Patient education: Multiple myeloma (The Basics)

What is multiple myeloma? — Multiple myeloma, or "MM," is a cancer of the "plasma cells." Plasma cells are a type of white blood cell. White blood cells fight infections in the body. They are made in the center of the bones, in a part called the bone marrow.

When a person has MM, their bone marrow makes too many plasma cells and not enough of the normal blood cells the body needs. This can lead to problems, including:

●Bone problems

●High levels of calcium in the blood

●Low red blood cell count, called "anemia"

●Kidney damage

●Infections

What are the symptoms of MM? — MM can cause different symptoms. Many of these are related to the problems that can happen when the body makes too many plasma cells.

Symptoms can include:

●Bone pain, or bones that break easily

●Nausea, vomiting, confusion, or feeling more thirsty than usual

●Feeling more weak, tired, or short of breath than usual

●Blurry vision

●Numbness, tingling, or weakness in the chest, lower back, or legs

●Getting sick more easily

●Losing weight without trying to

All of these symptoms can also be caused by conditions that are not MM. But if you have these symptoms, let your doctor or nurse know.

Sometimes, symptoms of MM can be a medical emergency. For example, it is an emergency if MM cells or pieces of broken bone push down on the spinal cord. The spinal cord is the group of nerves that runs down a person's back. See a doctor immediately if you have:

●Severe back pain

●Weakness, numbness, or tingling in the legs

●New problems controlling your bladder or bowel

Is there a test for MM? — Yes. Your doctor or nurse will do an exam and tests. Tests can include:

●Blood or urine tests

●Bone marrow biopsy – A doctor will take a very small sample of bone marrow. Another doctor will look at the sample under a microscope to see if cancer cells are present.

●Imaging tests, such as CT scans, PET scans, and MRI scans – Imaging tests create pictures of the inside of the body.

How is MM treated? — People with MM often have 1 or more of the following treatments:

●Medicines – Many different types of medicines are used for MM to kill the cancer cells and slow cancer growth. Common types of medicines include "immunomodulators," "proteasome inhibitors," steroid medicines, chemotherapy, and antibodies.

Antibodies are proteins in your blood. Your immune system makes them to help your body fight infections. But there are other types of antibodies that are created in a lab and used as medicine. They kill cancer cells by targeting specific parts of the cells.

●Bone marrow transplant – Bone marrow makes blood cells, including white blood cells. During a bone marrow transplant, a doctor removes some bone marrow from the body. Then, the person gets medicines called "chemotherapy." These medicines are usually used to kill cancer cells, but they also kill bone marrow cells. After chemotherapy, the doctor puts the bone marrow back into the person's body.

●"CAR-T" therapy – CAR-T therapy uses the person's own immune cells, called "T cells," to kill the cancer cells. The T cells are collected, modified, and returned to the body. They can then directly target the cancer cells.

People with MM also get medicines to strengthen their bones.

People with MM also get treatment for any symptoms they have. For example, doctors might treat bone symptoms with pain medicines and medicines to stop bone loss.

What happens after treatment? — After treatment, you will be checked every so often to see if the cancer comes back. Treatment does not usually cure the disease, but it can reduce symptoms and help people live longer. Follow-up tests can include blood tests, urine tests, imaging tests, or bone marrow biopsy.

What happens if the MM comes back? — If the MM comes back, your doctor might recommend trying a different treatment.

What else should I do? — People with MM can get sick from infections more easily than normal. Because of this, it's important to wash your hands often and stay away from people who are sick. Tell your doctor or nurse right away if you get a fever.

Follow all of your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Getting treated for MM involves making many choices, such as what treatment to have and when. Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

●What are the downsides to this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

More on this topic

Patient education: Autologous bone marrow transplant (The Basics)
Patient education: What are clinical trials? (The Basics)
Patient education: Bone marrow aspiration and biopsy (The Basics)

Patient education: Multiple myeloma symptoms, diagnosis, and staging (Beyond the Basics)
Patient education: Multiple myeloma treatment (Beyond the Basics)
Patient education: Hematopoietic cell transplantation (bone marrow transplantation) (Beyond the Basics)