Multiple myeloma (patient information)

For the WikiDoc page for this topic, click here

Editor-in-Chief: C. Michael Gibson, M.S., M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief: Jinhui Wu, M.D.

Overview
Multiple myeloma is a cancer of plasma cells that is a type of white blood cell. The exact cause of multiple myeloma is not known. Epidemiological data suggest that it is more common in older people and African-Americans. Usual symptoms may include bone pain, broken bones, weakness or fatigue, weight loss and repeated infections. Multiple myeloma is hard to cure. Treatments include chemotherapy, bisphosphonates, stem cell transplant, radiation therapy, surgery, or a combination of these methods. Multiple myeloma is hard to cure and the prognosis is not good.

What are the symptoms of Multiple myeloma?
Early multiple myeloma does not have any symptoms. As the tumor grows larger, people may notice one or more of the following symptoms:
 * Bone pain
 * Broken bones
 * Numbness and/or muscle weakness
 * Confusion
 * Dizziness
 * Edema in legs

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Who is at highest risk?
While the exact cause of multiple myeloma is not known, clinical data has suggested that the development of multiple myeloma is related to several factors.
 * Age: Age is the biggest risk factor for multiple myeloma. Most cases are found in people older than 65.
 * Plasma cell diseases: Studies show patients with other plasma cell diseases will develop multiple myeloma later.
 * Radiation exposure: Cases reports demonstrate exposure to radiation may increase the risk of multiple myeloma.
 * Exposure on oil-related industries: Some studies suggest that workers in some oil-related industries may be at a higher risk.
 * Family history: Some data suggest multiple myeloma seems to run in some families. But most patients have no other relatives with the disease.
 * Life-style: A study by the American Cancer Society found that being overweight increases a person's risk of developing multiple myeloma.
 * Race: Epidemiological data show multiple myeloma is almost twice as common among black Americans as white Americans.
 * Gender: Men are slightly more likely to get multiple myeloma than women.

When to seek urgent medical care?
Call your health care provider if symptoms of multiple myeloma develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:
 * Broken bones
 * Numbness
 * Muscle weakness
 * Confusion
 * Severe thirsty, oliguria and/or edema

Diagnosis

 * Quantitative immunoglobulins: In multiple myeloma, the level of one type may be high while the others are low.


 * Blood biochemistry tests: This test may show the high level of calcium in the blood and impairs of renal function.


 * Blood test: The blood test result of patients with multiple myeloma may show low level of all blood cells.


 * Bone marrow biopsy: This is the most valuable test for diagnosis of multiple myeloma. During this procedure, the doctor uses a needle to remove some solid bone and some bone marrow at the back of the pelvic bone.


 * Bone x-rays: By this test, the doctors can identify bone damage caused by the myeloma cells.


 * Computed tomography (CT) scan: CT scans can help to tell if the bones have been damaged by myeloma.


 * Magnetic resonance imaging (MRI): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture. MRI scans are very helpful in looking at bones, the brain, and the spinal cord damaged by the myeloma cells.


 * Positron emission tomography (PET) scan: When doing this test, a small amount of a radioactive medium is injected into your body and absorbed by the organs or tissues. This radioactive substance gives off energy which in turn is used to produce the images. PET can provide more helpful information than either CT or MRI scans. It is useful to see if the cancer has spread to the lymph nodes and it is also useful for your doctor to locate where the cancer has spread.

Treatment options
Patients with multiple myeloma have many treatment options. The selection depends on the stage of the tumor. The options are chemotherapy, bisphosphonates, stem cell transplant, radiation therapy, surgery, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effect are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.
 * Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.
 * Bisphosphonates: Treatment with a bisphosphonate helps prevent further bone damage in multiple myeloma patients.
 * Stem cell transplant: Treatment of stem cell transplant has become the standard treatment for myeloma patients in good health.
 * Radiation therapy: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.
 * Surgery: Surgery is not a main treatment for multiple myeloma. Emergency surgery may be needed to help support weight-bearing bones in the spine or legs to prevent bones from breaking.

Diseases with similar symptoms

 * Bone fracture
 * Reactive plasmacytosis
 * Macroglobulinemia
 * Bone metastatic tumor

Where to find medical care for Multiple myeloma?
Directions to Hospitals Treating multiple myeloma

Prevention of Multiple myeloma
For the exact cause is not clear, the preventive measure is unknown.

What to expect (Outlook/Prognosis)?
Multiple myeloma is hard to cure. The prognosis depends on the following:
 * Cytogenetic analysis of myeloma cells
 * The stage of the cancer
 * The patient's general health

Resources
Medlineplus

Cancer.org