Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Plasma cells help you fight infections by making antibodies that recognize and attack germs.
Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause kidney problems.
Signs and symptoms of multiple myeloma can vary and, early in the disease, there may be none.
When signs and symptoms do occur, they can include:
•Bone pain, especially in your spine or chest
•Loss of appetite
•Mental fogginess or confusion
•Weakness or numbness in your legs
If you’re experiencing symptoms, treatment can help relieve pain, control complications of the disease, stabilize your condition and slow the progress of the disease.
Immediate treatment may not be necessary
If you have multiple myeloma but aren’t experiencing any symptoms (smoldering multiple myeloma), you may not need treatment. However, your doctor will regularly monitor your condition for signs the disease is progressing. This may involve periodic blood and urine tests.
If you develop signs and symptoms or your multiple myeloma shows signs of progression, you and your doctor may decide to begin treatment.
Treatments for myeloma
Though there’s no cure for multiple myeloma, with good treatment results you can usually return to near-normal activity.
Standard treatment options include:
• Targeted therapy. Targeted drug treatment focuses on specific abnormalities within cancer cells that allow them to survive. Bortezomib (Velcade) and carfilzomib (Kyprolis) are targeted drugs that block the action of a substance in myeloma cells that breaks down proteins. This action causes myeloma cells to die. Both medications are administered through a vein in your arm.
• Biological therapy. Biological therapy drugs use your body’s immune system to fight myeloma cells. The drugs thalidomide (Thalomid), lenalidomide (Revlimid) and pomalidomide (Pomalyst) enhance the immune system cells that identify and attack cancer cells. These medications are taken in pill form.
• Chemotherapy. Chemotherapy drugs kill fast-growing cells, including myeloma cells. Chemotherapy drugs can be given through a vein in your arm or taken in pill form. High doses of chemotherapy drugs are used before a stem cell transplant.
• Corticosteroids. Corticosteroids, such as prednisone and dexamethasone, regulate the immune system to control inflammation in the body. They also are active against myeloma cells. Corticosteroids can be taken in pill form or administered through a vein in your arm.
• Stem cell transplantation. A stem cell transplant is a procedure to replace your diseased bone marrow with healthy bone marrow.
Before a stem cell transplant, blood-forming stem cells are collected from your blood. You then receive high doses of chemotherapy to destroy your diseased bone marrow. Then your stem cells are infused into your body, where they travel to your bones and begin rebuilding your bone marrow.
• Radiation therapy. This treatment uses beams of energy, such as X-rays, to damage myeloma cells and stop their growth. Radiation therapy may be used to quickly shrink myeloma cells in a specific area — for instance, when a collection of abnormal plasma cells form a tumor (plasmacytoma) that’s causing pain or destroying a bone.