Multiple myeloma is a cancer of your plasma cells, a type of white blood cell present in your bone marrow. Plasma cells normally make proteins called antibodies to help you fight infections. In multiple myeloma, a group of abnormal plasma cells (myeloma cells) multiplies, raising the number of plasma cells to a higher than normal level. Since these cells normally make proteins, the level of abnormal proteins in your blood also may go up. Health problems caused by multiple myeloma can affect your bones, immune system, kidneys and red blood cell count.

Complications of Myeloma
Multiple myeloma can result in several complications:

• Impaired immunity. Myeloma cells inhibit the production of antibodies needed for normal immunity. Having multiple myeloma may make you more likely to develop infections, such as pneumonia, sinusitis, bladder or kidney infections, skin infections, and shingles.
• Bone problems. Multiple myeloma also can affect your bones, leading to erosion of bone mass and fractures. The condition may cause compression of your spinal cord. Signs of this medical emergency include weakness, or even paralysis, in your legs.
• Impaired kidney function. Multiple myeloma may cause problems with kidney function, including kidney failure. Higher calcium levels in the blood related to eroding bones can interfere with your kidneys' ability to filter your blood's waste. The proteins produced by the myeloma cells can cause similar problems, especially if you become dehydrated.
• Anemia. As cancerous cells crowd out normal blood cells, multiple myeloma can also cause anemia and other blood problems.

Causes of Myeloma

The cause of myeloma is unknown. Several factors have been linked to myeloma, including genetic abnormalities, exposures to certain chemicals and other conditions in the workplace (petrochemical industry workers, leather workers, book binders, cosmetologists, shipyard workers, metallurgic industry workers), exposure to very large doses of radiation, certain viral infections, and immune system dysfunction. However, how any of these factors actually causes myeloma is unknown. Some people who develop myeloma have none of these risk factors. 

Signs & Symptoms of Myeloma

Signs and symptoms of multiple myeloma can vary from person to person. Although the condition may not cause symptoms early in the disease, it's likely that you'll experience one or more of the following as the disease progresses:

• Bone pain, particularly in your back, pelvis, ribs and skull.
• Presence of abnormal proteins — which can be produced by myeloma cells — in your blood or urine. These proteins — which are antibodies or parts of antibodies — are called monoclonal, or M, proteins. Often discovered during a routine exam, monoclonal proteins may indicate multiple myeloma, but also can indicate other conditions.
• High level of calcium in your blood. This can occur when calcium from affected bones dissolves into your blood.

If you have a high calcium level in your blood, you may experience signs and symptoms such as:

• Excessive thirst and urination.
• Constipation.
• Nausea.
• Loss of appetite.
• Mental confusion.

Other signs and symptoms of multiple myeloma may include:

• Anemia-related fatigue as myeloma cells replace oxygen-carrying red blood cells in your bone marrow.
• Unexplained bone fractures.
• Repeated infections — such as pneumonia, sinusitis, bladder or kidney infections, skin infections, and shingles.
• Weight loss.
• Weakness or numbness in your legs.

Diagnosis of Myeloma

Your doctor may first detect signs of multiple myeloma before you ever have symptoms -through blood and urine tests conducted during a routine physical exam. If you don't yet have symptoms, these lab tests may be repeated every few months so that your doctor can track whether your disease is progressing and determine the best time to start treatment.

Blood and urine tests

Other tests

You may also need other tests. They may include:

• Imaging. X-rays of your skeleton can show whether your bones have any thinned-out areas, common in multiple myeloma. If a closer view of your bones is necessary, your doctor may use magnetic resonance imaging (MRI), computerized tomography (CT) scanning or positron emission tomography (PET) scanning.
• Bone marrow examination. Your doctor may also conduct a bone marrow examination by using a needle to remove a small sample of bone marrow tissue. The sample is then examined under a microscope to check for myeloma cells.
• Staging and classification. These tests can help confirm whether you have multiple myeloma or another condition. If tests indicate you have multiple myeloma, the results from these tests allow your doctor to classify your disease as stage 1, stage 2 or stage 3. People with stage 3 myeloma are more likely to have one or more signs of advanced disease, including greater numbers of myeloma cells and kidney failure.

Treatments of Myeloma

If you have multiple myeloma and aren't experiencing any symptoms, you may not need treatment. However, your doctors will regularly monitor your condition for signs that indicate the disease is progressing. If it is, you may need treatment to help prevent symptoms.

If you're experiencing symptoms, treatment can help relieve pain, control complications of the disease, stabilize your condition and slow the progress of the disease.

Standard treatments for myeloma

Though there's no cure for multiple myeloma, with good treatment results you can usually return to near-normal activity. You may wish to consider approved clinical trials as an option.

Standard treatment options include:

• Bortezomib (Velcade).
• Thalidomide (Thalomid).
• Lenalidomide (Revlimid).
• Chemotherapy.
• Corticosteroids.
• Stem cell transplantation.
• Radiation therapy.

Prevention of Myeloma

There is no known way to prevent myeloma. A standard recommendation is to avoid the risk factors for the disease, but little is known concerning the risk factors for myeloma.

When to seek Medical Advice

If you're persistently more tired than you used to be, you've lost weight, and you experience bone pain, repeated infections, loss of appetite, excessive thirst and urination, persistent nausea, increased constipation, or weakness or numbness in your legs, your signs and symptoms may indicate multiple myeloma or other serious disease. See your doctor to determine the underlying cause.