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Multiple Myeloma

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OVERVIEW

What is multiple myeloma?

Multiple myeloma is a kind of cancer in the bone marrow. Bone marrow is the tissue inside the bones where new blood cells are made. Multiple myeloma is caused when your body makes too many of a certain blood cell, called a plasma cell. When this happens, the abnormal plasma cells group together and form tumors. These tumors kill the bone cells around them. They also prevent your body from making other blood cells you do need.

SYMPTOMS

What are the symptoms of multiple myeloma?

The symptoms of multiple myeloma include:

  • Bone pain, especially in the back, ribs and hips
  • Frequent bone fractures
  • Constipation and/or increased urination
  • Weakness and fatigue
  • Feelings of confusion

CAUSES & RISK FACTORS

What causes multiple myeloma?

The cause of multiple myeloma is currently unknown. This cancer usually occurs in people older than 60 years of age. It is slightly more common in men than in women.  It often can run in families.  There are higher incidences of myeloma within the Black population.  Some studies suggest that workers in agriculture or petroleum-based industries may be at greater risk due to exposure to chemicals.

DIAGNOSIS & TESTS

How does my healthcare provider know if I have multiple myeloma?

Several tests can help your healthcare provider tell if you have multiple myeloma. An X-ray can identify areas of bone loss. Your healthcare provider might take some blood tests.

If the multiple myeloma is in a later stage, you may need more tests. Your healthcare provider might want you to have a magnetic resonance imaging scan of your bones (also called an MRI scan). This scan can show if the multiple myeloma is in your spine.

The only way for your healthcare provider to be sure you have multiple myeloma is by using a needle to take a very small sample of the tissue inside your bone. This is called a bone marrow aspiration. This procedure hurts a little, but no special care is needed afterward.

PREVENTION

Can multiple myeloma be prevented or avoided?

There is no known way to prevent multiple myeloma.

TREATMENT

How is multiple myeloma treated?

There is currently no cure for multiple myeloma. Treatment includes medicine to relieve pain, and chemotherapy to destroy abnormal cells and to slow the development of the disease. You will also need treatment if you have broken bones, a low blood count, infection or kidney damage. Even with treatment, sometimes your symptoms will be better and sometimes they’ll be worse. The 2 medicines most often used together to treat multiple myeloma are melphalan (a chemotherapy drug) and prednisone (a steroid medicine).

Are there side effects of medicines used to treat multiple myeloma?

Yes, like most cancer medicines, these medicines have side effects. Your healthcare provider will probably give you blood tests once a month. When melphalan kills the cancer cells, it also kills some of your body’s “good” cells. You may lose some of your hair, but it will grow back after you stop chemotherapy. However, if you have these symptoms, you should contact your healthcare provider right away:

  • Fever
  • Bleeding (such as nosebleeds, bleeding gums or severe bruising),
  • Skin rash
  • Cough that doesn’t go away

These are some of the more serious side effects of melphalan. While you’re taking melphalan, you must not get pregnant because melphalan might be harmful for the baby.

If the cancer doesn’t respond to a combination of melphalan and prednisone, your healthcare provider may talk with you about other treatments. These may include other medicines, radiation treatments or a bone marrow transplant.

Living with multiple myeloma

Even with regular treatment, multiple myeloma may not completely go away. Or, if it does, you may live in fear of it coming back. That can cause much stress for you and your loved ones. Consider joining a support group or talking to a therapist about your feelings. Invite your family to do the same.

If you have multiple myeloma, you should try to stay active. Staying active helps keep the calcium in your bones instead of in your blood, which helps keep your bones strong. You should also eat a balanced diet and drink plenty of fluids.

FOR MORE INFORMATION

Canadian Cancer Society

http://www.cancer.ca

This information provides a general overview and may not apply to everyone. Talk to your healthcare provider to find out if this information applies to you and to get more information on this subject.

Contributed by familydoctor.org editorial staff.

Copyright (c) by the American Academy of Family Physicians

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, February 2025

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