Multiple Myeloma

What is multiple myeloma?

Multiple myeloma is a cancer of plasma cells. Plasma cells are a type of white blood cell. Plasma cells make antibodies to help your body fight infection. You may have high amounts of plasma cells that do not work correctly. Your body may make so many plasma cells or antibodies that they damage your bones and other healthy tissue.

What are the signs and symptoms of multiple myeloma?

• Bone pain, most commonly in the lower back, pelvis or ribs.
• Frequent infections.
• Nausea or vomiting.
• Fatigue, weakness or confusion.
• Constipation or difficulty urinating.
• Loss of appetite or weight loss.
• Shortness of breath.

How is multiple myeloma diagnosed?

• Blood and urine tests are used to find or measure antibodies, called M proteins. The tests may also be used to monitor your calcium levels and kidney function.
• A bone marrow biopsy is a sample from your bone to check for myeloma cells.
• An X-ray, CT, PET, or MRI may be done to find cancer in your body. You may be given contrast liquid to help the cancer show up better. Tell your healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell your healthcare provider if you have any metal in or on your body.

How is multiple myeloma treated?

Treatment will depend on your symptoms and the stage of cancer. The stage will depend on how much your bone and kidneys are involved and the level of calcium and proteins in your blood. Your healthcare provider may recommend that you have frequent tests and regular follow-up visits to watch for changes. You may also need one or more of the following:

• Medicine: Medicines are given to stop myeloid cells from growing and to kill new cancer cells. Medicines may also help strengthen your immune system.
• Radiation therapy: This therapy uses X-rays or gamma rays to treat cancer. Radiation kills cancer cells and may stop the cancer from spreading. It may be given alone or with chemotherapy.
• Transplant: A transplant is a procedure to give bone marrow or stem cells through an IV. The stem cells go to your bone marrow and begin to make new, healthy blood cells.

What can I do to manage my multiple myeloma?

• Prevent infection. Wash your hands often, avoid people who are sick and clean humidifiers daily. Ask your healthcare provider for more information on preventing infection.
• Prevent bleeding and bruising. Be careful with sharp or pointed objects, such as knives and toothpicks. Do not play contact sports, such as football. Use a soft toothbrush. Do not floss your teeth while your platelet count is low. Blow your nose gently. Your nose may bleed if you pick it. Do not take non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin. NSAIDs and aspirin thin your blood and increase your risk for bleeding.
• Do not smoke cigarettes or drink alcohol. Alcohol can thin your blood and make it easier to bleed. Nicotine can damage blood vessels and make it more difficult to manage your multiple myeloma. Smoking also increases your risk for new or returning cancer and delays healing after treatment. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke or drink and need help quitting.
• Drink liquids as directed. You may need to drink extra liquids to prevent dehydration, especially if you are vomiting or have diarrhea from cancer treatments. Ask how much liquid you need each day and which liquids are best for you.
• Exercise as directed. Multiple myeloma or its treatment may make you feel tired. Exercise can help you have more energy.
• Eat healthy foods. Healthy foods may help you feel better and have more energy. If you have trouble swallowing, you may need to have foods that are soft or in liquid form. Ask about any extra nutrition you may need, such as nutrition shakes or vitamins. Tell your healthcare provider if you have problems eating or if you are nauseated.

When should I seek immediate care?

• You had a bad fall and you may have broken a bone.
• You feel dizzy or faint.
• You cannot think clearly.
• You feel weak or numb on one side of your body.

Call 911 for any of the following:

• You have sudden chest pain, pounding or racing heartbeat, or shortness of breath.

When should I contact my healthcare provider?

• You are vomiting repeatedly and cannot keep food down.
• You have a fever.
• You have chills, cough, or feel weak and achy.
• Your pain is worse or does not go away after you take pain medicine.
• You cannot control your urine or bowel movements.
• You have questions or concerns about your condition or care.