Multiple Myeloma

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Multiple Myeloma Symptoms

Multiple myeloma is a cancer of certain cells of the bone marrow called plasma cells. Multiple myeloma is a form of bone marrow cancer. Plasma cells normally produce our antibodies. Multiple myeloma features abnormal proliferation of plasma cells in the bone marrow, destructive bone lesions, and the production of abnormal proteins, specifically antibodies. Multiple myeloma is also referred to as myeloma.

Multiple myeloma causes a host of organ problems and symptoms. Common symptoms of multiple myeloma include:

  • fatigue,
  • bone pain,
  • bone fracture,
  • susceptibility to infection,
  • kidney failure.

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Multiple myeloma facts

  • Multiple myeloma is a cancer of the plasma cells in the bone marrow.
  • The cause of multiple myeloma is not known.
  • Risk factors for multiple myeloma have not been established although researchers have suggested genetic abnormalities, such as c-Myc genes or environmental exposures, may play a role.
  • Symptoms and signs of multiple myeloma include
  • Multiple myeloma is diagnosed with a bone marrow aspiration and/or biopsy. Other tests include blood monoclonal immunoglobulin and radiology tests to determine the extent of bone lesions.
  • Although there are several staging systems, stages I, II, and III usually represent multiple myeloma with increasing severity of disease.
  • Treatment for multiple myeloma includes drugs that modulate the immune system, chemotherapy drugs, radiation therapy, stem cell transplants and, in some patients, surgery.
  • Although the patient's primary-care physician is involved in organizing treatments, specialists who treat multiple myeloma include oncologists, hematologists, radiologists, experts in stem cell transplantation and orthopedic and/or spine surgeons.
  • The prognosis for myeloma is only fair. Median survival is about three years, but some patients have a life expectancy of 10 years.
  • The International Myeloma Foundation can provide further support for myeloma patients.

What is multiple myeloma?

Multiple myeloma is often referred to simply as myeloma. It is a type of cancer that starts in the plasma cells of the bone marrow. These are protein-making cells which normally make all of the different kinds of proteins that comprise the antibodies of the immune system. In multiple myeloma, the plasma cells undergo what is referred to as a malignant transformation and thereby become cancerous. These myeloma cells stop making different forms of protein in response to the immune system's needs and instead start to produce a single abnormal type of protein referred to as a monoclonal or M protein. Multiple myeloma plasma cell populations accumulate and these collections of cells called plasmacytomas can erode the hard outer shell or cortex of the bone that normally surrounds the marrow. These weakened bones show thinning of the bone such as is seen in nonmalignant osteoporosis or what appear to be punched out or lytic bone lesions. These lesions may cause pain and even breaks or fractures of the bones so damaged. They may cause other systemic problems listed below. Multiple myeloma is also known as Kahler's disease.

What causes multiple myeloma?

What triggers plasma cells to become malignant in multiple myeloma is not known. The cancerous myeloma plasma cells proliferate and crowd out normal plasma cells and can etch away areas of bones. The proteins produced in large amounts can cause many of the symptoms of the disease by making the blood more thickened (viscous) and depositing the proteins in organs that can interfere with the functions of the kidneys, nerves, and immune system.

What are risk factors for multiple myeloma?

The definitive cause of multiple myeloma has not been established, but research has suggested several factors may be risk factors or contribute to multiple myeloma development in an individual. A genetic abnormality such as c-Myc oncogenes and others have been associated with multiple myeloma development. Currently, there is no evidence that heredity plays a role in multiple myeloma development. Environmental exposures to herbicides, insecticides, benzene, hair dyes, and radiation have been suggested as causes, but definitive data is lacking. Inflammation and infection have been suggested but again not proven to cause multiple myeloma. However, a benign proliferation of a plasma cell can result in a situation where a monoclonal antibody is produced in high amounts (but not as high as seen with multiple myeloma). This result is termed monoclonal gammopathy of unknown or undetermined significance (abbreviated as MGUS). Nevertheless, about 19% of MGUS patients develop multiple myeloma in about two to 19 years after MGUS diagnosis.

Medically Reviewed by a Doctor on 4/1/2016

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