Myeloma (also known as multiple myeloma) is a type of bone marrow cancer arising from plasma cells, which are normally found in the bone marrow. Plasma cells form part of your immune system.
Bone marrow is the ‘spongy’ material found in the centre of the larger bones in the body. The bone marrow is where all blood cells are made including plasma cells.
Normal plasma cells produce antibodies, which are also called immunoglobulins, to help fight infection.
In myeloma, these plasma cells become abnormal, multiply uncontrollably and release only one type of antibody known as a paraprotein which has no useful function. It is often through the measurement of this paraprotein that myeloma is diagnosed and monitored.
In the early stages, myeloma may not cause any symptoms. It is often only suspected or diagnosed following a routine blood or urine test. Myeloma does not usually take the form of a lump or tumour. Instead, the myeloma cells divide and expand within the bone marrow reducing the production of normal blood cells (including normal plasma cells) and hence the normal function of the bone marrow. Most of the symptoms and complications related to myeloma are caused by the build-up of myeloma cells in the bone marrow and the presence of the paraprotein in the blood or urine.
Myeloma is also known as multiple myeloma as the symptoms can affect different parts of the body.
The most common symptoms and complications include:
Bone disease: one of the most common complications of myeloma. Myeloma cells produce signals and substances known as cytokines and growth factors that increase bone breakdown but reduce new bone formation. Bone destruction can lead to painful bone lesions or even fractures. The middle or lower back, the rib cage and the hips are the most frequently affected places
Pain: the principal cause of pain for myeloma patients is myeloma bone disease, this is the most common symptom of myeloma affecting up to 80% of patients at some point. Effective control and management of pain is an important aspect of myeloma treatment
Fatigue: due to the myeloma itself, to one or more of its complications (e.g. anaemia), or it can be a side-effect of treatment
Recurring infection: common in myeloma patients because the myeloma and its treatments reduce the function of the immune system
Anaemia: a reduction in the number of red blood cells (haemoglobin). It can occur as a result of the myeloma or as a side-effect of treatment and can cause fatigue, weakness or breathlessness
Kidney damage: can be caused by the myeloma itself as the abnormal protein produced by the myeloma cells can damage the kidneys. It can also be a side-effect of treatment
Hypercalcaemia: a condition in which the level of calcium in the blood is too high. It can occur as a result of myeloma bone disease and can cause thirst, nausea, vomiting, confusion and/or constipation
Peripheral neuropathy: damage to the nerves that make up the peripheral nervous system. It can be caused by the treatments for myeloma and also the myeloma itself
Not everyone will experience all or any of these. Supportive treatments are commonly used alongside and after anti-myeloma treatment to relieve, stabilise and in some cases, help prevent these symptoms and complications.
The causes of myeloma are not known for certain. Exposure to specific chemicals, radiation, and age are thought to be risk factors. A risk factor is anything that may increase your chance of getting myeloma.
Myeloma is an uncommon cancer with approximately 4,800 new diagnoses each year in the UK.
Myeloma mostly affects people aged 65 and over, but it can be diagnosed in people in their twenties and beyond. Myeloma is slightly more common in men than in women and is twice as common in the Afro-Caribbean compared to the Caucasian population.
Myeloma is a treatable disease for most patients, but there is unfortunately no cure at present. New treatments and drugs are being studied and licensed, and the survival rate over the past ten years has improved significantly.