Multiple myeloma is a type of cancer that occurs when plasma cells located in your bone marrow become malignant, or multiply out of control. When this happens, the plasma cells create a tumor which grow in several places, including the soft tissue of the bone marrow. When these tumors appear in several sites, the condition is called multiple myeloma. It usually affects people over age 50.
Experts estimate that 14,400 new cases of multiple myeloma will occur in 2001: 7,500 cases in men and 6,900 cases in women. Approximately 11,200 people in the United States are estimated to die of this disease in 2001.
The most significant risk factor for multiple myeloma is age. The average age of diagnosis is 70, and only 2 percent of cases occur in people younger than 40. In American patients, the disease is found twice as much among African Americans as Caucasian Americans. The reason for this is unknown.
The cause of multiple myeloma is generally unknown. However, some cancers can be caused by defects in the DNA. Genes that promote cell division are called oncogenes. Some studies have shown that defects in some oncogenes may develop early in people with multiple myeloma.
Plasma cells, or white blood cells, fight infection by producing antibodies. Bone marrow, a fatty tissue, is located inside your bones. In people with multiple myeloma, their bones are weakened, their bone marrow does not produce proper parts of the blood, and the small number of plasma cells that remain are abnormal and unable to fight infection.
Symptoms of multiple myeloma include:
- Bone pain. Tumors associated with multiple myeloma release osteoclasts, or bone-absorbing cells, which cause painful bone weakness.
- Bone weakness, or osteoporosis, can lead to bone fractures from relatively minor stress or injury.
- Blood problems. As myeloma growth takes over the normal formation of marrow cells, there is a shortage of red blood cells, white blood cells, and platelets. This can lead to anemia, infections, and serious bleeding due to small cuts.
- Nervous system issues. Weakness in spinal bones may compress nerves, causing numbness, severe pain, and weakness in the limbs.
- Kidney symptoms. Too much myeloma protein can injure the kidneys, reducing the patient’s ability to dispose of bodily waste, fluid, and excess salt.
- Infections. The most serious infection picked up by a multiple myeloma patient is pneumonia. These patients are 15 times more likely to develop pneumonia than other people.
Several tests are done to confirm diagnosis of multiple myeloma:
- The blood and urine are tested for an abnormal immunoglobin, or antibody. If this type of immunoglobin is found in high levels, it may indicate multiple myeloma.
- Bone X-ray.
- MRI.
- Bone marrow aspiration.
Treatment for multiple myeloma will include chemotherapy and radiation therapy. Surgery is generally not an option to treat multiple myeloma. However, emergency surgery may be necessary if the disease causes sudden paralysis, muscle weakness, or numbness. Bone marrow transplantation is also an option to treat multiple myeloma.
Multiple myeloma can be detected at three stages: Stage I (small number of myeloma cells) to Stage III (large number of myeloma cells). The patient’s outlook depends on the stage of diagnosis.
- The five-year survival rate for a Stage I diagnosis is 50 percent. The median survival time is over 60 months.
- The five-year survival rate for a Stage II diagnosis is 40 percent. The median survival time is about 41 months.
- The five-year survival rate for a Stage III diagnosis is 10 to 25 percent. The median survival time is about 23 months.
There is no known prevention for multiple myeloma.
