Am Fam Physician. 2017;95(6):online
See related article on multiple myeloma
What is multiple myeloma?
Multiple myeloma is a type of cancer that affects blood cells. It causes the body to make too many plasma cells. This can affect other areas of the body, such as the bones, kidneys, eyes, and nerves.
Multiple myeloma often takes a long time to affect the overall function of the body. There are other conditions involving plasma cells that do not always develop into cancer. For these conditions, doctors usually do not start treatment right away.
What are the symptoms?
Many symptoms of multiple myeloma are vague and hard to pin down. Patients may feel tired or weak, lose weight for no apparent reason, get frequent serious infections, or have pain in one of their bones. Sometimes patients have no symptoms, and the disease is found because of a blood test.
How is it diagnosed?
Your doctor will order blood and urine tests for evidence of multiple myeloma. Most patients will also need to have part or all of their body scanned with an x-ray or other tools that can take pictures of a bone. The diagnosis can only be confirmed with a bone marrow biopsy. To do this, your doctor or an oncologist (cancer specialist) will use a needle to take a sample from inside your bone.
How is it treated?
Treatment depends on your overall health and the stage of your multiple myeloma. You and your oncologist should discuss the specific risks and benefits of each type of treatment based on your personal case. Here are the most common approaches to treatment:
Observation: If your condition is not fully developed multiple myeloma and has a low chance of turning into cancer, carefully monitoring your status is best.
Immune therapy: This changes the way your immune system works and decreases the production of cancer cells.
Chemotherapy: These are a group of medicines that destroy the multiple myeloma cells.
Steroid therapy: This is medicine that decreases the production of cancer cells.
Bone marrow transplant: This is a treatment that uses both chemotherapy and surgery. Your doctor will give you medicine to kill the cancer cells in your body, along with the bone marrow in your body where the cells are made. The destroyed bone marrow is then replaced with healthy bone marrow.
What happens after treatment?
You will see your doctor often. You and your doctor will discuss how often your blood levels should be checked for signs that cancer has returned.
What happens if the cancer comes back?
You and your doctor will discuss treatment options. It will likely require using several of the treatments mentioned above at the same time.
Where can I get more information?
Your doctor
AAFP's Patient Information Resource
American Cancer Society
International Myeloma Foundation
Multiple Myeloma Research Foundation
National Cancer Institute
National Library of Medicine
