Dr. M.J. Bazos,
Patient Handout
MULTIPLE
MYELOMA
About Your
Diagnosis
Multiple myeloma is cancer of
the mature lymphocytes (plasma cells). A lymphocyte is a white blood cell
involved in the immune system. Lymphocytes are produced in the bone marrow (the
soft substance in the center of bones). They produce antibodies that attack any
foreign substance (eg, virus, bacteria) in the body. The cause of multiple
myeloma is not known. Many different theories exist, including genetic, viral,
and radiation-related causes. More than 14,000 new cases of multiple myeloma
were diagnosed last year in the United States. The disease is not contagious.
Multiple myeloma is diagnosed when a patient has the following findings: (1) an
abnormal protein in the blood, (2) characteristic findings on bone radiographs
(x-rays), and (3) an abnormal bone marrow biopsy (marrow removed from the bone
and examined under a microscope). There is no cure for multiple
myeloma.
Living With Your
Diagnosis
Symptoms of multiple myeloma
are caused by (1) expansion and invasion of the bone marrow, which prevents
formation of blood cells and (2) production of substances by the cancer cells.
Bone pain is the most common symptom of multiple myeloma. The back is most often
affected. Myeloma cells destroy the bone and release calcium into the blood
system, leading to other complications, such as nerve compression, lower leg
weakness, and kidney failure. Elevated calcium levels in the blood can cause
increased urination, weakness, and confusion. Anemia and infections are common
among patients with multiple
myeloma.
Treatment
Once
the diagnosis is confirmed, multiple myeloma is classified into one of three
stages. To determine this, the physician orders blood tests and radiographs of
the bones. The staging of the cancer gives a prognosis. Many people live longer
than 5 years if they have disease in stage I; patients with stage III disease
have an average survival time of 15 months. Management of multiple myeloma may
involve no treatment at all unless signs and symptoms
of
bone pain, elevated calcium level,
kidney failure, anemia, or compression of the spinal cord are present. Decisions
about starting chemotherapy, the choice of chemotherapeutic drugs, the duration
of treatment, and monitoring response are made by an oncologist (physician
specializing in cancer). Side effects of chemotherapy are nausea, vomiting, loss
of appetite, weight loss, hair loss, easy bruising and bleeding, and infections.
Radiation therapy is used to relieve bone pain and medical emergencies such as
compression of the spinal cord. Side effects of radiation depend on which part
of the body is irradiated. If the pelvic area is irradiated, nausea, vomiting,
diarrhea, urinary difficulties, and fatigue may occur. Orthopedic operations are
needed for bone fractures.
Supportive
treatment such as use of antibiotics for infections, diuretics (water pills) for
elevated blood calcium levels, and narcotic pain medications for relief of pain
improve well-being.
The
DOs
• Stay active. This helps
keep calcium in your bones.
• Drink
lots of fluid. This is the first line of management of elevated calcium blood
levels.
• Take your medications as
prescribed. A diuretic may be prescribed to help keep your calcium level down.
Medicines for pain and infections may be prescribed in the appropriate
situations.
• Use back support if
needed.
The
DON’Ts
• Do not be
immobile. This can lead to a rise in calcium
level.
• Do not do heavy
lifting.
• Do not be afraid to ask
for pain medication. Multiple myeloma can be painful because it involves the
bone.
• Do not miss follow-up
appointments. Your physician needs to repeat blood tests, radiographs, and urine
collections to monitor response to treatment or to decide to start treatment.
When to Call Your
Doctor
• If you are having
pain.
• If you are having
fevers.
• If you are having back
pain, leg numbness or weakness, stool or urinary incontinence (leaking or loss
of control). These can be caused by
compression
on the spinal
cord.
• If you notice blood in stool,
urine, phlegm, or vomit.
• If you
feel depressed.