Is Multiple Myeloma Cancer Curable?

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 removes 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.  These complications include:

• Peripheral neuropathy (nerve damage that often causes weakness, numbness, and pain, usually in your hands and feet)
• Cognitive impairment (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)

The International Staging System (ISS) is the most commonly used classification of multiple myeloma. It makes use of two tests: serum-beta-2 microglobulin (β2-M) and serum albumin.  

According to ISS, there are three stages of multiple myeloma:

• Stage I: β2-M <3.5 mg/L with a serum albumin of 3.5 g/dL or more
• Stage II: Either of these 2 criteria: β2-M between 3.5 mg/L and 5.5 mg/L or Albumin <3.5 g/dL
• Stage III: β2-M >5.5 mg/L

This system has recently been revised to include serum LDH) and high-risk gene abnormalities (defined by the FISH test). This new system is called the revised-ISS (or R-ISS).