What is multiple myeloma?

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 diagnosed with multiple myeloma, cancer cells eventually overtake the healthy plasma cells. This process depletes your body of much-needed white blood cells. As the ratio of cancerous cells to healthy cells grows, so do symptoms of the cancer.

Your doctor will run several tests to give you a diagnosis and a cancer stage. These tests look for and detect many 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’re diagnosed with multiple myeloma, your doctor will want to determine how advanced the cancer is. Multiple myeloma is classified by stage 1, 2, or 3. In multiple myeloma cases, stage 3 is the terminal stage. This means it’s the most advanced stage of this type of rare cancer.

Doctors use the international staging system to determine the stage of the cancer. This system is based on the levels of serum beta-2 microglobulin and serum albumin.

Stageserum beta-2 microglobulin levelserum albumin level
Stage 1Less than 3.5 (mg/L)3.5 (g/dL) or greater
Stage 2Between 3.5 and 5.5

Less than 3.5
Any level

Below 3.5
Stage 35.5 or greaterAny level

Multiple myeloma rarely has any symptoms until stage 3. Symptoms of this late-stage cancer include:

  • nausea
  • constipation
  • pain
  • fatigue
  • frequent infections
  • weight loss
  • muscle weakness
  • increased thirst
  • decreased appetite

Early stages of the cancer may not need immediate treatment. Treatment for stage 3 multiple myeloma aims to reduce the discomfort caused by the cancer. Treatment can also help stabilize the cancer and slow the progress of its growth.

Treatments for multiple myeloma include:

Immunomodulatory drugs

Also known as biological therapies, these medicines are designed to help turn your body’s immune system into a cancer-fighting tool. They include lenalidomide (Revlimid), thalidomide (Thalomid), and pomalidomide (Pomalyst).

Protease inhibitors

These medicines are a part of a treatment called targeted therapy. They hone in on specific abnormalities in the multiple myeloma cancer cells that allow the cancer to survive and prevent them from growing and thriving. This causes the myeloma cells to eventually die. Examples of this medication include carfilzomib (Kyprolis) and bortezomib (Velcade).


A standard cancer treatment, chemotherapy seeks out and destroys the cancer cells in your body. Chemotherapeutic agents that specifically treat multiple myeloma include doxorubicin hydrochloride (Doxil, Adriamycin) and alkylating agents.


These medications are often used to boost and regulate the immune system and control inflammation. However, they also show promise as a multiple myeloma treatment. Corticosteroids include prednisone (Deltasone) and dexamethasone (Decadron).

Stem cell transplants

A stem cell transplant is designed to replace your cancer-laden bone marrow with healthy, cancer-free marrow. However, you may have to undergo high-dose chemotherapy prior to the transplant.

Combination treatment regimens

You may take a combination of several myeloma treatments, such as an immunomodulatory drug, a protease inhibitor, and a corticosteroid. This treatment approach shows promise and may have greater success than one type of treatment alone

Advances in treatment

A cure for multiple myeloma currently doesn’t exist. However, significant research is making progressive leaps toward a treatment that eliminates the cancer entirely. The U.S. Food and Drug Administration has approved several new types of treatments in recent years. Today’s treatments are getting closer to a cure.

The average survival rate for stage 3 multiple myeloma is 29 months. However, significant medical advances are helping to increase survival rates. Researchers are attempting to find new treatment methods that can prolong the survival rate.

Factors that affect outlook

The median survival rate is not every person’s survival rate. Several factors affect your survival rate, including:

  • Age: Older people with multiple myeloma don’t live as long as younger people with the cancer.
  • Cell growth rate: How fast your cancer cells are growing can tell your doctor a lot about your prognosis. 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.

Once you have been diagnosed with 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 can help navigate you through the information, numbers, possibilities, and realities. Together, 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 that you are able to influence your treatment decisions. Talk to an oncologist who can help you find that path.