Multiple Myeloma

What is multiple myeloma?

Multiple myeloma is a type of cancer which occurs in the plasma cells of the body. These cells are normally found in the bone marrow and form a part of the immune system. Multiple myeloma results in the accumulation of plasma cells in the bone marrow, affecting the production of blood cells.

What are its main signs and symptoms?

Multiple myeloma starts to display a wide range of signs and symptoms in the later stages, some of which are:

• Consistent bone pain
• Weakening of the bones, resulting in frequent fractures even with the slightest impact
• Anaemia
• Frequent infections
• Raised levels of calcium in the blood which leads to stomach pains, extreme thirst, constipation and drowsiness
• Kidney problems start to occur, leading to malfunction or failure of the kidneys

What are the main causes?

The exact cause of multiple myeloma is not described or confirmed by doctors, but there are certain factors believed to increase the risk of multiple myeloma. Age above 35, obesity, family history of multiple myeloma, male gender and being African American increases the risk of being diagnosed with the condition.

One important factor is the imbalance between oncogenes and tumour suppressor genes. The oncogenes are responsible for the growth of cells in the human body, while the tumour suppressor genes slow down the growth or cause the death of cells at the right time. A condition resulting in mutation and malfunction of these genes can lead to uncontrolled growth of plasma cells, resulting in multiple myeloma.

How is it diagnosed and treated?

If the symptoms and signs are suggestive of multiple myeloma, an X-ray, complete blood count, urine analysis, CT scan, PET scan, or MRI is ordered. These scans help in determining the location and extent of a tumour.

A biopsy is a more definitive test for confirming multiple myeloma. Samples of bone marrow are taken to determine the possible existence of cancerous plasma cells in the bone marrow.

Chemotherapy is the most common treatment for multiple myeloma, though it results in certain side effects too. Chemotherapy drugs are used to kill the cancerous cells and stop tumour growth.

Other medications are also used but are not always successful in curing the disease or have many side effects. These medications include:

• Steroids – Steroids are generally used to complement the chemotherapy drugs and make them more effective. The main side effects of steroids are heartburn, indigestion and difficulty sleeping.
• Thalidomide – Thalidomide also helps in killing the myeloma cells but often result in constipation and dizziness. Moreover, there is a risk of blood clot formation which presents as pain or swelling in the leg, breathlessness and chest pain.
• Stem cell transplant – In extreme cases of myeloma, a stem cell transplant is performed to replace the damaged bone marrow tissue with healthy stem cells, which results in the growth of new cells and allows the bone marrow to recover.

These treatments are costly, painful and require a lot of commitment from the patient and the doctors in charge of the treatment.

1. National Health Service [Internet]. UK; Multiple myeloma.
2. American Cancer Society [Internet] Atlanta, Georgia, U.S; Multiple myeloma.
3. National Institutes of Health; [Internet]. U.S. National Library of Medicine. Multiple myeloma.
4. National Organization for Rare Disorders [Internet]; Multiple myeloma.
5. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Multiple Myeloma.