Multiple myeloma is a rare cancer with many treatment options, though it currently has no cure. We asked our experts at Huntsman Cancer Institute (HCI) to weigh in on frequently asked questions about multiple myeloma, including how the disease works and how treatment looks. In this piece, Douglas W. Sborov, MD, MS, Assistant Professor in the Department of Internal Medicine at the University of Utah and Grace L. Blissell, APRN share their knowledge and expertise.
What is multiple myeloma?
Multiple myeloma is a blood cancer. The cancer is in plasma cells, a type of white blood cell found in bone marrow. Plasma cells make antibodies, which fight infections, viruses, allergies, and bacteria.
What are the first signs of myeloma?
Common symptoms of multiple myeloma include:
- Back pain
- Bone pain
- Infections that don’t go away or that keep coming back
People with multiple myeloma may have one or all of these symptoms.
Doctors use a set of criteria known as myeloma defining events (MDE) to diagnose multiple myeloma. MDE patients have at least 10% malignant plasma cells in their bone marrow and/or a mass of plasma cells either inside or outside of the bones.
How quickly does myeloma typically progress?
In most cases, multiple myeloma grows slowly. It can progress over the course of years. It is usually diagnosed when the cancerous plasma cells in the bones and/or blood stream reaches a high level.
Is myeloma cancer deadly?
Myeloma is incurable but treatable. Since 1975 (the first year multiple myeloma data was available), survival rates have continued to increase. Now, multiple myeloma patients who have standard risk factors can live 10 years on average. There are many FDA-approved treatments available, and the number of new treatments are increasing. In fact, in 2019, two new drugs were approved for patients with relapsed and refractory disease.
It is very important to know that the myeloma research community, including the team at Huntsman Cancer Institute (HCI), continues to look for a cure. Many clinical trials are investigating new, exciting ways of activating the immune system to fight myeloma. These immunotherapies are some of the newest and most advanced treatments available.
What is a common treatment plan for myeloma?
Most patients receive a three-drug combination. Some drugs are pills, some are injections, and some are infusions given through a vein.
Patients who are young and fit get this combination for three to four months. Then the patient receives an autologous bone marrow transplant. Once patients have recovered from this procedure, they continue with other types of treatment. When the disease progresses, we look for combination treatments to keep the disease in control.
Can myeloma metastasize (spread)?
The term "metastasis" isn’t really used for multiple myeloma since it already occurs throughout the body in the bone marrow. But some patients do develop - masses outside their bones. Doctors can sometimes feel these masses during a physical exam. They may also be found through imaging tests such as PET/CT or MRI.