Is Multiple Myeloma Always Fatal?

Multiple myeloma is a type of blood cancer that is somewhat rare and typically has a poor prognosis. Several factors play an important part in a person's survival rate, including age, health condition, and whether it involves a single tumor.
Multiple myeloma is a type of blood cancer that is somewhat rare and typically has a poor prognosis. Several factors play an important part in a person's survival rate, including age, health condition, and whether it involves a single tumor.

Multiple myeloma is a relatively rare cancer that occurs when plasma cells in the blood grow abnormally and out of control. 

Multiple myeloma had a very poor prognosis in the past, however, the outlook and survival rates for the disease are improving due to newer treatments. While there is no cure, a number of factors affect a person’s chances of survival after diagnosis:

  • Age: survival rates are higher in younger people 
  • Overall health
  • Whether a single plasmacytoma (single tumor) is found or if multiple myeloma is diagnosed
  • The tumor’s chromosome changes (cytogenetics)
  • The levels of certain proteins and other substances in the blood
  • Kidney function 

Life expectancy for multiple myeloma is often expressed in five-year survival rates, that is, how many people will be alive five years after diagnosis. 

  • Multiple myeloma five-year survival rates:
  • Localized (solitary plasmacytoma): 75%
    • About 95% of cases are diagnosed at this stage
  • Regional: Not applicable 
  • Distant (multiple myeloma): 53%

What Are Multiple Myeloma Symptoms?

It is possible to have multiple myeloma and not notice any symptoms. Symptoms of multiple myeloma occur can include:

  • Bone problems: pain, weakness, fractures
  • Low blood counts of red blood cells (anemia), white blood cells (leukopenia), or plasma cells (thrombocytopenia)
  • High blood levels of calcium (hypercalcemia)
  • Infections, including pneumonia
  • Nervous system symptoms if the bones in the spine weaken and cause spinal cord compression, a medical emergency. See a doctor right away if you have: 
    • Sudden severe back pain
    • Numbness, usually in the legs
    • Muscle weakness, usually in the legs
  • Nerve damage 
    • Weakness and numbness 
    • “Pins and needles” 
  • Kidney problems
    • Shortness of breath
    • Itching
    • Leg swelling
    • Weakness
  • Thickened blood (hyperviscosity) that slows blood flow to the brain
    • Dizziness
    • Confusion
    • Stroke symptoms, such as slurred speech and weakness on one side of the body

What Are the Causes and Risk Factors of Multiple Myeloma?

The cause of multiple myeloma is not known, but a possible cause may be due to genetic changes (mutations). 

Risk factors that may increase the chance of developing multiple myeloma include:

  • Age: over 65 years old
  • Gender: men are slightly more likely to develop multiple myeloma 
  • Family history
  • Obesity
  • Race: more than twice as common in African Americans than in white Americans
  • Having other plasma cell diseases

How Do You Get a Multiple Myeloma Diagnosis?

Your doctor will review your patient history, and you will also submit to a physical examination, as well as blood, urine, and imaging tests in order to be diagnosed with multiple myeloma. 

Lab tests used to diagnose multiple myeloma include: 

  • Blood tests
    • Complete blood count (CBC
    • Blood chemistry 
    • Levels of creatinine, albumin, calcium, and other electrolytes
    • Quantitative immunoglobulins
    • Lactic dehydrogenase (LDH) levels 
    • Electrophoresis
    • Beta-2 microglobulin
    • Serum free light chains
  • Urine tests 
  • Biopsies
  • Imaging tests
    • Bone X-rays
    • Computed tomography (CT) scan
    • Magnetic resonance imaging (MRI) scan
    • Positron emission tomography (PET) scan
    • Echocardiogram (“echo”) of the heart

A diagnosis of multiple myeloma requires:

  1. A plasma cell tumor (proven by biopsy) OR at least 10% plasma cells in the bone marrow, AND
  2. At least one of the following:
  • Low red blood cell counts (anemia)
  • High blood calcium level
  • Poor kidney function
  • Increase in one type of light chain in the blood so that one type is 100 times more common than the other
  • Holes in the bones from tumor found on imaging studies 
  • 60% or more plasma cells in the bone marrow
References
https://www.cancer.org/cancer/multiple-myeloma.html

https://www.cancer.net/cancer-types/multiple-myeloma/statistics