Symptoms and diagnosis of myeloma – Macmillan Cancer Support

My name is Charlotte Pawlyn. I’m a haematology
doctor specialising in myeloma. I work at the Royal Marsden Hospital and I’m currently
doing some research here at the Institute of Cancer Research looking at developing new
treatments for patients with myeloma. Myeloma is a cancer of a particular kind of
cell that’s found in the bone marrow. It’s also sometimes called multiple myeloma. The
bone marrow is the jelly-like substance in the middle of some of the bones in your body.
The plasma cells in myeloma grow out of control and so there are too many in the bone marrow.
Myeloma is more common in people who are over the age of about 60 but we do sometimes see
it in patients who are younger than this as well. It is slightly more common in men than
women. The most common symptoms that people would
notice are pains in the bones, having more infections than normal or feeling generally
unwell, for example feeling tired or lethargic or losing weight without trying. The protein
can also clog up the kidneys and that means that the kidneys don’t work as well. Having
too many of these plasma cells in the bone can also cause some damage to the bone and
some pains in the bones. These pains are most commonly in the lower back or in the ribs
but can be in other bones as well. If you were to notice any of these symptoms, the
first step would obviously be to see your GP and discuss the symptoms that you were
having. What the GP might do would be to arrange some blood tests and if they suspected myeloma
to refer you to see a haematologist. The haematologist would review all of your symptoms, the blood
tests you’d had so far and possibly arrange some more tests to investigate the possibility
of myeloma. There are lots of different treatments available
for myeloma and many of these have been developed over the last ten years and so we now have
many more treatments available than we did in the past. The newer treatments that have
been developed are called immunomodulatory agents such as a drug called thalidomide or
proteasome inhibitors such a drug called bortezomib. These are normally given in combination treatments
along with a more classical kind of chemotherapy and a steroid treatment. Depending on the
way that a patient’s myeloma presents and the problems that they have associated with
it, it might be that one or other treatment is more appropriate at that time and this
is something the doctor would discuss with them. The aim of treatment is to get
rid of as many of the myeloma cells from the bone marrow as possible and to keep them away
for as long as possible. The treatments are usually well tolerated and work very well,
such that a lot of the patients can remain in remission for long periods of time. More
information would be available from your haematologist or your GP and there’s lots of information
available on the Macmillan website.

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