Multiple myeloma is a type of blood cancer that develops in plasma cells, a type of white blood cell that normally helps the immune system produce antibodies. In multiple myeloma, abnormal plasma cells multiply in the bone marrow and can interfere with healthy blood-cell production, weaken bones, affect the kidneys, and cause other complications. (Cancer.gov)
Some people have few or no symptoms in the early stages. Others may develop persistent bone pain, fatigue, frequent infections, anemia, kidney problems, or high calcium levels. Modern treatments can often control multiple myeloma for long periods, although it is generally considered a treatable but not usually curable cancer. (American Cancer Society)
What Is Multiple Myeloma?
Multiple myeloma, also called plasma cell myeloma, occurs when abnormal plasma cells grow uncontrollably in the bone marrow. These cells can produce an abnormal antibody protein known as M protein, which does not protect the body from infection and can contribute to complications. (American Cancer Society)
As myeloma cells accumulate, they can crowd out normal red blood cells, white blood cells, and platelets. They can also damage bone tissue and affect kidney function.
The condition is part of a group of diseases called plasma cell neoplasms. Related conditions include monoclonal gammopathy of undetermined significance (MGUS) and plasmacytoma. (Cancer.gov)
Multiple Myeloma Symptoms
Symptoms vary from person to person. Some people are diagnosed after abnormal blood or urine test results before they notice any symptoms.
Common multiple myeloma symptoms include:
1. Bone Pain
Bone pain is one of the more common symptoms. It may occur in the:
- Back
- Ribs
- Hips
- Skull
- Other bones
Myeloma can weaken bones and increase the risk of fractures, sometimes following relatively minor injuries. (American Cancer Society)
2. Persistent Fatigue and Weakness
Abnormal plasma cells can crowd out healthy red blood cells in the bone marrow, causing anemia. This may result in:
- Persistent tiredness
- Weakness
- Dizziness
- Shortness of breath
3. Frequent Infections
Multiple myeloma can interfere with normal immune function. As a result, people with the disease may become more vulnerable to infections, including serious respiratory infections such as pneumonia. (American Cancer Society)
4. Easy Bruising or Bleeding
When myeloma cells reduce the production of platelets, a person may experience easier bruising or increased bleeding. (American Cancer Society)
5. Increased Thirst and Frequent Urination
Bone damage can release calcium into the bloodstream, causing hypercalcemia. High calcium levels may lead to:
- Excessive thirst
- Frequent urination
- Dehydration
- Constipation
- Nausea or vomiting
- Weakness
- Loss of appetite
- Confusion
Severe hypercalcemia can become a medical emergency. (American Cancer Society)
6. Kidney Problems
Myeloma-related proteins and high calcium levels can damage the kidneys. Kidney problems may initially cause few noticeable symptoms and may instead be detected through blood or urine testing.
Advanced kidney dysfunction can cause weakness, swelling, itching, and shortness of breath. (American Cancer Society)
7. Numbness or Tingling
Some people may develop nerve-related symptoms, including tingling or numbness. In certain cases, multiple myeloma can also be associated with amyloidosis, in which abnormal proteins accumulate in organs or nerves. (Cancer.gov)
What Causes Multiple Myeloma?
The exact cause of multiple myeloma is not fully understood. It begins when plasma cells acquire changes that cause them to grow and survive abnormally.
Researchers have identified several factors associated with an increased risk, but having a risk factor does not mean that someone will definitely develop multiple myeloma. (Cancer.gov)
Risk Factors for Multiple Myeloma
Potential risk factors include:
- Older age: Multiple myeloma is more common among middle-aged and older adults.
- Male sex: Men have a higher risk than women.
- MGUS: A history of monoclonal gammopathy of undetermined significance can increase the risk.
- Certain environmental exposures: Exposure to radiation or some chemicals has been associated with increased risk.
- Personal history of certain plasma-cell disorders: Some related conditions can increase the likelihood of developing myeloma.
Importantly, multiple myeloma can occur in people without any known risk factors. (Cancer.gov)
How Is Multiple Myeloma Diagnosed?
Doctors may use several tests to determine whether multiple myeloma is present and how extensively it has affected the body.
Blood Tests
Blood tests can evaluate:
- M protein
- Immunoglobulin levels
- Free light chains
- Calcium levels
- Kidney function
- Red and white blood cell counts
- Platelet counts
- Beta-2-microglobulin and other markers
These tests can help doctors identify abnormal plasma-cell activity and assess complications. (Cancer.gov)
Urine Tests
Urine testing can detect abnormal proteins produced by myeloma cells and help evaluate kidney involvement.
Bone Marrow Examination
A bone marrow biopsy and aspiration may be performed to determine whether abnormal plasma cells are present and how many are present.
Additional laboratory testing can examine the characteristics and genetic changes of the myeloma cells. (Cancer.gov)
Imaging Tests
Doctors may use imaging such as:
- X-rays
- MRI
- CT scans
- PET-CT scans
These tests can identify bone lesions, weakened areas, fractures, or other signs of disease. (Cancer.gov)
Multiple Myeloma Treatment
Treatment depends on several factors, including the person’s age, overall health, disease characteristics, kidney function, symptoms, previous treatments, and whether the person is eligible for a stem cell transplant. (Cancer.gov)
1. Drug Therapy
Medicines are the main treatment for active multiple myeloma. Doctors commonly combine different types of drugs to improve disease control.
Drug classes may include:
- Immunomodulatory drugs
- Proteasome inhibitors
- Monoclonal antibodies
- Corticosteroids
- Traditional chemotherapy
- T-cell engagers and other newer therapies
The exact combination is individualized according to the patient’s disease and overall health. (American Cancer Society)
2. Stem Cell Transplant
For people who are healthy enough to undergo the procedure, an autologous stem cell transplant may be considered after initial treatment.
This approach generally involves collecting the patient’s own stem cells, giving intensive treatment to reduce myeloma cells, and then returning the stem cells to the body.
Not everyone with multiple myeloma is eligible for transplantation. (Cancer.gov)
3. Targeted and Immunotherapy
Advances in myeloma treatment have expanded the use of targeted medicines and immunotherapies.
CAR T-cell therapy, for example, involves modifying a patient’s T cells so they can better recognize and attack cancer cells. Other immune-based treatments are also available or being studied. (American Cancer Society)
4. Radiation Therapy
Radiation therapy may be used to treat specific areas affected by myeloma, particularly when a localized bone lesion causes significant pain or other problems. (American Cancer Society)
5. Treatment for Bone Problems
Because multiple myeloma can weaken bones, doctors may prescribe medicines such as bisphosphonates or denosumab to help reduce bone-related complications. (American Cancer Society)
6. Supportive Treatment
Supportive care focuses on preventing or managing complications. Depending on the patient’s needs, it may include treatment for:
- Bone damage
- Infections
- Anemia
- High calcium levels
- Kidney complications
- Pain
- Other treatment-related side effects
Supportive care can improve comfort and quality of life alongside cancer-directed treatment. (American Cancer Society)
Can Multiple Myeloma Be Cured?
At present, multiple myeloma is generally not considered curable, but treatment can often control the disease for extended periods. Some people experience long-lasting remission.
Treatment outcomes vary considerably depending on factors such as disease stage, genetic characteristics, kidney function, overall health, and response to treatment. (Cancer.gov)
New medicines, immunotherapies, cellular therapies, and clinical trials continue to improve treatment options.
When Should You See a Doctor?
Persistent or unexplained symptoms such as bone pain, unusual fatigue, repeated infections, unexplained fractures, easy bruising, excessive thirst, frequent urination, or abnormal blood-test results should be discussed with a healthcare professional.
These symptoms do not necessarily mean you have multiple myeloma. Many other conditions can cause similar problems. However, persistent or unexplained symptoms deserve appropriate medical evaluation.
Seek urgent medical attention for severe confusion, extreme weakness, severe dehydration, difficulty breathing, significant bleeding, or other rapidly worsening symptoms.
Frequently Asked Questions
What are the first symptoms of multiple myeloma?
Early symptoms can include persistent bone pain, fatigue, weakness, frequent infections, or symptoms related to anemia. Some people have no noticeable symptoms and are diagnosed after abnormal blood or urine tests. (American Cancer Society)
What is the main cause of multiple myeloma?
The exact cause is unknown. Multiple myeloma develops when abnormal plasma cells acquire changes that allow them to grow uncontrollably. Certain factors, including older age and a history of MGUS, are associated with increased risk. (Cancer.gov)
Is multiple myeloma a type of blood cancer?
Yes. Multiple myeloma is a cancer of plasma cells, which are immune-system cells normally found in the bone marrow. (Cancer.gov)
Can multiple myeloma affect the kidneys?
Yes. Myeloma proteins and complications such as high calcium levels can damage the kidneys. Kidney involvement can sometimes be detected through blood and urine tests before significant symptoms develop. (American Cancer Society)
Is multiple myeloma treatable?
Yes. Multiple myeloma has several treatment options, including combinations of medicines, stem cell transplantation for eligible patients, immunotherapy, targeted treatments, and supportive care. Although it is generally not considered curable, treatment can control the disease for long periods in many patients. (American Cancer Society)
Final Takeaway
Multiple myeloma is a cancer of plasma cells that can affect the bones, blood, kidneys, and immune system. Common symptoms include bone pain, fatigue, recurrent infections, anemia, easy bruising, increased thirst, and kidney problems. Because symptoms can resemble those of many other conditions, diagnosis usually requires blood and urine tests, bone marrow examination, and imaging.
Treatment is personalized and may involve several medicines, stem cell transplantation, immunotherapy, targeted therapy, radiation, and supportive care. Early medical evaluation and appropriate specialist care are important for managing the disease and its complications.