Multiple myeloma is a cancer of the bone marrow. More accurately, it’s an uncontrolled growth of plasma cells. Normally, plasma cells make up a very small part of the bone marrow - about 5%. People with myeloma have uncontrolled growth of plasma cells. They have increased numbers of plasma cells in their bone marrow (greater than 10% - often over 90%)

Plasma cells produce substances that stimulate growth/activity of osteoclasts that, in sufficient amounts, will dissolve bone. After more than 30% of bone has been eaten away, the damage will appear as a dark spot on an x-ray, giving the appearance of ‘holes’ in the bone. These holes can weaken the bone and cause pathological (disease-related) fractures. As a result, bone pain, and/or fractures are often the first noticeable symptom of myeloma.

When plasma cells are multiplying in this manner, bone is being destroyed. This can greatly disturb the body’s chemical balance. Blood can thicken because of excess proteins, calcium levels rise as bone is dissolved which can lead to kidney damage or failure. Fatigue and anaemia often occur due to red and white blood cells being destroyed because of the excess proteins secreted by the malignant plasma cells.

The International Myeloma Foundation is a Godsend for us as patients, and also for our care-givers. Please visit the site.

Chemotherapy - kills malignant plasma cells, with the aim of inducing a remission or plateau. Hopefully, a cure will eventually will be found.

Radiation Therapy - is used locally, where there is bone destruction and pain. The affected area is exposed to controlled doses of radiation. Radiation can kill malignant cells much more quickly than chemotherapy and has less side-effects. It is therefore, used to achieve quicker pain relief and control severe bone destruction. It can be used either with or without chemotherapy.

Bone Marrow & Peripheral Stem Cell Transplants - Typically, they involve extremely high doses of chemotherapy. The therapy is so potent, it destroys all of the patient’s bone marrow. The marrow transplant replaces the destroyed marrow, ‘rescuing’ the patient. It is hoped that by destroying all the marrow, the malignant myeloma cells will also be destroyed. Bone marrow and stem cell transplants are by far the most aggressive treatment programs in common use today, and they also have the highest level of risk. Some long remissions have been obtained with this type of treatment.

There is a lot of research going on currently with different protocols, types of transplants and new drugs. Many new therapies are being explored with the view to perhaps not curing myeloma, but being able to control it in much the same way as diabetes is controlled. This would be wonderful for those of us who have myeloma!