Myeloma

What is myeloma?

Myeloma is a type of cancer that affects plasma cells. Plasma cells form part of your immune response and they produce antibodies. Antibodies are proteins which fight off infections. Plasma cells are made in your bone marrow, a spongy tissue in the middle of most bones. 

Myeloma happens when the production of plasma cells becomes out of control, resulting in the formation of myeloma cells. 

Since the plasma cells are abnormal, they can’t make antibodies to fight off infections like they usually would. 

Abnormal plasma cells can also build up in the bone marrow, which affects the body’s ability to produce red and white blood cells. Red and white blood cells also contribute to keeping you healthy, so if less of these are produced, it can affect how well you are. 

What are symptoms of Myeloma?

In the early stages of myeloma, you might not notice any symptoms or changes. Myeloma doesn’t produce a lump or bump, as some other types of cancer do.

If you do have symptoms, they might include: 

• Feeling extremely tired 

• Noticing that you’re bruising more easily than you previously did 

• Noticing that you’re catching infections more than you previously did 

• Constant bone pain in one area, like the ribs, the back or hips 

Myeloma can also cause some damage to the bones, such as bone thinning and fractures. Damage to the bones can cause high levels of calcium in your blood, which can cause symptoms like: 

• Feeling sick or nauseous

• Vomiting 

• Being unable to poo 

• Peeing more frequently, especially at night

• Headaches 

What causes myeloma?

Unfortunately, the cause of myeloma is not known. 

What increases the risk of developing myeloma?

Although the cause is unknown, there are some factors which could potentially increase your risk for developing myeloma. These are: 

• If you’re over age 40 

• If someone in your family has myeloma

• If you’re obese 

• If you’re male 

• If you’re of Black African ethnicity

• If you have an autoimmune condition such as pernicious anaemia or systemic lupus erythematous

How is myeloma diagnosed?

If your blood results and/or your symptoms indicate that you may have myeloma, your doctor might order some tests to be performed. A diagnosis of myeloma cannot be made with just one test.

• A urine test to look for a specific protein called the Bence Jones protein

• A bone marrow biopsy to look for myeloma cells in the bone marrow 

• Chromosome testing to look for specific changes in your genes to work out how your cancer will respond to treatment

You might also be asked to have an MRI or CT scan carried out. In some cases, a full body X-Ray is performed. 

What are the types of myeloma?

Smouldering Myeloma

This is myeloma without symptoms, sometimes called asymptomatic myeloma. This requires monitoring but doesn’t always require treatment. It can progress to myeloma in some people but it is difficult to predict when, if at all, this may happen.

 Symptomatic Myeloma

This is myeloma with symptoms. This can mean that you might have: 

• Abnormal plasma cells in bone marrow 

• Damage to tissues or organs which can lead to high levels of calcium, low levels of red blood cells, kidney or bone problems. 

If you have symptomatic myeloma, you need treatment. 

Multiple Myeloma

This is where the myeloma is present in different places throughout the body.

Relapsed Myeloma

Myeloma usually responds well to treatment and people usually go into complete or partial remission. Remission is where there is no active disease in the body. If the condition has relapsed, it means that the disease has become active again, despite at one point it being inactive.

How is myeloma treated?

Myeloma is usually treated with chemotherapy in the first instance. This can be in the form of tablets or through a vein in your arm. 

You might be offered a stem cell transplant in combination with chemotherapy or radiotherapy. People usually respond well to treatment.