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Multiple Myeloma

Multiple Myeloma

What is multiple myeloma? — Multiple myeloma is a cancer of 1 type of white blood cell. White blood cells fight infections in the body. They are made in the center of your bones, in a part called the bone marrow. When people have multiple myeloma, the bone marrow makes too many of these white blood cells and not enough of the normal blood cells a person's body needs. This can cause symptoms.
What are the symptoms of multiple myeloma? — Multiple myeloma can cause many different symptoms. These include:
Bone pain or bones that break easily
Nausea, vomiting, confusion, or feeling more thirsty than usual
Feeling more weak, tired, or short of breath than usual
Blurry vision
Numbness, tingling, or weakness in the chest, lower back, or legs
Getting sick more easily
Losing weight without trying to
All of these symptoms can also be caused by conditions that are not multiple myeloma. But if you have these symptoms, let your doctor or nurse know.
Sometimes, symptoms of multiple myeloma can be a medical emergency. For example, it is an emergency if multiple myeloma cells or pieces of broken bone push down on a person's spinal cord. The spinal cord is the group of nerves that runs down a person's back. See a doctor immediately if you have:
Severe back pain
Weakness, numbness, or tingling in the legs
No control over your bladder or bowel (that is a new problem)
People with multiple myeloma can get sick from infections more easily than normal. Because of this, it's important to wash your hands often and stay away from people who are sick. Tell your doctor or nurse right away if you get a fever.
Is there a test for multiple myeloma? — Yes. Your doctor or nurse will do an exam and tests. Tests can include:
Blood or urine tests
Bone marrow biopsy – A doctor will take a very small sample of the bone marrow. Another doctor will look at the sample under a microscope to see if cancer cells are present.
Imaging tests, such as CT scans, PET scans, MRI scans, or X-rays – Imaging tests create pictures of the inside of the body.
How is multiple myeloma treated? — People with multiple myeloma often have 1 or more of the following treatments:
"Watch and wait" – Some people have a condition called "smoldering myeloma" before they get multiple myeloma. These people do not have any symptoms and might not receive treatment right away. But they do get checked by a doctor regularly. When they start to have symptoms, they will have active treatment.
Chemotherapy – Chemotherapy is the term doctors use to describe a group of medicines that kill cancer cells.
Steroid medicines – These medicines can kill cancer cells and slow cancer growth. These are not the same as the steroids some athletes take illegally.
Medicines called "immune modulating medicines" – These medicines stop the cancer from growing.
Antibodies – Antibodies are proteins in your blood. Your immune system makes them to help your body fight infections. But there are other types of antibodies that are created in a lab and used as medicine. They kill cancer cells by targeting specific parts of the cells.
Bone marrow transplant – The bone marrow makes blood cells, including white blood cells. During a bone marrow transplant, a doctor removes some bone marrow from the body. Then, the person gets medicines called "chemotherapy." These medicines are usually used to kill cancer cells, but they also kill bone marrow cells. After chemotherapy, the doctor puts the bone marrow back into the person's body.
People with multiple myeloma also get treatment for any symptoms they have. For example, doctors might treat bone symptoms with pain medicines, medicines to stop bone loss, or radiation therapy. Radiation can kill cancer cells.
What happens after treatment? — After treatment, you will be checked every so often to see if the cancer comes back. Treatment does not usually cure the disease, but it can reduce symptoms and help people live longer. Follow-up tests can include blood tests, urine tests, imaging tests, or bone marrow biopsy.
What happens if the multiple myeloma comes back? — If the multiple myeloma comes back, you might get more chemotherapy, immune modulating medicines, steroid medicines, antibodies, or bone marrow transplant.
What else should I do? — It is important to follow all your doctors' instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for multiple myeloma involves making many choices, such as what treatment to have and when. Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the downsides to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15531 Version 14.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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