What is Multiple Myeloma?
Multiple myeloma is a cancer of your plasma cells—special white blood cells in your bone marrow that normally make antibodies to fight infections—where these cells grow out of control and crowd out healthy blood cells. 1, 2
Understanding Your Bone Marrow and Plasma Cells
Your bone marrow is the soft, spongy tissue inside your bones that makes all your blood cells. Plasma cells are a type of white blood cell that produces proteins called antibodies to help fight infections. In multiple myeloma, these plasma cells become cancerous and:
- Multiply uncontrollably in your bone marrow
- Produce abnormal proteins (called monoclonal proteins or M-proteins) instead of helpful antibodies
- Crowd out healthy blood cells, preventing your body from making enough red blood cells, white blood cells, and platelets 2, 3
How Common Is This?
Multiple myeloma is the second most common blood cancer in the United States, with about 35,000-36,000 new diagnoses each year 2, 3. It typically affects people around age 65-70 years old 1. It occurs twice as often in African Americans compared to Caucasians 4.
What Symptoms Might You Experience?
Many patients notice symptoms related to how the cancer affects different parts of their body 2, 3:
Bone problems:
- Bone pain, especially in your back or ribs
- Weakened bones that break easily
- The cancer cells damage your bones, creating holes or "lytic lesions"
Blood problems:
- Fatigue and weakness from anemia (low red blood cells)
- Frequent infections because your immune system is weakened
- Easy bruising or bleeding
Kidney problems:
- The abnormal proteins can damage your kidneys
- About 19% of patients have kidney injury at diagnosis 3
High calcium levels (hypercalcemia):
- Confusion, excessive thirst, constipation
- This happens when calcium leaks from damaged bones into your blood
Important note: Some patients have no symptoms at all and are diagnosed through routine blood work 2.
What Happens Before Multiple Myeloma?
Multiple myeloma doesn't usually appear suddenly. Most people go through earlier stages 1:
- MGUS (Monoclonal Gammopathy of Undetermined Significance): A benign condition where you have abnormal proteins but no cancer
- Smoldering Multiple Myeloma: An intermediate stage where you have more plasma cells and proteins but no symptoms or organ damage—about one-third of these patients actually have early myeloma 1
- Active Multiple Myeloma: When the disease causes symptoms and organ damage
Is It Curable?
Multiple myeloma is not currently curable, but it is highly treatable 4. Modern treatments have dramatically improved survival—about 60% of patients who receive stem cell transplants are alive 10 years later 1. The overall 5-year survival rate is about 61% 1. Most patients will experience periods where the disease is well-controlled, though it typically returns over time and requires additional treatment.
What Does Treatment Involve?
Treatment typically includes a combination of medications that work in different ways 3, 5:
- Proteasome inhibitors (like bortezomib) that block proteins cancer cells need to survive
- Immunomodulatory drugs (like lenalidomide) that help your immune system fight the cancer
- Steroids (like dexamethasone) that kill cancer cells
- Monoclonal antibodies (like daratumumab) that target cancer cells directly
- Stem cell transplantation for eligible patients, where your own healthy stem cells are collected and returned after high-dose chemotherapy
Many patients also receive supportive care including medications to strengthen bones and prevent blood clots 2.
Living with Multiple Myeloma
The disease and its treatments can significantly affect your daily life 6:
- Physical symptoms like nerve pain, fatigue, and nausea
- Emotional and psychological challenges
- Impact on work and relationships
- Need for caregiver support
Your care team should include you in treatment decisions, as patients consistently report wanting to be involved in choosing therapies that balance effectiveness with quality of life 6, 7.