Multiple Myeloma

Last Updated January 2021 | This article was created by editorial staff and reviewed by Beth Oller, MD

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.

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

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. Multiple myeloma is also twice as common in Black people than it is in white people. Some studies suggest that workers in agriculture or petroleum-based industries may be at greater risk due to exposure to chemicals.

How is multiple myeloma diagnosed?

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

If the multiple myeloma is in a later stage, you may need more tests. Your doctor 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 doctor 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. It can be done in your doctor’s office. This procedure hurts a little, but no special care is needed afterward.

Can multiple myeloma be prevented or avoided?

There is no known way to prevent multiple myeloma.

Multiple myeloma treatment

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 doctor will likely order monthly blood tests to evaluate progress. 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 call your doctor 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 doctor 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.

Questions to ask your doctor

  • What can I do to keep myself as healthy as possible?
  • I’m in a lot of pain. Is there anything I can take to stop the pain?
  • How long can I live with multiple myeloma?
  • I’m having frequent nosebleeds. What can I do to stop them?
  • Is multiple myeloma something my children may be prone to?
  • I worked around a lot of chemicals when I was younger. Do I need to be screened for multiple myeloma?