Multiple myeloma

Multiple myeloma, also known as myeloma, is a type of bone marrow cancer.

Bone marrow is the spongy tissue found at the centre of some bones. It produces the body's blood cells.

The cancer affects the plasma cells (a type of blood cell) inside the bone marrow, which are an important part of the immune system.

Myeloma does not usually take the form of a lump or tumour. Instead, the myeloma cells divide and expand within the bone marrow.

Myeloma often affects many places in the body where there is bone marrow, which is why it is called multiple myeloma. This includes the:

bones of the spine
skull
pelvis
rib cage
areas around the shoulders and hips
sometimes the legs and arms

In the early stages, myeloma may not cause any symptoms. It is often only suspected or diagnosed following a routine blood or urine test.

However, myeloma will eventually cause a wide range of symptoms including tiredness, infections, bone pain and bone fractures.

Read more about the symptoms of multiple myeloma.

What causes multiple myeloma?

It is not known what causes the plasma cells inside the bone marrow to become cancerous.

However, research suggests there are a number of factors that may increase your chance of developing multiple myeloma. These include:

having a family history of myeloma
having a lowered immunity due to taking immunosuppressants, or having a condition such as HIV or AIDS
being overweight or obese

Read more about the risk factors for multiple myeloma.

When to see your GP

You should always see your GP if you have any of the following symptoms:

unexplained tiredness that lasts for more than two weeks
persistent unexplained bone pain, particularly in your ribs or lower back
unexplained weight loss
passing lots of urine and always feeling thirsty
weakness, numbness or tingling in your arms or legs
loss of bladder or bowel control (urinary incontinence and bowel incontinence)

Although these symptoms are not usually the result of multiple myeloma, they still need to be investigated by your GP.

Your GP will examine you to check for bone tenderness, bleeding, signs of infection, and any other symptoms that suggest you may have myeloma.

Blood tests play an important part in diagnosing myeloma. They can be used to check whether your bone marrow (which makes your blood) is functioning properly and whether your blood contains the abnormal proteins produced by myeloma cells.

A urine test will also be needed to help determine whether there is any underlying damage to your kidneys or myeloma protein in your urine.

If your GP thinks that you may have myeloma, they will refer you to a consultant haematologist (a specialist in blood conditions) for further tests.

Read more about how multiple myeloma is diagnosed.

Treating multiple myeloma

For most people with multiple myeloma there is no cure, but treatment can control the progression of the cancer for several years or, in some cases, many years (see below).

The three main goals of treatment are to:

bring the myeloma under control using various combinations of anti-myeloma treatments that remove the cancerous cells from your bone marrow
treat the symptoms associated with myeloma, such as anaemia and bone pain
reduce the risk of developing fractures and bone disease using medication to protect the bones

Read more about treating muliple myeloma.

Outlook

As with other types of cancer, the outlook for someone with multiple myeloma will depend on the stage the condition is at when they are diagnosed.

Age and fitness are also important factors, as well as the type of treatment you have. There are some very intensive treatments for myeloma, but to have them you often need to be otherwise fit and healthy.

In England, Wales and Scotland, about 70 out of 100 people who are diagnosed with myeloma live for at least one year after diagnosis. Around 37 out of every 100 people live for at least five years, and 15-19 people in every 100 live for at least 10 years.