Myeloma

Multiple myeloma is a type of blood cancer that affects your bones and different parts of your body.

What is myeloma?

• Myeloma (sometimes known as multiple myeloma) is a type of cancer that affects the blood and bone marrow.
• Bone marrow, which is found inside bones, is where blood cells are made. Myeloma happens when your bone marrow makes certain blood cells (plasma cells) that do not work properly.
• Myeloma can affect different parts of your body, including your kidneys and immune system.
• Myeloma cannot usually be cured, but it can be managed with treatment.
• It's more common as you get older.

Get your symptoms checked

It's important to get any symptoms of myeloma checked as soon as possible. Finding it early can mean it's more treatable.

Symptoms of myeloma

Main symptoms of myeloma

Symptoms of myeloma may include:

• bone pain – you may feel this in your back, hips, shoulders or ribs
• feeling very tired for no reason
• shortness of breath
• muscle weakness
• headaches
• feeling very thirsty and needing to pee more often than usual
• losing weight without trying

Sometimes myeloma does not cause symptoms at first. You may find out you have it after having a blood test for another reason.

See a GP if:

• you think you may have myeloma

Call 112 if you or someone else:

• suddenly lose feeling in your arms or legs, or cannot walk or stand
• suddenly feel confused
• suddenly cannot control when you poo or pee

These could be a sign of a condition called spinal cord compression which needs to be treated immediately.

Do not drive yourself to A&E.

The person you speak to at 112 will give you advice about what to do.

Important

Some of the symptoms of myeloma are very common and can be caused by other conditions.

Having the symptoms does not definitely mean you have myeloma, but it's important to get checked by a GP.

If your symptoms are caused by cancer, finding it early may mean it's easier to treat.

What happens at your GP appointment

Depending on your symptoms, the GP may ask to check parts of your body that are painful.

You can have a friend, family member or another member of staff in the room with you during the exam if you’d like.

They may also ask you to give a pee sample or have a blood test.

Referral to a specialist

The GP may refer you for more tests or to see a specialist in hospital if they think you have a condition that needs to be investigated.

This does not definitely mean you have cancer.

Causes of myeloma

Main causes of myeloma

It's not clear what causes myeloma, but you may be more likely to get it if:

• you're overweight
• a close relative has had myeloma
• you're from a Black African or African Caribbean background
• you have a condition called monoclonal gammopathy of unknown significance (MGUS) or pernicious anaemia

You’re more likely to get myeloma as you get older. Myeloma is slightly more common in men.

How to lower your risk of myeloma

You cannot always prevent myeloma, but losing weight if you’re overweight may reduce your risk of getting it. 

It’s important to get any symptoms of myeloma checked by a GP.

Tests and next steps for myeloma

Main tests for myeloma

If a GP refers you to a specialist because they think you could have myeloma, you'll have tests to check for cancer.

The main tests for myeloma usually include:

• a CT or MRI scan
• a bone marrow biopsy – where a small piece of your bone marrow is removed for testing

Getting your results

You should get your test results in 1 to 2 weeks.

You can call the hospital or your GP if you're worried and they may be able to update you if your results are ready.

If you're told you have myeloma

Being told you have cancer can feel overwhelming. You may be feeling anxious about what will happen.

You'll be helped through your diagnosis and treatment by a team of specialists.

This team will include a clinical nurse specialist who will be your main point of contact during and after your treatment. You can ask them any questions you may have.

Treatment for myeloma

Main treatments for myeloma

Myeloma can be difficult to treat.

The treatment you'll have for myeloma depends on:

• your symptoms
• if your myeloma has come back (relapsed)
• your age and general health

Sometimes you may not need any treatment straight away.

You may be offered a combination of treatments including chemotherapy, radiotherapy, targeted medicines, steroids and medicines to help with bone thinning called bisphosphonates.

Your specialist treatment team will:

• explain the treatments, the benefits and side effects
• work with you to make a treatment plan that's best for you
• help you to manage the side effects of treatment

If you have any questions or worries, you can talk to your specialist team.

Targeted medicines

Targeted medicines kill cancer cells.

You may be treated with targeted medicines if:

• your myeloma is causing symptoms
• your myeloma has come back

Chemotherapy

Chemotherapy is medicine that kills cancer cells.

You may have chemotherapy for myeloma if:

• your myeloma is causing symptoms
• your myeloma has come back

Steroids

Steroids can treat myeloma and also help chemotherapy and targeted medicines be more effective.

You may have steroids for myeloma if:

• your myeloma is causing symptoms
• you’re having chemotherapy or targeted medicines

Radiotherapy

Radiotherapy uses radiation to kill cancer cells. A machine is used to target beams of radiation directly at tumours.

You may have radiotherapy for myeloma if:

• you have pain in a certain part of your body (such as your back) that does not get better after other treatments, such as chemotherapy
• painkillers are not working

Stem cell transplant

Stem cell transplants can help your body make new blood plasma cells that work correctly.

When used to treat myeloma, a stem cell transplant usually involves removing and treating cells found in your bone marrow (stem cells). The treated stem cells are then put back into your blood, like a blood transfusion.

You may be considered for a stem cell transplant for myeloma:

• after a course of chemotherapy or targeted medicines
• if you’re in good general health

Bisphosphonates

Myeloma damages and weakens your bones which may be painful, and your bones can break easily. Bisphosphonates are medicines that can stop or slow down damage to your bones.

What happens if you're told your cancer cannot be cured

Myeloma cannot usually be cured and it might be very hard to treat.

The aim of your treatment is often to limit the cancer and its symptoms, and help you live longer.

You will be referred to a special team of doctors and nurses called the palliative care team or symptom control team.

They will work with you to help manage your symptoms and make you feel more comfortable. The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.