Overview
Multiple myeloma is a type of cancer that originates in plasma cells, a specific type of white blood cell responsible for producing antibodies. In healthy individuals, plasma cells create helpful antibodies that fight off infections. However, in multiple myeloma, cancerous plasma cells accumulate in the bone marrow, crowding out healthy blood cells and producing abnormal proteins called monoclonal proteins or M proteins. These M proteins can cause damage to the body, such as affecting kidney function, and may lead to bone weakness and an increased risk of fractures. Multiple myeloma can develop from a preliminary condition called monoclonal gammopathy of undetermined significance (MGUS). Risk factors for multiple myeloma include older age, male gender, Black race, family history, and having MGUS. Symptoms can include bone pain, fatigue, frequent infections, and weight loss, among others. If you experience concerning symptoms, consult a doctor or other healthcare professional.
Understanding the disease
Symptoms
The symptoms of multiple myeloma may include bone pain, especially in the spine, chest, or hips; nausea; constipation; loss of appetite; mental fogginess or confusion; tiredness; infections; weight loss; weakness; thirst; and needing to urinate often. If you have symptoms that worry you, it is important to see a doctor or other healthcare professional.
Risk Factors
Risk factors for developing multiple myeloma include:
- Getting older: Most people are diagnosed in their late 60s.
- Being male: Men are more likely to develop the disease than are women.
- Being 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 sibling or parent with multiple myeloma increases the risk of the disease.
- Having monoclonal gammopathy of undetermined significance (MGUS): Multiple myeloma starts as MGUS, so having this condition increases the risk.
Development
Multiple myeloma starts as a condition called monoclonal gammopathy of undetermined significance (MGUS). In MGUS, there is an increase in the level of a type of protein called M protein in the blood. Over time, some of these M proteins may become cancerous and develop into multiple myeloma. It is not clear what causes the initial change from a single plasma cell to a cancerous myeloma cell, but researchers believe it may be related to genetic factors and exposure to certain environmental factors.
Assessment and Diagnosis
Triage
You should see a doctor if you have symptoms that worry you, even if you suspect multiple myeloma. It's important to consult with a healthcare professional if you experience any of the following symptoms: bone pain, especially in the spine, chest or hips; nausea; constipation; loss of appetite; mental fogginess or confusion; tiredness; infections; weight loss; weakness; thirst; needing to urinate often. Early detection and evaluation can help determine the appropriate course of action, whether it's monitoring the condition or initiating treatment.
Diagnosis
To diagnose multiple myeloma, a health care professional may use a combination of blood tests, urine tests, imaging tests, and bone marrow tests. Blood tests can detect the presence of M proteins produced by myeloma cells, while urine tests may reveal Bence Jones proteins. Imaging tests like X-rays, MRIs, CT scans, or PET scans can show bone problems associated with the condition. Bone marrow tests, including biopsy and aspiration, help identify myeloma cells and provide more information about their genetic makeup. A health care professional will assess the results of these tests to determine the stage and risk level of the multiple myeloma, which helps guide treatment decisions.
Management and Treatment
Complications
Potential complications of multiple myeloma include infections, bone problems such as bone pain, thinning bones, and broken bones, kidney problems leading to kidney failure, low red blood cell count (anemia), and other blood problems.
Home Remedies
It is important to consult with a healthcare professional for medical advice and treatment options for multiple myeloma.
Treatment
Treatments for multiple myeloma typically involve managing symptoms, controlling the disease, and addressing complications. Depending on the individual case, treatment options may include:
- Watchful waiting: For some patients with slow-growing and asymptomatic multiple myeloma, the doctor may recommend close monitoring without immediate treatment.
- Medications: Targeted therapies and immunotherapies can help control the disease by targeting specific molecules or immune responses. Chemotherapy, steroids, and other drugs may be used to reduce the number of cancer cells and manage symptoms.
- Stem cell transplant: This procedure involves collecting healthy stem cells from the patient or a donor, giving the patient high-dose chemotherapy to kill the cancer cells, and then re-infusing the collected stem cells to help the body recover and produce new healthy blood cells.
- Radiation therapy: High-energy rays or particles are used to destroy cancer cells and shrink tumors.
- Bone-strengthening medications: To help prevent bone fractures and reduce bone pain, medications such as bisphosphonates or denosumab may be prescribed.
- Supportive care: Treatments to manage symptoms and complications, such as pain management, nutrition support, and infection prevention, are important aspects of multiple myeloma care. It is important to consult with a healthcare professional to determine the best treatment approach for an individual with multiple myeloma, as treatment plans are tailored to the specific patient and the stage of the disease.
Preparing for medical consultation
To prepare for an appointment for multiple myeloma, make a list of your symptoms, medical history, medications, and questions to ask your healthcare provider. Consider bringing a family member or friend for support. Be aware of any pre-appointment restrictions, and write down key personal information and any major stresses or recent life changes.