Multiple Myeloma

Multiple myeloma is a rare type of cancer. It starts with the uncontrolled production of plasma cells. These are a type of white blood cell in the bone marrow.

Healthy plasma cells make antibodies that help fight infection. But the myeloma plasma cells make abnormal antibodies. This can make it hard for your body to fight infection. And when there are too many plasma cells, they can crowd out normal blood cells. This can cause anemia and increased bruising or bleeding.

The plasma cells can collect in the bone to form small, painful tumors. These tumors can lead to broken bones. The plasma cells and the abnormal antibodies can also cause problems with the kidneys.

The exact cause of multiple myeloma is not known. Changes (mutations) in the DNA of your cells may play a role. These changes may prompt your body to start creating too many plasma cells and abnormal antibodies.

Common symptoms of multiple myeloma include bone pain and broken bones. You may also have weakness or fatigue. You could have frequent infections, fever, pneumonia, numbness, or kidney failure. You may bruise or bleed easily. Some people have no symptoms in the early stages of myeloma.

Your doctor will do a physical exam and talk with you about your current symptoms and past health. Your doctor will also do several tests, such as:

• Blood tests: These are used to look at the levels of red and white cells in your blood. Some tests check for abnormal antibodies in the bloodstream.
• Urine tests: These check to see how well your kidneys work. They are also used to look for signs of multiple myeloma.
• Imaging tests: These may include X-rays, MRIs, CT scans, or PET scans. They can show broken bones, bone tumors, or other problems with your bones.
• Bone marrow biopsy: This test is used to look for the amount of cancer cells in your bones.

Sometimes myeloma is found by chance in people who have no symptoms of this cancer. This can happen when they get one of these tests for another reason.

Multiple myeloma that isn't causing symptoms may not need treatment right away. If you need treatment, it may include:

• Chemotherapy: These medicines kill fast-growing cells like cancer cells.
• Radiation therapy: This uses high-dose X-rays to destroy cancer cells and shrink tumors.
• Steroid medicines: These can help treat myeloma and help with treatment side effects, such as pain and swelling.
• Targeted therapy: These medicines attack only cancer cells, not normal cells. They help keep cancer from growing or spreading.
• Stem cell transplants: This replaces damaged cells with healthy stem cells. They help your bone marrow make healthy blood cells.
• Immunotherapy: This treatment helps your immune system fight cancer. It may be given in several ways.
• Bone-modifying agents: These medicines make bones stronger. This helps prevent fractures and reduces bone pain.

Bone tumors caused by multiple myeloma may be treated with medicines, radiation, and surgery.

• Tell your doctor if you are experiencing new pain, or pain that interferes with your daily activities. Do not try to “tough it out.”
• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You may get medicine for nausea and vomiting if you have these side effects.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. Drink liquid meal replacements for extra calories and protein. Try to eat your main meal early.
• Get some physical activity every day, but do not get too tired. Keep doing the hobbies you enjoy as your energy allows.
• Take steps to control your stress and workload. Learn relaxation techniques.
  • Share your feelings. Stress and tension affect our emotions. By expressing your feelings to others, you may be able to understand and cope with them.
  • Consider joining a support group. Talking about a problem with your spouse, a good friend, or other people with similar problems is a good way to reduce tension and stress.
  • Express yourself through art. Try writing, crafts, dance, or art to relieve stress. Some dance, writing, or art groups may be available just for people who have cancer.
  • Be kind to your body and mind. Getting enough sleep, eating a healthy diet, and taking time to do things you enjoy can contribute to an overall feeling of balance in your life and can help reduce stress.
  • Get help if you need it. Discuss your concerns with your doctor or counselor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids (enough so that your urine is light yellow or clear like water) to prevent dehydration. Choose water and other caffeine-free clear liquids until you feel better. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.

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