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Types of Cancer - Multiple Myeloma

Each year, nearly 13,000 people in the United States learn that they have multiple myeloma. It is a cancer that affects certain white blood cells called plasma cells. To understand multiple myeloma, it is helpful to know about normal cells, especially plasma cells, and what happens when they become cancerous.

Types of Cancer

What are Plasma Cells?

When cancer involves plasma cells, the body keeps producing more and more of these cells. The unneeded plasma cells - all abnormal and all exactly alike - are called myeloma cells. Myeloma cells tend to collect in the bone marrow and in the hard, outer part of bones. Sometimes they collect in only one bone and form a single mass, or tumor, called a plasmacytoma. In most cases, however, the myeloma cells collect in many bones, often forming many tumors and causing other problems. When this happens, the disease is called multiple myeloma. Although plasmacytoma and multiple myeloma affect the bones, they begin in cells of the immune system. These cancers are different from bone cancer, which actually begins in cells that form the hard, outer part of the bone.

Because people with multiple myeloma have an abnormally large number of identical plasma cells, they also have too much of one type of antibody. These myeloma cells and antibodies can cause a number of serious medical problems:

Symptoms

Symptoms of multiple myeloma depend on how advanced the disease is. In the earliest stage of the disease, there may be no symptoms. When symptoms do occur, patients commonly have bone pain, often in the back or ribs. Patients also may have broken bones, weakness, fatigue, weight loss, or repeated infections. When the disease is advanced, symptoms may include nausea, vomiting, constipation, problems with urination, and weakness or numbness in the legs.

Diagnosis

If a patient has bone pain, x-rays can show whether any bones are damaged or broken. Samples of the patient's blood and urine are checked to see whether they contain high levels of antibody proteins called M proteins. The doctor also may do a bone marrow aspiration and/or a bone marrow biopsy to check for myeloma cells. In an aspiration, the doctor inserts a needle into the hip bone or breast bone to withdraw a sample of fluid and cells from the bone marrow. To do a biopsy, the doctor uses a larger needle to remove a sample of solid tissue from the marrow. A pathologist examines the samples under a microscope to see whether myeloma cells are present. To plan a patient's treatment, the doctor needs to know the stage, or extent, of the disease.

Treatment

Treatment depends on the extent of the cancer and the patient's symptoms. Treatment decisions for multiple myeloma are complex.

Treatment Methods

Plasmacytoma and multiple myeloma are very hard to cure. Although patients who have a plasmacytoma may be free of symptoms for a long time after treatment, many eventually develop multiple myeloma. For those who have multiple myeloma, treatment can improve the quality of a patient's life by controlling the symptoms and complications of the disease.

People who have multiple myeloma but do not have symptoms of the disease usually do not receive treatment. For these patients, the risks and side effects of treatment are likely to outweigh the possible benefits. However, these patients are watched closely, and they begin treatment when symptoms appear. Patients who need treatment for multiple myeloma usually receive chemotherapy and sometimes radiation therapy.

Treatment Studies

Because multiple myeloma is so hard to control, many researchers are looking for more effective treatments. Many clinical trials of new treatments for multiple myeloma are under way.