Multiple Myeloma/Plasmacytoma

Multiple myeloma is a common form of blood cancer that affects plasma cells, blood cells that play a part in the body's immune system. The affected plasma cells become abnormal and multiply out of control to form tumors in the bone marrow, where these cells originate. When multiple tumors develop throughout the skeletal system, it is referred to as multiple myeloma. This can lead to bone and kidney damage, and disruption of the immune system. Multiple myeloma is more common in men than women.

What causes multiple myeloma is unknown, but it has been associated with exposure to radiation, certain pesticides, and viral infection with HIV and herpes virus.

Symptoms include pain in the bone, fever, fatigue and night sweats. Pain is usually felt in the sternum (breastbone) and hip bones. The bone weakens as a result of the tumor and often fractures. When it affects the vertebrae, the spinal cord may get compressed, leading to back and leg pain. Multiple myeloma can lead to high levels of calcium in the blood (hypercalcemia) and fewer red blood cells (anemia). Various symptoms can occur related to these conditions. As the cancer progresses, you may experience recurrent infections and kidney failure.

To diagnose multiple myeloma, your doctor will review your history and symptoms and perform a physical examination. Imaging studies such as X-rays, CT scans, MRI or bone scans are ordered. X-rays give the appearance of punched out holes in the bone. A sample of bone marrow (biopsy) may be obtained for laboratory analysis to look for an increase in the number of plasma cells. Blood tests are performed to determine the level of calcium, blood cells, and specific proteins that are released by malignant plasma cells.

There is no cure for multiple myeloma, but recent advances in medicine have improved response and survival. Chemotherapy can prolong life and relieve symptoms. Newer forms of chemotherapy involve harvesting your blood cells, administering high-dose chemotherapy, then transfusing the harvested blood cells back into your body. Radiotherapy may be advised to reduce the size of the bone lesions. Supportive therapy may be offered to ameliorate symptoms and help you maintain function. Your doctor will prescribe medication to manage pain, strengthen bone, elevate red blood cell levels, prevent infection and control calcium levels. Surgery may be recommended to repair fractures and provide stability to the spine, hip or shoulder so that function and quality of life can be maintained.