Multiple myeloma is a cancer of the plasma cells, particularly the bone marrow. Learn about this cancer, the tests and treatments for it, and more in this lesson.
Multiple Myeloma & Plasma Cells
If you take a look at yourself in the mirror, you see a person with arms, legs, a head, and a torso. But if we were to put your whole body under a powerful microscope, we would see your body is not as solid as it appears in the mirror. Your body is actually made up of trillions of individual living cells. These cells grow, perform functions, and then naturally die, only to be replaced by more cells. This is a harmonious system and a basic process of life, but this orderly system can be disrupted if certain cells start to grow out of control. This is what happens in a person with cancer.
If this abnormal growth affects the plasma cells, which are cells made in the bone marrow that make antibodies, then a specific type of cancer is present, known as multiple myeloma. Therefore, multiple myeloma can be defined as a cancer of the plasma cells. And when we look closely at this term, we see that it does a nice job of explaining some of the main characteristics of this disease. For instance, the prefix 'myelo' refers to bone marrow and the suffix 'oma' refers to tumor, so 'multiple myeloma' literally means 'multiple bone marrow tumors.'
Plasma cells are made in your bone marrow alongside other cells, including red blood cells, white blood cells, and platelets. Plasma cells are important to our immune system because they produce the infection-fighting proteins called antibodies, or immunoglobulins, which is another name for antibodies. As the plasma cells grow in a person with multiple myeloma, they take up space within the bone marrow. This can reduce production of the other cells simply because they get crowded out. A reduction in red blood cell production can lead to a related condition or symptom of multiple myeloma called anemia.
In a patient with multiple myeloma we might see another related condition, which is erosion of the bones. This erosion may be seen on an X-ray as fairly well-defined areas of bone loss, which makes it look like the bone has been punched out. Therefore, these bone lesions are sometimes called 'punched out lesions.'
These lesions can occur in multiple areas of bone, and we know that bones are made up of calcium; therefore, a patient with multiple myeloma may have elevated calcium levels in the blood as the bones deteriorate. As we mentioned, the plasma cells are produced in excess and they, in turn, produce a certain type of antibody, which is a protein. This excess protein in the system must be filtered by the kidneys, but too much protein is hard on the kidneys and can lead to another related condition, renal failure, which is another name for kidney failure.
So we see that we have some related conditions of multiple myeloma, which are excessive calcium in the blood, renal failure, anemia, and bone lesions. You can recall these related conditions by remembering the acronym 'CRAB,' which stands for Calcium, Renal, Anemia, and Bone lesions.
Tests for Multiple Myeloma
By knowing these related conditions, we can understand the tests for multiple myeloma. One group of tests that are beneficial in the diagnosis of this form of cancer are laboratory tests, such as blood and urine tests.
One of the first tests that might be ordered if multiple myeloma is suspected is a serum protein electrophoresis, which is a test to detect abnormal proteins in the blood. 'Serum' refers to the blood, so you can remember that this test is used to detect blood proteins. 'Electrophoresis' simply refers to the way the test is performed, which is through the 'phoresis,' or movement of charged or electrical particles, hence the name 'electrophoresis.'
A complete blood count is another lab test that helps in the diagnosis of this condition. This is a test to detect the level of red blood cells, which would reveal if anemia is present. So we see that lab tests for multiple myeloma look for abnormal proteins and anemia. Additional lab tests can be performed to look for higher-than-normal calcium levels and to evaluate kidney function.
X-rays and other radiological studies may be performed to show if bony lesions are present. And, if multiple myeloma is suspected, a patient might undergo a bone marrow biopsy, which is a procedure used to extract a small sample of bone marrow, which is then examined under a microscope for the presence of abnormal cells.
Treatment for Multiple Myeloma
Surprisingly, a person can be diagnosed with multiple myeloma yet require no immediate treatment. If the person is not experiencing symptoms, then he or she may be closely monitored, but not treated.
If the disease progresses or in a case where the patient is symptomatic, then treatment for multiple myeloma may include chemotherapy, which uses drugs to kill cancer cells. These destroyed cells can be replaced with healthy stem cells using a bone marrow transplant. So we define a bone marrow transplant as a procedure that replaces damaged bone marrow cells with stem cells. A simple way to think of stem cells is to think of them as immature cells that other cells 'stem' or grow from. These stems cells can come from the patient's own body or from a donor.
Other drugs that can be prescribed in the treatment of multiple myeloma include proteasome inhibitors, which are injectable medications that kill cancer cells by blocking the action of proteasomes. Proteasomes are involved in the breakdown of proteins.
Another drug that may be used is thalidomide, which is a drug administered in a pill form. You might remember thalidomide for its not-so-positive past. In the late 1950s, thalidomide was given to pregnant women to relieve nausea; unfortunately, this lead to birth defects, including the absence of limbs. However, a few decades later, this same drug was found to be effective in combating multiple myeloma. Another treatment for multiple myeloma is radiation therapy, which involves the use of X-rays or other radiological substances to kill cancer cells.
Let's review. Multiple myeloma is a cancer of the plasma cells. Plasma cells are cells made in the bone marrow that make antibodies, which are infection-fighting proteins. There are some related conditions of multiple myeloma that we can recall by remembering the acronym 'CRAB.' This stands for Calcium due to excess blood calcium levels, Renal due to the occurrence of renal, or kidney, failure, Anemia caused by the reduction of red blood cells, and Bone lesions that result due to bone destruction.
These related conditions can be detected with laboratory tests for multiple myeloma, such as serum protein electrophoresis, which is a test to detect abnormal proteins in your blood, or a complete blood count, which is a test to detect the level of red blood cells. Additional lab tests look for higher-than-normal calcium levels, while others can be used to evaluate kidney function. X-rays or a bone marrow biopsy may also be ordered to test for the presence of this disease.
Treatment for multiple myeloma may include chemotherapy, which uses drugs to kill cancer cells, along with a bone marrow transplant, which is a procedure that replaces damaged bone marrow cells with stem cells. Other drugs that can be prescribed in the treatment of multiple myeloma include proteasome inhibitors, which are injectable medications that kill cancer cells by blocking the action of proteasomes, and thalidomide, which is a drug administered in a pill form that was associated with birth defects in the 1950s. Another treatment for multiple myeloma is radiation therapy, which involves the use of X-rays or other radiological substances to kill cancer cells.
By the end of this lesson you should be able to:
- Describe multiple myeloma and how it affects the body's functions
- Recall the acronym to help remember the conditions related to multiple myeloma
- List some of the ways to diagnose multiple myeloma
- Explain some of the symptoms and treatment options for a person with this type of cancer