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Understanding Multiple Myeloma


Photo by Cancer Type

Plasma cell neoplasms are diseases in which the body makes too many plasma cells. Multiple myeloma is a type of plasma cell neoplasm.

In multiple myeloma, abnormal plasma cells (myeloma cells) build up in the bone marrow and form tumors in many bones of the body. These tumors may keep the bone marrow from making enough healthy blood cells. Normally, the bone marrow makes stem cells (immature cells) that become three types of mature blood cells:
Red blood cells that carry oxygen and other substances to all tissues of the body
White blood cells that fight infection and disease
Platelets that form blood clots to help prevent bleeding

As the number of myeloma cells increases, fewer red blood cells, white blood cells, and platelets are made. The myeloma cells also damage and weaken the bone.

Sometimes multiple myeloma does not cause any signs or symptoms. It may be found when a blood or urine test is done for another condition. Signs and symptoms may be caused by multiple myeloma or other conditions. Check with your doctor if you have any of the following symptoms:
Bone pain, especially in the back or ribs
Bones that break easily
Fever for no known reason or frequent infections
Easy bruising or bleeding
Trouble breathing
Weakness of the arms or legs
Feeling very tired

Plasma cell neoplasms, including multiple myeloma, are most common in people who are middle aged or older.

A tumor can damage the bone and cause hypercalcemia (too much calcium in the blood). This can affect many organs in the body, including the kidneys, nerves, heart, muscles, and digestive tract, and cause serious health problems.

Hypercalcemia may cause the following signs and symptoms:
Loss of appetite
Nausea or vomiting
Feeling thirsty
Frequent urination
Feeling very tired
Muscle weakness
Confusion or trouble thinking

Multiple myeloma and other plasma cell neoplasms may cause a condition called amyloidosis.
In rare cases, multiple myeloma can cause peripheral nerves (nerves that are not in the brain or spinal cord) and organs to fail. This may be caused by a condition called amyloidosis. Antibody proteins build up and stick together in peripheral nerves and organs, such as the kidney and heart. This can cause the nerves and organs to become stiff and unable to work the way they should.

Amyloidosis may cause the follow­ing signs and symptoms:
Feeling very tired
Purple spots on the skin
Enlarged tongue
Swelling caused by fluid in your body’s tissues
Tingling or numbness in your legs and feet

Age can affect the risk of plasma cell neoplasms.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer, and not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk.

Plasma cell neoplasms, including multiple myeloma, are most common in people who are middle aged or older. For multiple myeloma, other risk factors include the following:
Being black
Being male
Having a personal history of monoclonal gammopathy of undetermined significance (MGUS) or plasmacytoma
Being exposed to radiation or certain chemicals

Tests that examine the blood, bone marrow, and urine are used to detect and diagnose multiple myeloma and other plasma cell neoplasms.
The following tests and procedures may be used:
Physical exam and history
Blood and urine immunoglobulin studies
Bone marrow aspiration and biopsy, which is sometimes followed by a cytogenetic analysis of the tissue sample
Skeletal bone survey
Complete blood count (CBC) with differential
Blood chemistry studies
24-hour urine test
MRI (magnetic resonance imaging)
CT scan (also called CAT scan, computed tomography, computerized tomography, or computerized axial tomography) F PET-CT scan

Certain factors affect prognosis and treatment options.
Your multiple myeloma prognosis (chance of recovery) depends on the following:
The stage of the disease
Whether a certain immunoglobulin (antibody) is present
Whether there are certain genetic changes
Whether the kidney is damaged
Whether the cancer responds to initial treatment or recurs (comes back)

Multiple myeloma treatment options depend on the following:
Your age and general health
Whether there are signs, symptoms, or health problems (such as kidney failure or infection) related to the disease
Whether the cancer responds to initial treatment or recurs

Your multiple myeloma treatment options may include chemotherapy, other drug therapy, targeted therapy, high-dose chemotherapy with stem cell transplant, biologic therapy, radiation therapy, surgery, and watchful waiting. Your doctor will help you determine which treatment option is best for you.

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Source: National Cancer Institute

This article was published in Coping® with Cancer magazine, November/December 2015.