How Long a Person Can Live With Multiple Myeloma?

Multiple myeloma is a type of cancer that affects the bone marrow. The survival rates for multiple myeloma vary depending on the stage and can range from about two to five years.

Multiple myeloma is a cancer of the bone marrow. Bone marrow is the spongy tissue inside the long bones. 

• In this cancer, plasma cells (a type of white blood cell) accumulate in the bone marrow, giving rise to tumors in multiple bones of the body.
• Normal plasma cells make antibodies that help the body fight against infection and various diseases.
• An increase in the number of multiple myeloma cells crowds out the normal cells and destroys them.

Multiple myeloma is discovered through routine blood screening when patients are being evaluated for other problems such as frequent infections. 

Since 2000, the percentage of patients living five years after diagnosis has been on the rise. With improved treatment, survival results are likely to be better. 

According to the American Cancer Society, the median survival rates are as follows:

Remember, these survival rates are only estimates. They cannot predict the exact period you can live with multiple myeloma. How long you can survive depends upon your body’s response to cancer therapy. Discuss with your doctor to better understand your specific situation.

Multiple myeloma can be without symptoms, with multiple symptoms, or can have complications that require emergent treatment.

The first signs of multiple myeloma include the following:

• Fractures
• Bone pain
• Weakness
• Exhaustion 
• Bleeding
• Easy bruising
• Anemia
• Frequent infections
• Weight loss
• Nerve damage
• Bowel or bladder incontinence

Multiple myeloma can cause hypercalcemia (increased blood calcium levels) whose signs and symptoms are:

• Loss of appetite
• Nausea or vomiting
• Feeling thirsty
• Frequent urination
• Constipation
• Feeling very tired
• Muscle weakness
• Restlessness
• Confusion or trouble thinking

In one-third of patients, multiple myeloma is diagnosed after the patient complains of frequent fractures. Two-thirds of patients complain of bone pain, commonly lower back pain. 

The exact cause of multiple myeloma is unknown; however, you are at slightly higher risk if you have:

• Age > 65 years
• Male gender
• African American lineage
• Family member history of multiple myeloma
• Obesity
• Exposure to radiation
• Exposed to certain viruses

Contact with chemicals used in rubber manufacturing, woodworking, firefighting, or herbicides

Multiple myeloma can cause such problems as the following:

• Renal failure is seen in 25% of patients with multiple myeloma.
• Anemia, neutropenia (low white blood cell count), or thrombocytopenia (low platelet count) due to the abnormal growth of plasma cells in the bone marrow. 
• Thrombosis is the formation of a blood clot inside the blood vessel.
• Raynaud phenomenon is a condition resulting in discoloration of the fingers and/or the toes after exposure to changes in temperature (cold or hot) or emotional events.
• Severe bone pain
• Spinal cord compression: As many as 20% of patients develop spinal cord compression at some point in their disease. Symptoms typically include back pain, weakness, or paralysis and numbness in the legs. 
• Bacterial infection is the leading cause of death in patients with myeloma. The highest risk is in the first two to three months of chemotherapy.
• Hyperviscosity syndrome (thickening of the blood): Easy bruising, bleeding in the eye, heart problems, seizures, and confusion may occur because of hyperviscosity syndrome.
• Hypercalcemia may cause increased urination (polyuria) and increased thirst (polydipsia), muscle cramps, constipation, and a change in the patient’s mental status.

While multiple myeloma is not curable, treatment can help extend a person's life.

There is no cure for multiple myeloma. Treatment for multiple myeloma can only reduce the severity of its symptoms and extend the patient’s survival by a few months or two to three years. 

The best treatment for multiple myeloma varies from patient to patient and is often a combination of various therapies that include: 

• Immunomodulators (medications used to help regulate or normalize the immune system)
• Steroids
• Chemotherapy drugs
• Bisphosphonate therapy (drugs that prevent weakening or destruction of bones)
• Blood or platelet transfusions
• Plasmapheresis (filtering the blood and removing harmful antibodies)
• Radiation therapy (use of high-energy waves to kill tumor cells)
• Surgery (that repairs the damaged bones)
• Bone marrow transplant (a procedure to replace damaged or destroyed bone marrow with healthy stem cells )

Although the treatment for multiple myeloma helps reduce disease progression and the development of complications, treatment may itself produce certain complications.

The side effects of multiple myeloma treatment may include:

• Peripheral neuropathy (nerve damage that often causes weakness, numbness, and pain, usually in your hands and feet)
• Cognitive impairment (a condition in which a person has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life)
• Second cancers (a new and different type of cancer that happens in someone who has had cancer before)
• Venous thromboembolism (blood clots in the deep veins of your legs or arms)
• Cardiac toxicity (heart damage by chemotherapy drugs)
• Renal toxicity (kidney damage by chemotherapy drugs)

It’s difficult to diagnose multiple myeloma early since there are no symptoms in its early stages. Early symptoms, if at all, are usually attributed to other diseases. Hence, multiple myeloma is often diagnosed based on certain tests, the patient’s symptoms, and the doctor’s physical exam of the patient. 

If symptoms suggest that a person might have multiple myeloma, more tests are done that include:

• Blood counts: The complete blood count (CBC) is a test that measures the levels of red blood cells (RBC), white blood cells (WBC), and platelets in the blood. 
• Blood chemistry tests: Levels of blood creatinine, albumin, and calcium will be particularly checked.  A blood test that measures lactate dehydrogenase (LDH) levels can predict a patient’s chances of survival.
• Quantitative immunoglobulins: This test measures the blood levels of the different antibodies (also called immunoglobulins). 
• Urine tests: A routine urine sample or urine collected over 24 hours can measure how much myeloma protein is present. 
• Bone marrow biopsy: Bone marrow biopsy involves drawing a sample of bone marrow to check for abnormal growth of plasma cells.

Other tests include:

• Electrophoresis
• Serum-free light chains (a component of antibodies called light chains present freely in the serum)
• Beta-2 microglobulin (β2-M)
• Immunohistochemistry
• Flow cytometry
• Cytogenetics
• Fluorescent in situ hybridization (FISH)
• Fine needle aspiration biopsy
• Core needle biopsy
• Bone X-rays
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI) scans
• Positron emission tomography (PET) scans
• Echocardiogram (ECHO)