What is Multiple Myeloma? Symptoms, Causes, & Treatment

Multiple myeloma is a type of blood cancer that affects plasma cells in your bone marrow. These plasma cells are special white blood cells that normally help fight infections by making antibodies. When you have multiple myeloma, these cells become cancerous and multiply uncontrollably, crowding out healthy blood cells and weakening your immune system.

This cancer gets its name because it typically affects multiple areas of bone marrow throughout your body. While it sounds overwhelming, understanding what's happening in your body can help you feel more prepared and empowered to work with your healthcare team.

What are the symptoms of multiple myeloma?

Multiple myeloma symptoms often develop gradually and can be easy to mistake for other conditions. Many people don't notice symptoms in the early stages, which is completely normal with this type of cancer.

The most common symptoms you might experience include:

• Bone pain - Often felt in the back, ribs, or hips, and may worsen with movement
• Fatigue and weakness - Feeling unusually tired even after rest
• Frequent infections - Getting sick more often than usual
• Easy bruising or bleeding - Bruises appearing without obvious cause
• Shortness of breath - Difficulty breathing during normal activities
• Excessive thirst and urination - Needing to drink and urinate more frequently

Some people may also experience less common symptoms like unexplained weight loss, nausea, or confusion. These symptoms happen because the cancer affects your body's ability to make healthy blood cells and maintain normal calcium levels.

Remember, having these symptoms doesn't necessarily mean you have multiple myeloma. Many conditions can cause similar signs, so it's important to discuss any persistent symptoms with your doctor.

What are the types of multiple myeloma?

Multiple myeloma is classified into different types based on how aggressive it is and what proteins the cancer cells produce. Understanding your specific type helps your doctor choose the best treatment approach for you.

The main types include:

• Smoldering multiple myeloma - A slow-growing form that may not need immediate treatment
• Active multiple myeloma - The most common form that requires treatment
• Plasma cell leukemia - A rare, more aggressive form where cancer cells circulate in the blood
• Solitary plasmacytoma - Cancer affecting only one area of bone or tissue

Your doctor will also classify your myeloma based on which proteins it produces, such as IgG, IgA, or light chain only. This information helps determine how the cancer might behave and respond to treatment.

What causes multiple myeloma?

The exact cause of multiple myeloma isn't fully understood, but researchers believe it develops when plasma cells undergo genetic changes that make them grow uncontrollably. These changes typically happen over time and aren't something you can prevent or control.

Several factors may contribute to these cellular changes:

• Age - Most people diagnosed are over 60 years old
• Gender - Men are slightly more likely to develop it than women
• Race - African Americans have about twice the risk of other ethnic groups
• Previous plasma cell disorders - Having conditions like MGUS increases risk
• Radiation exposure - High levels of radiation may increase risk
• Chemical exposure - Some studies suggest links to certain pesticides or solvents

It's important to know that multiple myeloma isn't contagious and isn't directly inherited from parents to children. While some families may have a slightly higher risk, the vast majority of cases occur in people with no family history of the disease.

When to see a doctor for multiple myeloma?

You should consider seeing your doctor if you're experiencing persistent bone pain, especially in your back or ribs, that doesn't improve with rest or over-the-counter pain relievers. This is often one of the earliest and most common signs that something needs attention.

Other symptoms that warrant a doctor's visit include:

• Unexplained fatigue that interferes with daily activities
• Frequent infections or illnesses that seem to last longer than usual
• Easy bruising or bleeding without obvious cause
• Persistent shortness of breath
• Unexplained weight loss
• Excessive thirst combined with frequent urination

Don't worry about seeming overly cautious. Your doctor would rather evaluate symptoms that turn out to be benign than miss something important. Early detection and treatment generally lead to better outcomes.

If you have risk factors like a family history of blood cancers or a previous diagnosis of MGUS, discuss regular monitoring with your healthcare provider.

What are the risk factors for multiple myeloma?

Risk factors are characteristics that may increase your chances of developing multiple myeloma, but having them doesn't mean you'll definitely get the disease. Many people with risk factors never develop cancer, while others with no known risk factors do.

The most significant risk factors include:

• Age over 60 - The average age at diagnosis is about 70
• Male gender - Men have a slightly higher risk than women
• African American ethnicity - About twice the risk compared to other groups
• MGUS (monoclonal gammopathy) - This benign condition progresses to myeloma in about 1% of cases yearly
• Obesity - Being significantly overweight may increase risk
• Radiation exposure - High doses from medical treatments or occupational exposure

Some less common risk factors include exposure to certain chemicals like benzene or petroleum products, and having other plasma cell disorders. A small percentage of cases may have a genetic component, but this is relatively rare.

Remember, most people with these risk factors never develop multiple myeloma. These factors simply help doctors understand who might benefit from closer monitoring.

What are the possible complications of multiple myeloma?

Multiple myeloma can affect various parts of your body because it interferes with normal blood cell production and bone health. Understanding potential complications helps you and your healthcare team watch for warning signs and address problems early.

Common complications you might encounter include:

• Bone problems - Weakened bones leading to fractures or severe pain
• Kidney damage - Abnormal proteins can harm kidney function
• Anemia - Low red blood cell count causing fatigue and weakness
• Infections - Weakened immune system making you more susceptible to illness
• High calcium levels - Can cause confusion, kidney problems, and heart rhythm issues
• Bleeding problems - Low platelet count leading to easy bruising or bleeding

Less common but serious complications include spinal cord compression from bone damage, blood clots, and severe kidney failure requiring dialysis. Some people may also develop secondary cancers later, though this is relatively rare.

The good news is that modern treatments have significantly reduced the risk of many complications. Your healthcare team will monitor you closely and take steps to prevent or treat complications as they arise.

How can multiple myeloma be prevented?

Unfortunately, there's no proven way to prevent multiple myeloma since we don't fully understand what causes the genetic changes that lead to this cancer. Most risk factors, like age and genetics, are beyond your control.

However, you can take steps to support your overall health and potentially reduce your risk:

• Maintain a healthy weight - Obesity may increase risk, so staying at a healthy weight could help
• Limit radiation exposure - Avoid unnecessary medical imaging when possible
• Protect yourself from chemicals - Use safety equipment if you work with potentially harmful substances
• Get regular check-ups - Especially important if you have MGUS or family history
• Stay informed - Learn about symptoms so you can seek help early if needed

If you have MGUS, work closely with your doctor to monitor your condition. While most people with MGUS never develop myeloma, regular monitoring can catch any changes early.

Focus on what you can control: maintaining good overall health, staying informed about your body, and building a strong relationship with your healthcare team.

How is multiple myeloma diagnosed?

Diagnosing multiple myeloma involves several tests because doctors need to confirm the presence of cancer cells and understand how the disease is affecting your body. The process might seem extensive, but each test provides important information for your treatment plan.

Your doctor will likely start with blood tests to check for abnormal proteins and measure your blood cell counts. These tests can reveal the characteristic protein markers that myeloma cells produce.

Additional tests typically include:

• Bone marrow biopsy - A small sample taken from your hip bone to examine plasma cells directly
• Imaging studies - X-rays, CT scans, or MRI to check for bone damage
• Urine tests - To detect abnormal proteins that might affect kidney function
• Specialized blood tests - Including immunofixation and light chain analysis

Your doctor may also order tests to check your kidney function, calcium levels, and overall health status. These help determine the stage of your disease and guide treatment decisions.

The diagnostic process usually takes a few weeks as results come back and your healthcare team reviews all the information together. This thoroughness ensures you receive the most appropriate treatment for your specific situation.

What is the treatment for multiple myeloma?

Multiple myeloma treatment has advanced significantly in recent years, offering many people the chance to live well with this condition. Your treatment plan will be personalized based on your age, overall health, and specific characteristics of your cancer.

The main treatment approaches include:

• Targeted therapy drugs - Medications that specifically attack cancer cells
• Immunotherapy - Treatments that help your immune system fight the cancer
• Chemotherapy - Traditional cancer drugs that destroy rapidly dividing cells
• Corticosteroids - Powerful anti-inflammatory medications that can kill myeloma cells
• Stem cell transplant - May be recommended for younger, healthier patients
• Radiation therapy - Used to treat specific areas of bone pain or damage

Many people receive combination treatments that work together more effectively than single drugs. Your doctor might recommend starting with one approach and switching to others if needed.

Treatment often happens in cycles, with periods of active treatment followed by rest periods. This approach helps your body recover while fighting the cancer effectively.

How to manage symptoms at home during multiple myeloma treatment?

Managing multiple myeloma at home involves taking care of both physical symptoms and emotional well-being. Simple strategies can make a significant difference in how you feel day to day.

For bone pain and fatigue, consider these approaches:

• Gentle exercise - Walking or light stretching can help maintain bone strength and energy
• Pain management - Work with your doctor to find effective pain relief options
• Rest when needed - Listen to your body and don't push through severe fatigue
• Proper nutrition - Eat a balanced diet to support your immune system and energy levels
• Stay hydrated - Drink plenty of water to help your kidneys function well
• Infection prevention - Wash hands frequently and avoid crowds during treatment

Emotional support is equally important. Consider joining support groups, talking with counselors, or connecting with others who understand what you're going through.

Keep a symptom diary to track what helps and what doesn't. This information can be valuable for your healthcare team in adjusting your treatment plan.

How should you prepare for your doctor appointment?

Preparing for your doctor visits can help you make the most of your time together and ensure you get answers to your most important questions. A little preparation goes a long way in feeling more confident and informed.

Before your appointment, gather this information:

• Complete symptom list - Write down all symptoms, when they started, and how severe they are
• Medication list - Include all prescription drugs, over-the-counter medications, and supplements
• Family medical history - Note any blood cancers or related conditions in relatives
• Previous test results - Bring copies of recent blood work or imaging studies
• Insurance information - Have your cards and relevant paperwork ready

Prepare a list of questions you want to ask. Don't worry about having too many questions - your healthcare team wants to help you understand your condition.

Consider bringing a trusted friend or family member to help you remember important information and provide emotional support. Many people find it helpful to have someone else listen and take notes during medical appointments.

What's the key takeaway about multiple myeloma?

Multiple myeloma is a serious but increasingly treatable blood cancer that affects plasma cells in your bone marrow. While receiving this diagnosis can feel overwhelming, it's important to know that treatments have improved dramatically in recent years, and many people live full, active lives with this condition.

The most important thing you can do is work closely with your healthcare team to develop a treatment plan that's right for you. Every person's experience with multiple myeloma is different, and treatments can be adjusted based on how you respond and how you're feeling.

Remember that having multiple myeloma doesn't define you. With proper medical care, support from loved ones, and attention to your overall well-being, you can continue to enjoy meaningful activities and relationships.

Stay informed, ask questions, and don't hesitate to seek support when you need it. Your healthcare team, family, friends, and support groups are all valuable resources on this journey.