Multiple myeloma is a rare type of cancer that develops in plasma cells. Plasma cells are a type of white blood cell in the body. In a healthy body, plasma cells are responsible for recognizing and fighting off invading germs and infections.
In people with a diagnosis of multiple myeloma, cancerous plasma cells
Your doctor will run several tests to give you a diagnosis and a cancer stage. These tests look for and detect several different signs of the disease that can’t be seen with the eye. Test results will reveal the following if you have advanced-stage multiple myeloma:
- high levels of blood calcium
- high levels of M protein in the blood or urine
- advanced bone damage
- moderate to severe anemia
When you receive a diagnosis of multiple myeloma, your doctor will want to determine how advanced the cancer is. Multiple myeloma is classified as stage 1, 2, or 3. Stage 3 is the most advanced stage of this type of rare cancer.
Doctors use the
| Stage | blood beta-2 microglobulin level | blood albumin level | blood LDH level and cytogenetics |
|---|---|---|---|
| Stage 1 | less than 3.5 (mg/L) | 3.5 (g/dL) or greater | normal LDH/cytogenetics low risk |
| Stage 2 | between 3.5 and 5.5 or less than 3.5 | any level or below 3.5 | high LDH and/or cytogenetics high risk. |
| Stage 3 | 5.5 or greater | any level | high LDH/cytogenetics high risk |
The prevalence of a particular symptom depends on what it is and ranges from
These can include:
- nausea
- constipation
- pain in the bones and back
- depression
- fatigue
- frequent infections
- weight loss
- bruising
- pain in hands or feet
- rashes
- nosebleeds
- muscle weakness
- increased thirst
- decreased appetite
- swelling and fluid buildup in lower limbs
There are two forms of multiple myeloma: smoldering and active.
When a doctor diagnoses smoldering multiple myeloma, often you do not display any symptoms. Your doctor will also not likely take any steps to treat it. Instead, they will watch and wait, meaning you will need to get regular monitoring to check for disease progression.
Smoldering multiple myeloma occurs in about
On the other hand, active multiple myeloma refers to a cancer that’s growing, spreading, and causing symptoms. As the cancer grows and spreads, you may notice increasing symptoms and complications. Stage 3 is an active stage of this cancer.
What are the final stages of multiple myeloma?
As multiple myeloma progresses to end stage, the symptoms you’re likely to experience are known as CRAB, which stands for:
- C: increase in blood calcium
- R: renal (kidney) dysfunction
- A: anemia
- B: lesions in your bones
This can lead to an increasing number of infections, easily broken bones, pain in joints, back, hands, and feet, and a lack of energy and fatigue.
Often, your treatment team will work with you to address your symptoms, which can help improve your quality of life.
Early stages of the cancer may not need immediate treatment. Doctors may opt for watchful waiting when symptoms do not appear and the disease is progressing slowly.
Treatment for stage 3 multiple myeloma aims to reduce symptom severity and slow its growth and progression. A person’s treatment will vary based on several factors, including:
- presence or absence of certain symptoms
- tumor size
- age
- overall health
Common treatments for multiple myeloma include:
- Immunomodulatory drugs (biologicals): These medications help turn your body’s immune system into a cancer-fighting tool. They include lenalidomide (Revlimid), thalidomide (Thalomid), and pomalidomide (Pomalyst).
- Protease inhibitors: These hone in on specific abnormalities in the cancer cells that allow the cancer to survive and prevent them from growing and thriving. This causes the myeloma cells to die eventually. Examples of this medication include carfilzomib (Kyprolis) and bortezomib (Velcade).
- Chemotherapy: These drugs seek out and destroy cancer cells in your body. Chemotherapeutic agents that specifically treat multiple myeloma include doxorubicin hydrochloride (Doxil, Adriamycin) and alkylating agents.
- Corticosteroids: These help regulate the immune system and control inflammation. In multiple myeloma, medications such as prednisone (Deltasone) and dexamethasone (Decadron) can help improve appetite and decrease nausea. However, they can suppress the immune system, so they are used in the short term.
- Stem cell transplant: This procedure involves replacing your bone marrow with healthy, cancer-free marrow. However, you may have to undergo high dose chemotherapy prior to the transplant and receive ongoing maintenance therapy after.
- Combination treatments: A combination of several myeloma treatments may have
greater success than one type of treatment alone
In multiple myeloma cases, stage 3 is the terminal stage. It can also be referred to as the distant stage, which means the cancer has spread beyond its initial location.
Even with treatment, the 5-year relative survival rate for distant multiple myeloma is about
Can you live 10 years with multiple myeloma?
Cancer survival data primarily focuses on 5-year survival rates, so there is little data on survival beyond that time frame.
That said, research does indicate that with treatment, it may be possible to survive for 10 years after diagnosis, particularly for those who are younger.
Factors that can affect your outlook
The median survival rate is not absolute. Several factors affect your survival rate, including:
- Age: Advanced age can negatively affect a person’s survival rate.
- Cell growth rate: How fast your cancer cells are growing can tell your doctor a lot about your outlook. Cancer cells that grow rapidly will overtake healthy cells much faster. This leads to a poorer outlook.
- Kidney function: Multiple myeloma cancer cells will eventually cause damage to your kidneys. Your outlook will be worse if your kidneys were unhealthy prior to your diagnosis or if the cancer made a larger impact on them.
- Genes: Certain chromosome changes or abnormalities may predict a poorer outcome.
- Tumor size: The overall size and number of tumors can also affect your outlook.
Is there a cure?
Though a cure for multiple myeloma currently doesn’t exist, treatments can slow the progression of stage 3 multiple myeloma and improve symptoms. Meanwhile, research is making progressive leaps toward a treatment that eliminates the cancer entirely.
Future and current studies plan to focus on finding safer and more effective targeted therapies to help improve quality of life and life expectancy.
Following diagnosis, you should talk with your doctor about your outlook based on your unique situation.
If you receive a diagnosis of stage 3 multiple myeloma, you can take steps to cope with the cancer beyond medical treatments. Certain behavioral changes are an option that can help improve your overall health and reduce the severity of the cancer.
Some behavioral-based changes that
- eating a healthy diet with a variety of fruits and vegetables, whole grains, and lean proteins
- drinking plenty of water or other fluids low in sugar
- trying to get enough sleep at night and taking naps as needed
- staying active and maintaining an exercise routine
- taking steps to care for your health, such as getting the flu vaccination and regular exams and checkups
Beyond these behavioral changes, other methods of coping can focus on getting psychological help to deal with any challenges that may come with a multiple myeloma diagnosis. Some useful coping techniques based on psychological help include:
- cognitive behavioral therapy approaches
- mindfulness-based stress reduction
- other integrative therapy methods for coping
Once your doctor diagnoses multiple myeloma, you’ll likely receive care from a team of doctors, including an oncologist. An oncologist is a type of doctor who specializes in treating cancer. They help you navigate through the oncoming amount of information, numbers, possibilities, and realities.
Together with your healthcare team, you can find a treatment plan that maintains an aggressive approach to treating the cancer while maintaining a sense of control for you.
It’s important to be able to influence your treatment decisions. Talk with an oncologist who can help you find that path.