What is multiple myeloma?

Multiple myeloma is cancer in plasma cells, which are a type of white blood cell. The cancer cells crowd out normal cells in the bone marrow, causing problems like anemia and bleeding. The cancer cells can also weaken bone and form tumors in the bone or other areas.

Healthy plasma cells make antibodies that help fight infection. But myeloma plasma cells make abnormal antibodies. This can make it hard for your body to fight infection and can cause problems with the kidneys.

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 aspiration and biopsy.

These tests look for the number of cancer cells in your bones.

Genetic tests.

These tests look for changes in your genes and chromosomes.

Sometimes myeloma is found by chance in people without symptoms. 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 and may cause less harm to 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.
• 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.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep, and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor or a counselor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other 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.