What is Multiple Myeloma?

Multiple myeloma is a cancer of the plasma cells, a type of white blood cell that makes antibodies which help fight bacteria and viruses in the body. Multiple myeloma begins in the bone marrow, the soft spongy tissue in the center of the bones where new blood cells are made. The unhealthy plasma cells multiply in bone marrow and produce soft spots, or lesions, on the bone.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of multiple myeloma. Collaborative care is provided by our hematologist/ oncologist and oncology-certified nurses in our facility that is accredited by the Commission on Cancer. Plus, our infusion centers are located in convenient locations throughout central Kentucky.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

When present, symptoms of multiple myeloma can be similar to other conditions. The most common symptoms include:

• Anemia
• Bone pain and/or fracture
• Constant thirst
• Constipation
• Decreased alertness
• Fatigue
• Frequent infections
• Frequent urination
• Nausea
• Numbness, tingling, burning or pain in the hands and feet
• Shortness of breath

Diagnosis

Multiple myeloma is often diagnosed when blood tests are done for other conditions. If multiple myeloma is suspected, we perform a physical examination and ask questions about symptoms. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Common diagnostic procedures can include:

Blood and urine tests: These tests look for the proteins or cancer cells associated with multiple myeloma.

Bone marrow test: During this test, local anesthetic numbs the area where the sample of bone marrow will be taken, typically on the hip. A small incision is made and a thin, hollow needle goes into the bone to collect a small portion of marrow to examine for cancer cells.

CT scans: X-rays and computers can be used to create images of abnormalities or tumors in soft tissue.

Magnetic resonance imaging (MRI) scan: A large magnet, radio waves and a computer are used to produce pictures of the spine, brain and bones. This scan can capture images of myeloma cells or a tumor growing in the bone or soft tissue.

Positron emission tomography (PET) scan: This imaging test uses a radioactive substance called a tracer to look for disease in the body.

Causes

Researchers don’t know the exact cause of multiple myeloma, but they have found certain changes in DNA can cause plasma cells to become cancerous. Other causes can include:

• Exposure to radiation or asbestos, benzene, pesticides and other chemicals used in rubber manufacturing may cause higher risk for developing myeloma.
• Being overweight or obese may increase risk.

Risk Factors

Multiple myeloma risk factors can include:

Age: People older than 50 develop this cancer more often than younger people.

Family history: Risk of developing the disease is up to four times greater if a family member has been diagnosed. 

Gender: Men are diagnosed with multiple myeloma slightly more than women.

Medial history: People with a history of monoclonal gammopathy of unknown significance (MGUS) have a higher risk of multiple myeloma.

Race: African-Americans are twice as likely to develop multiple myeloma, compared to white Americans.

Prevention

Few cases of multiple myeloma are linked to preventable risk factors. Maintaining a healthy weight and limiting and/or avoiding environmental and occupational exposures may help prevent multiple myeloma.

Prognosis

While there is no cure for multiple myeloma, good treatment can help a patient return to activities at near-normal levels. Multiple myeloma symptoms can reoccur after remission. For the best outcome, it is important to see your physician to monitor your health during regular check-ups and follow-up visits.

Treatment and Recovery

Multiple myeloma treatment depends on the stage determined after a diagnosis is confirmed and what symptoms are being experienced. The goals of treatment for multiple myeloma are to reduce symptoms, slow disease progression, provide prolonged remission and lengthen survival. Treatments can include: 

Biological Therapy

These treatments help the immune system recognize and attack myeloma cells.

Chemotherapy

Special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream. 

Stem Cell Transplant

This procedure replaces diseased bone marrow with healthy bone marrow. Before the transplant, blood-forming stem cells are collected from a patient’s blood. Then, high doses of chemotherapy or radiation are used to destroy diseased bone marrow. The previously collected stem cells are infused back into the body to help healthy bone marrow develop. 

Radiation Therapy

High-energy radiation targets deposits of myeloma cells to stop their growth or shrink them to alleviate pain. Most often, radiation treatments are given five days a week for several weeks.

Supportive Treatments 

Patients may need treatments to fight other conditions linked to multiple myeloma. Treatments can include:

• Medication to treat infection, pain, blood clots, depression, gastrointestinal problems and reduce the risk of fractures.
• Plasmapheresis to remove thick proteins from the blood,.
• Exercise to increase bone strength.

In cases of smoldering myeloma, treatment is often not needed as blood tests may be normal and there are often no signs of organ or bone damage. Individuals with this type of multiple myeloma should continue to follow up with their physicians to evaluate for progression of disease. 

Follow-up Care 

It is important to go to all follow-up visits during treatment and after it is completed. Your physician will ask about your symptoms, perform a physical exam and order blood tests, CT scans or X-rays to determine if treatment is effective or if more is needed. Most cancer treatment has side effects that can last days, weeks or permanently. Be sure to tell your physician about any side effects that you experience. While multiple myeloma is treatable, it is not curable and it can return. 

Complications

Complications of multiple myeloma stem from the depletion of normal blood cells as well as side effects of treatment and may include:

Anemia: When healthy red blood cells are crowded out by the fast-growing white cells, it can cause fatigue and shortness of breath.

Bone problems: Multiple myeloma can cause bones to weaken, break or deteriorate. 

Bleeding: Because the platelets are crowded out by fast-growing white blood cells, the blood is not able to clot as well, resulting in bleeding.

Frequent infections: Because the white cells are not healthy, the immune system can’t effectively fight infections.

Kidney problems: The antibody created by myeloma cells can damage the kidneys and possibly cause kidney failure.

Pain: Multiple myeloma often causes pain in the bones, nerves, muscles and tissues.

Thrombosis and embolism: Multiple myeloma increases the risk for thrombosis (blood clots) which can break away (embolism) and block blood flow in veins and arteries.

Peripheral neuropathy: Multiple myeloma can cause nerve damage.

Myelosuppression: Multiple myeloma may also cause bone marrow to decrease, resulting in fewer red and white blood cells and platelets.