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Understanding Multiple Myeloma: Symptoms, Diagnosis, and Treatment Options

William Wadzinski | MD

Medically reviewed by William Wadzinski | MD, Uniformed Services University of the Health Sciences on April 2nd, 2024.

Key Takeaways

  • This cancer originates when plasma cells—immune cells that produce antibodies—become malignant and crowd out healthy bone marrow, affecting 34,000 Americans annually with a median age of diagnosis at 70.

  • The classic symptom combination includes bone pain (especially back pain from compression fractures), anemia-related fatigue, hypercalcemia causing confusion, and kidney dysfunction from excess protein production.

  • Blood tests reveal elevated M-protein (abnormal antibodies), while imaging shows characteristic "punched-out" bone lesions; bone marrow biopsy confirming >10% plasma cells clinches the diagnosis.

  • African Americans have twice the risk of developing this cancer compared to whites, while prior MGUS (monoclonal gammopathy) progresses to active disease at 1% per year.

  • Treatment typically involves 3-4 cycles of induction therapy (often lenalidomide, bortezomib, and dexamethasone), followed by autologous stem cell transplant in eligible patients under 65-70 years old.

Multiple myeloma, also known as Kahler's disease, is a type of blood cancer that affects plasma cells in the bone marrow. Although there is no cure for multiple myeloma, treatments can help slow the progression of the disease and manage symptoms. In this article, we'll explore the causes, symptoms, diagnosis, and treatment options for multiple myeloma.

What Causes Multiple Myeloma?

The exact cause of multiple myeloma is unknown, but several factors can increase your risk of developing the disease. These risk factors include:

  • Being over the age of 65

  • Being male

  • Being African American

  • Having a family history of multiple myeloma

  • Being overweight or obese

  • Exposure to radiation or certain chemicals

Symptoms of Multiple Myeloma

In the early stages of multiple myeloma, you may not experience any symptoms. As the disease progresses, you may notice:

  • Bone pain

  • Weakness and fatigue

  • Weight loss and loss of appetite

  • Nausea and constipation

  • Confusion

  • Frequent infections

  • Severe thirst

  • Numbness or weakness in the arms and legs

Diagnosing Multiple Myeloma

If your doctor suspects you may have multiple myeloma, they will order several tests to confirm the diagnosis. These tests may include:

  • Blood tests to measure calcium levels, red blood cell count, kidney function, and protein levels

  • Urine tests to check for unusual proteins

  • Bone marrow biopsy to examine the number of plasma cells in the bone marrow

  • Imaging tests such as X-rays, CT scans, MRIs, or PET scans to look for bone damage

Understanding Multiple Myeloma: Symptoms, Diagnosis, and Treatment Options

Treatment Options for Multiple Myeloma

Treatment for multiple myeloma depends on the stage of the disease and the individual patient's needs. Common treatment options include:

Medications

  • Chemotherapy drugs to kill cancer cells

  • Targeted therapies to prevent cancer growth

  • Immunomodulatory drugs to strengthen the immune system

  • Corticosteroids to help manage side effects and enhance other treatments

Stem Cell Transplant

In some cases, a stem cell transplant may be recommended. This involves using high-dose chemotherapy to destroy cancer cells and then replacing the damaged bone marrow with healthy stem cells from the patient or a donor.

Treatments for Bone Symptoms

  • Bisphosphonates to slow bone breakdown

  • Monoclonal antibodies to stop cells that break down bone

  • Radiation therapy to kill cancer cells and strengthen weakened bones

Outlook for Multiple Myeloma Patients

The outlook for multiple myeloma patients varies depending on the stage of the disease and the individual's response to treatment. Some patients may live for years with few symptoms, while others may experience a more rapid progression of the disease. Blood tests measuring albumin and beta-2-microglobulin levels can help predict survival rates.

If you or a loved one has been diagnosed with multiple myeloma, it's essential to work closely with your healthcare team to develop a personalized treatment plan. Seeking support from organizations like the Multiple Myeloma Research Foundation can also provide valuable resources and support for patients and their families.

For more information on multiple myeloma, visit the following reputable sources:

The Bottom Line

While incurable, modern treatments have doubled survival rates to 6-7 years, with some patients living decades through sequential therapies and maintenance protocols. Early recognition of bone pain, fatigue, and recurrent infections is crucial since prompt treatment prevents irreversible organ damage. If you're experiencing persistent symptoms or have concerning lab results, Doctronic can help connect you with specialists quickly.

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