience any of these symptoms, it's crucial to see a doctor for a proper diagnosis.

If you're experiencing health concerns, please schedule an appointment with a doctor or other medical professional.

Sign up for our free guide to managing cancer. This comprehensive resource will help you understand how to cope with cancer and also provides advice on getting a second opinion from another doctor. You can easily unsubscribe at any time.

Your cancer coping guide will be sent to your inbox soon.

Multiple myeloma, a type of blood cancer, has an unclear cause. It begins when a single plasma cell, a type of blood cell made in the soft, inner part of the bones called the bone marrow, becomes cancerous. This cancerous cell, now a myeloma cell, begins rapidly multiplying, creating many more myeloma cells.

Unlike healthy cells that grow and die at a specific rate, cancer cells ignore these natural controls. They keep dividing and making new cells without stopping, even when healthy cells would naturally die. In myeloma, these extra myeloma cells build up in the bone marrow, crowding out healthy blood cells. This overcrowding makes people feel tired and more vulnerable to infections because the body doesn't have enough healthy blood cells.

Although myeloma cells are similar to healthy plasma cells, they still try to produce antibodies. These antibodies, called M proteins, are not helpful to the body. Instead of fighting infection, the M proteins build up, causing problems like kidney damage. Myeloma cells also damage bones, increasing the risk of fractures.

Often, multiple myeloma starts as a condition called monoclonal gammopathy of undetermined significance (MGUS). In MGUS, the body produces slightly abnormal antibodies (M proteins), but the levels are very low and don't cause any problems. So, MGUS is a precursor to myeloma, but not everyone with MGUS will develop myeloma. It's important to note that many people with MGUS never develop myeloma.

Multiple myeloma is a type of cancer. Several things might make a person more likely to get it, but none of these things are guarantees. Here are some factors:

• Age: Most people are diagnosed with multiple myeloma when they are in their late 60s. As people get older, their risk tends to increase.

• Sex: Men are slightly more likely to develop multiple myeloma than women.

• Race: Black people have a higher risk of developing multiple myeloma compared to other racial groups. It's important to remember that this doesn't mean everyone of that race will get it.

• Family history: If a person has a close relative (like a sibling or parent) with multiple myeloma, their risk of developing the disease is a bit higher. This suggests a possible genetic link, but it doesn't mean everyone with a family history will get it.

• MGUS (Monoclonal Gammopathy of Undetermined Significance): Sometimes, people develop a condition called MGUS. This condition is related to multiple myeloma, and having MGUS significantly increases the chances of developing multiple myeloma later. It's important to note that most people with MGUS never develop myeloma.

It's crucial to understand that there's no way to prevent multiple myeloma. If someone develops the disease, it's not their fault. It's a complex condition with multiple possible causes, and current research is ongoing to better understand its development.

Multiple myeloma can cause several problems. One major issue is a weakened immune system, making the body more vulnerable to infections. This is because myeloma, a type of cancer, interferes with the body's natural defenses.

Another significant complication is bone damage. Multiple myeloma can cause pain in the bones, make them weaker and more prone to fractures, and even lead to thinning of the bones. This happens because myeloma cells can disrupt the normal bone-building process.

Kidney problems are also a concern. Myeloma can affect the kidneys, potentially causing kidney damage and, in severe cases, kidney failure. This is because the myeloma cells can build up in the kidneys, interfering with their function.

Finally, myeloma can also affect blood cell production. The cancer cells can crowd out healthy blood cells, leading to a low red blood cell count, a condition called anemia. This can cause fatigue, weakness, and shortness of breath, among other symptoms. Other blood cell types can also be affected.

Diagnosing Multiple Myeloma: A Look at the Tests

Doctors sometimes find multiple myeloma during routine blood tests for other health concerns. Other times, symptoms prompt a test to check for the disease. Several tests and procedures help diagnose multiple myeloma:

1. Urine Tests: A urine sample can reveal abnormal proteins, called Bence Jones proteins, which are sometimes present in multiple myeloma.

2. Bone Marrow Tests: To examine bone marrow, doctors use a procedure called a bone marrow biopsy and aspiration. Bone marrow is the spongy tissue inside your bones that produces blood cells. A small sample of the solid part of the bone marrow (biopsy) and a sample of the liquid part (aspiration) are taken, usually from the hip bone. These samples are sent to a lab for analysis. Lab tests look for myeloma cells. Further specialized tests, like fluorescence in situ hybridization (FISH), examine the cells' genetic material for any changes.

3. Imaging Tests: Imaging tests, such as X-rays, MRI scans, CT scans, and PET scans, can show any bone damage associated with multiple myeloma. These images help reveal potential problems in the bones.

4. Blood Tests: The abnormal proteins (M proteins) produced by myeloma cells can be detected in blood samples. Blood tests also look for another protein called beta-2-microglobulin, which can be elevated in multiple myeloma. Doctors also check kidney function, blood cell counts, calcium levels, and uric acid levels. These tests provide valuable information about the condition.

Understanding the Stage and Risk of Multiple Myeloma:

The results of these tests help doctors determine the stage of the multiple myeloma. There are three stages (1, 2, and 3). Stage 1 indicates a slow-growing disease, while stage 3 shows a more aggressive, quickly progressing form.

Doctors also assign a risk level to multiple myeloma. This further clarifies the aggressiveness of the disease.

How the Diagnosis Impacts Treatment:

The stage and risk level of multiple myeloma are crucial in determining the best treatment plan and predicting the likely outcome (prognosis) of the disease. Doctors use this information to personalize the treatment approach for each patient.

Multiple myeloma treatment isn't always needed right away. If there are no symptoms, doctors might monitor the myeloma to see if it worsens. This is often done through regular checkups and tests, like blood and urine tests. When symptoms appear, treatment usually begins with medication.

Treatment aims to relieve pain, manage any complications, and slow the growth of myeloma cells. Sometimes, multiple myeloma doesn't cause symptoms right away. This is called "smoldering multiple myeloma." In these cases, treatment might not be necessary immediately. Instead, the cancer is closely monitored.

If the myeloma is in an early stage and growing slowly, regular checkups and tests (like blood and urine tests) are used to watch for any changes. If the cancer shows signs of worsening, treatment can be started.

Several types of treatments are available:

• Targeted therapy: These drugs target specific parts of the myeloma cells, causing them to die.

• Immunotherapy: This type of treatment helps the body's immune system recognize and destroy myeloma cells. The immune system is your body's defense against germs and other harmful things. Cancer cells often hide from the immune system; immunotherapy helps the immune system fight them.

• CAR-T cell therapy: This treatment modifies a type of white blood cell (called a T cell) to specifically recognize and attack myeloma cells. A sample of T cells is taken, modified in a lab to recognize myeloma cells, and then returned to the body. These modified T cells then find and destroy the myeloma cells.

• Chemotherapy: Powerful drugs that kill fast-growing cells, including myeloma cells.

• Corticosteroids: These drugs help reduce swelling and inflammation in the body and also affect myeloma cells.

• Bone marrow transplant (stem cell transplant): This procedure replaces the diseased bone marrow with healthy bone marrow. There are two types:

  • Autologous transplant: Healthy stem cells are collected from the patient's own blood, and high doses of chemotherapy are used to kill the diseased bone marrow. Then, the healthy stem cells are returned to the body.
  • Allogeneic transplant: Stem cells come from a healthy donor.

• Radiation therapy: This uses high-energy beams (like X-rays) to kill cancer cells. It can be used to shrink tumors or relieve pain if myeloma cells are causing bone damage.

Choosing the Right Treatment:

The best treatment plan depends on many factors, including the likelihood of a bone marrow transplant and the patient's overall health and age.

• When a bone marrow transplant is an option: Treatment often starts with a combination of targeted therapy, immunotherapy, corticosteroids, and sometimes chemotherapy. After a few months, healthy stem cells are collected. The transplant can happen soon after or later, potentially after a relapse. Sometimes multiple transplants are recommended. Following the transplant, targeted therapy or immunotherapy is often used to help prevent the myeloma from returning.

• When a bone marrow transplant isn't an option: Treatment might include a combination of targeted therapy, immunotherapy, corticosteroids, and sometimes chemotherapy.

• When myeloma returns or doesn't respond to treatment: Doctors might use another course of the same treatment or try other available treatments. Ongoing research is developing new treatments, and patients may have the opportunity to participate in clinical trials.

Managing Complications:

Treatment also addresses complications related to multiple myeloma, such as:

• Bone pain: Pain medication, radiation therapy, or surgery may be used.
• Kidney damage: Dialysis may be necessary for severe cases.
• Infections: Vaccines can help prevent infections.
• Bone loss: Medications can help strengthen bones.
• Anemia: Medications can increase the number of red blood cells to address anemia.

Coping with Multiple Myeloma:

Living with a cancer diagnosis can be challenging. Strategies to cope include:

• Informed decision-making: Learning about multiple myeloma and treatment options allows for informed choices. Discussing treatment options and their side effects with your healthcare team is essential. Reliable sources of information include the National Cancer Institute and the International Myeloma Foundation.

• Strong support system: Friends, family, and support groups can provide emotional and practical assistance. Online support groups can also be helpful.

• Setting realistic goals: Creating achievable goals helps maintain a sense of purpose and control, even if daily activities may need to be adjusted.

• Self-care: Prioritizing rest, relaxation, and a healthy diet can help manage stress and fatigue.

Important Note: While some alternative therapies might help with stress and side effects, there are no alternative medicines proven to treat multiple myeloma. Always discuss any alternative therapies with your healthcare provider before trying them.