Myeloma is a cancer of plasma cells, which are a type of white blood cell that help to fight infection. Plasma cells are located in the bone marrow, which is a soft tissue inside the bones where new blood cells are made. When myeloma develops, plasma cells become cancerous and grow out of control. They crowd out healthy blood cells, preventing them from developing and growing properly. This reduces the amount of normal blood cells produced, and causes a problem known as anemia. Anemia can lead to fatigue, weakness and shortness of breath.
Myelomas are very difficult to diagnose because they can produce a wide range of symptoms. Some people may not have any symptoms at all, so they are only diagnosed when tests for another condition show that they have a high level of a protein called paraprotein in their body. This protein is a marker for myeloma and can be found in the blood and urine. Other symptoms include bone pain, especially in the back and ribs; thinning of the bones (osteolysis); and kidney problems. Myeloma can also cause a build-up of calcium in the blood (hypercalcaemia), which can make you feel thirsty, sick and pass a lot of urine as your body tries to get rid of it. It can also put pressure on the spinal cord, which can cause tingling in the arms and legs and a feeling of being drowsy or difficult to wake up.
There is no way to prevent myeloma. It is not known what causes it, but some factors are believed to increase the risk. These include being black, being older and having a family member with multiple myeloma. The risk is lower in women than in men.
Treatment for myeloma aims to bring you into remission, which means that there are few or no myeloma cells left in the body. It also aims to manage the side effects of myeloma, such as bone damage and kidney problems.
When deciding what to do about your myeloma, it is important to talk to your specialist. You should be given as much information as possible, including about the available treatments and their side effects, so that you can make a decision that is right for you.
If your myeloma is smouldering, which means that it has not yet caused any symptoms but is slow-growing, you might not have any immediate treatment. Instead, your doctor might suggest regular check-ups and close monitoring. This approach is known as watch and wait. If your myeloma progresses to active myeloma, treatment will be needed straight away. In many cases, this will involve a combination of treatments including chemotherapy and drugs that protect your kidneys. These may be taken as tablets, injected into a vein (intravenously) or under the skin (subcutaneously).
