Multiple myeloma

Myeloma is a type of cancer that affects your plasma cells. Plasma cells are a type of white blood cell found in your bone marrow (the inside of your bones). They are a part of your immune system and help fight infection. Plasma cells are not the same as plasma — the liquid part of blood.

Myeloma causes plasma cells to grow abnormally and build up in your bone marrow. These abnormal plasma cells are known as myeloma cells.

When diagnosed, myeloma is usually found in many areas of bone marrow. That's why myeloma is often called 'multiple myeloma'.

When myeloma first develops, you may have no symptoms at all. You may only discover you have myeloma if you have a blood test that shows abnormal cells.

As time goes on, symptoms can include:

• bone pain or fractures
• fatigue
• frequent infections
• shortness of breath
• dizziness
• nosebleeds or bruising
• swollen ankles

If you have high calcium levels in your blood, you may experience:

• confusion
• constipation
• increased thirst
• nausea

The cause of myeloma isn't known. Several factors may increase your chance of developing myeloma, such as:

• exposure to high levels of radiation
• ongoing exposure to industrial or environmental chemicals
• viruses, such as HIV

Myeloma is more common later in life. This may be part of the ageing process itself, or due to a lifelong build-up of toxic substances.

Other people get myeloma without any of these risk factors.

If you have symptoms of multiple myeloma, see a doctor. They can discuss the possible causes of your symptoms and refer you for tests.

Seek urgent medical attention if you have neutropenia (low levels of white blood cells) and you develop fever or other symptoms of an infection.

Symptoms of myeloma can be the same as those of many other conditions. This can make it difficult to diagnose.

Your doctor may refer you for several tests to find the cause of your symptoms, such as:

• urine tests — to check for proteins produced by myeloma cells
• blood tests
• x-rays
• bone marrow biopsy

There is no cure for myeloma. Various treatments can help slow its progression and help ease your symptoms.

Early on, if you don't have symptoms, you may not need any treatment. Your doctor will monitor you with regular tests. They will recommend treatment if your myeloma has become worse. Symptoms of myeloma progression include:

• high calcium levels
• kidney problems
• anaemia
• damage to your bones

Treatments may include:

• immunotherapy medicines
• chemotherapy
• steroid medicines
• radiotherapy

A stem cell transplant is also an option for some people. Since people respond differently to treatments, results can vary greatly.

If you choose not to have treatment for your myeloma, you can still get treatment for your symptoms. A palliative care specialist can help to manage your pain and other symptoms.

Research is ongoing to develop better treatments for myeloma.

Living with myeloma involves managing both physical and mental health challenges. Here are some ways you can care for your bones, immunity and overall wellbeing.

Bone health

When myeloma cells build up in the bone marrow, they cause your bones to become weaker and more brittle. There are some medicines available to help strengthen your bones.

Ask your doctor if they might be suitable for you.

Immunity

Myeloma can make you vulnerable to infections.

Here's how you can lower your chance of serious infections:

• Wash your hands regularly.
• Avoid crowded areas and people who are unwell.
• Keep your vaccinations up to date but check with your doctor about which ones are safe for you.
• Maintain a healthy lifestyle with a balanced diet and physical activity.

Check-ups

After treatment, many people with myeloma have periods of remission. This is when your disease isn't getting worse and you won't need treatment. You will still need to have regular check-ups with your doctor to make sure that the cancer stays in remission.

Mental health

Living with myeloma can impact your mental health.

Signs of depression include:

• difficulty sleeping
• loss of interest in activities
• irritability

If you are struggling with your mental health, speak with your doctor and get support.

Complications of myeloma can affect different parts of your body such as your bones, kidneys and blood.

Myeloma can damage different bones in your body such as your:

• spine
• skull
• pelvis
• rib cage
• shoulders
• hips

Bones damaged by myeloma cells, can release too much calcium into your bloodstream.

Abnormal plasma cells can also make too much of certain proteins. These proteins can block your kidneys and affect how well they work. High calcium levels can also affect your kidney function.

Abnormal plasma cells can build up in the bone marrow and take up the space needed to make normal blood cells. This means that fewer red and other white blood cells are made. This can lead to anaemia.

Other common complications may include:

• frequent infections — such as pneumonia, urinary tract infections or shingles
• bone damage — weakened bones can cause pain and broken bones
• bleeding problems — low platelets can lead to increased bleeding or bruising

Myeloma can also damage nerves, leading to a condition called peripheral neuropathy. This can cause different sensations in your hands and feet, such as:

• numbness
• tingling
• burning
• pain

Myeloma can't be prevented as its cause is unknown.

To find out more about myeloma you can contact the following organisations:

• Myeloma Australia (Opens in new tab) — visit their website or call their support line on 1800 693 566.
• Leukaemia Foundation (Opens in new tab) offers information, practical and emotional support.
• Cancer Council Australia (Opens in new tab) offers services for people affected by cancer.
• Cancer Australia (Opens in new tab) provides resources on the social and emotional impact of cancer.
• Beyond Blue (Opens in new tab) offers support for depression and anxiety — call 1300 22 4636.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Languages other than English

Cancer Council (Opens in new tab) has booklets, factsheets and videos in several languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• Leukaemia Australia (Opens in new tab) provides blood cancer information booklets for Aboriginal and/or Torres Strait Islander people.
• Our Mob and Cancer (Opens in new tab) provides information on cancer for Aboriginal and/or Torres Strait Islander people.