Multiple Myeloma

Multiple myeloma is a type of cancer that affects the bone marrow, the body's blood-forming system. The plasma cells (a type of white blood cell) become abnormal and multiply rapidly, interfering with the production of normal blood cells. The overgrowth of malignant cells in the bone marrow can also weaken the bones, especially in the back and ribs, causing pain and bone fractures.

Multiple myeloma is uncommon, affecting about 20,000 people annually in the United States. Although the exact cause is unknown, multiple myeloma can be controlled in most patients, sometimes for many years. The development of new drugs has helped control multiple myeloma in a larger number of patients, and has resulted in longer survival.

Symptoms

People diagnosed with multiple myeloma often don't have any symptoms in the early stages of disease. Signs to look out for include:

Fractures

Bone damage is the most serious concern at the time myeloma is diagnosed. Bone damage occurs because myeloma cells produce substances called cytokines, which can trigger bone cells (osteoclasts) to destroy surrounding bone. When more than 30 percent of the bone has been destroyed, X-rays will show either a thinning of the bone (osteoporosis) or the presence of dark holes (lytic lesions). The weakened area of bone can break, which is called a pathological fracture. To prevent bone destruction, your doctor may recommend giving you drugs that prevent osteoclasts from destroying bone (e.g., Zometa® or Aredia®).

Bone Pain

This is especially common in the middle and/or lower back, rib cage or hips. The pain can be mild or severe depending on the size of the lesion, the speed with which it has developed and whether or not a fracture or nerve compression has occurred. Typically, movement makes the pain much worse.

Fatigue

Because the myeloma cells crowd out the other blood cells in the bone marrow, the number of red cells in the body decreases. This leads to symptoms of tiredness or fatigue

Infection

Because the myeloma cells crowd out normal white blood cells, which fight infection, there is a risk of infection. Symptoms of infection depend upon where the infection is located. Pneumonia, bladder or kidney infections, sinusitis and skin infections are common.

Hypercalcemia

A high amount of calcium in the blood stream. When the bone is destroyed, calcium is released into the bloodstream. As the amount increases, the kidneys are unable to get rid of the calcium in the urine. Symptoms of hypercalcemia include thirst, nausea, constipation and mental confusion.

Having one or more of the symptoms listed above does not necessarily mean you have multiple myeloma. However, it is important to discuss any symptoms with your doctor, since they may indicate other health problems.