What is 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.

Myeloma is often called 'multiple myeloma' because in most cases, myeloma is found in many areas of bone marrow when the condition is diagnosed.

Effects of myeloma on your body

Myeloma can affect your body in a number of different ways.

Myeloma can damage different bones in your body — for example, your spine, skull, pelvis, rib cage, shoulders and hips. When bones are damaged by myeloma cells, they can release too much calcium into your bloodstream.

Abnormal plasma cells can 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.

The buildup of abnormal plasma cells in the bone marrow can reduce the space available to produce normal blood cells. This results in fewer red and other white blood cells being produced. This can lead to anaemia.

What are the symptoms of 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 develop including:

• 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

What causes myeloma?

The cause of myeloma is not known. Several factors may increase your risk of developing myeloma, such as:

• exposure to high doses of radiation
• ongoing exposure to industrial or environmental chemicals
• Viruses, such as HIV

Myeloma is more common later in life. This may be the ageing process itself, or the result of a lifelong accumulation of toxic substances.

Other people develop myeloma without any of these risk factors.

When should I see my doctor?

If you are experiencing 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 develop fever or other symptoms of an infection and have neutropenia (low levels of white blood cells).

How is myeloma diagnosed?

Symptoms of myeloma may be similar to many other conditions. This can make it difficult to diagnose.

Your doctor may refer you for a range of 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

How is myeloma treated?

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

Early on, you may not need any treatment if you don't have symptoms. Your doctor will monitor you with regular tests. They will recommend treatment if you develop signs that your myeloma has progressed, such as:

• 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 receive 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

Living with myeloma involves managing both physical and mental health challenges. Here's how 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

Your bone marrow makes blood cells that help protect you from infections. Myeloma cells can reduce the space available for other types of blood cells. This can make you vulnerable to infections.

Here's how you can reduce 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 is not getting worse and no treatment is needed. You will still need to have regular check-ups with your doctor to make sure that the cancer is 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.

What are the complications of myeloma?

Complications of myeloma can affect different parts of the body. Common complications may include:

• frequent infections — such as pneumonia, urinary tract infections or shingles due to lower white blood cell levels
• bone damage — weakened bones can cause pain and broken bones
• bleeding problems — low platelets can lead to increased bleeding or bruising
• kidney problems
• anaemia

Myeloma can also damage nerves, leading to a condition called peripheral neuropathy. This causes sensations such as numbness, tingling, burning and pain, usually in your hands and feet.

Can myeloma be prevented?

Myeloma cannot be prevented as its cause is unknown.

Resources and Support

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

• Myeloma Australia — visit their website or call their support line on 1800 693 566.
• Leukaemia Foundation offers information, practical and emotional support.
• Cancer Council Australia offers services for people affected by cancer.
• Cancer Australia provides resources on the social and emotional impact of cancer.
• Beyond Blue 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.

Do you prefer to read in languages other than English?

Cancer Council has booklets, factsheets and videos in several languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• Leukaemia Australia provides blood cancer information booklets for Aboriginal and/or Torres Strait Islander people.
• Our Mob and Cancer provides information on cancer for Aboriginal and/or Torres Strait Islander people.