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Multiple myeloma at at a glance

Each year there are nearly 3,800 new cases of multiple myeloma. It accounts for around 1 per cent of all new cases of cancer diagnosed each year.

Myeloma develops from cells within the bone marrow called plasma cells. Plasma cells produce proteins called antibodies, which help to fight infection. In myeloma, a single plasma cell develops faults and multiplies out of control. This makes the immune system much less effective at fighting infection.

Myeloma cells produce excessive amounts of a single type of antibody, which is known as paraprotein, or monoclonal spike.

Myeloma usually develops at a number of different sites within the body. This cancer is therefore called multiple myeloma. The most common sites for multiple myeloma are the pelvis, spine, rib cage, skull, shoulders and hips.

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• Risks and causes
• Signs and symptoms
• Detection
• Treatment

If you are a patient looking for information on multiple myeloma cancer, please visit our patient information website, CancerHelp UK.

Risks and causes

Age

Multiple myeloma is more common from the age of 50 onwards.

People who have been exposed to high doses of radiation may have a greater risk of developing multiple myeloma.

People with a disease called monoclonal gammopathy are at increased risk of developing multiple myeloma.

Multiple myeloma is about twice as common in people of African descent than in the general population.

You can find out more about what 'cancer risk' means in the Understanding 'risk' section of this website.

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Signs and symptons

Multiple myeloma may not cause symptoms in its early stages. Symptoms can include:

• bone pain (this may be a result of bone damage)
• bleeding/bruising problems (this can be a result of impaired healing)
• anaemia
• tiredness
• weakness
• shortness of breath
• infection (as a result of not having enough healthy white blood cells)
• confusion
• constipation.

The excessive production of antibody, or paraprotein, in multiple myeloma can lead to kidney damage. Symptoms of kidney damage include:

• difficulty passing urine
• swollen ankles
• thirst
• nausea
• vomiting.

These signs and symptoms usually indicate problems other than cancer. However, people who notice any symptoms should see their doctor.

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Detection

Initially the doctor will ask questions about previous medical problems, and carry out a physical examination. The doctor or, after referral, a specialist may also want to do further tests, which can include:

• Blood tests
  These will check the number and appearance of different types of cells in the blood, as well as the levels of antibodies and certain proteins that may indicate kidney damage.
• Urine test
  The doctor may examine the urine for Bence-Jones protein, which is part of paraprotein and consists of fragments of antibodies.
• X-rays
  X-rays may show signs of bone damage caused by myeloma cells.
• Bone marrow tests

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Treatment

Treatment for multiple myeloma may include:

Chemotherapy is the main treatment for multiple myeloma.

Radiotherapy is commonly used to treat localised areas where there is bone destruction and pain. Doctors may give radiotherapy as a treatment on its own, or in addition to chemotherapy.

Steroids may be used with chemotherapy to treat multiple myeloma.

Doctors may use thalidomide to treat multiple myeloma. It may be given on its own or in combination with chemotherapy and/or steroids. Velcade (bortezomib) is another new biological therapy used to treat myeloma.

Doctors may use high-dose chemotherapy or radiotherapy in combination with a bone marrow or stem cell transplant.

Doctors may use treatments such as blood transfusions and drugs to treat anaemia, antibiotics to fight infections, and painkillers and bisphosphonate drugs for bone damage.

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