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, 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’re diagnosed with multiple myeloma, your doctor will want to determine how advanced the cancer is. Multiple myeloma is classified as 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
| Stage | serum beta-2 microglobulin level | serum albumin level |
| Stage 1 | Less than 3.5 (mg/L) | 3.5 (g/dL) or greater |
| Stage 2 | Between 3.5 and 5.5 Less than 3.5 | Any level Below 3.5 |
| Stage 3 | 5.5 or greater | Any level |
About 1/3 of all people diagnosed with multiple myeloma have no
- 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.
Active multiple myeloma refers to a cancer that’s growing, spreading, and causing symptoms. Stage 3 multiple myeloma is an active stage of the cancer.
As the cancer grows and spreads, you may notice increasing symptoms and complications. Some symptoms of progressing multiple myeloma include:
- increasing number of infections
- easily broken bones
- anemia
- pain in joints, back, hands, and feet
- 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
Also known as biological therapies, these medicines help turn your body’s immune system into a cancer-fighting tool. They include lenalidomide (Revlimid), thalidomide (Thalomid), and pomalidomide (Pomalyst). Doctors often use these medicines for people newly diagnosed with multiple myeloma.
Protease inhibitors
Also known as targeted therapy, protease inhibitors 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).
The inhibitors also make up the new standard of care.
Chemotherapy
A traditional standard cancer treatment, chemotherapy seeks out and destroys cancer cells in your body. Chemotherapeutic agents that specifically treat multiple myeloma include doxorubicin hydrochloride (Doxil, Adriamycin) and alkylating agents.
Corticosteroids
Doctors often prescribe corticosteroids to regulate the immune system and control inflammation. In multiple myeloma, medications — such as prednisone (Deltasone) and dexamethasone (Decadron) —
Stem cell transplants
A stem cell transplant replace 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 following 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, 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.
If you are diagnosed with 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 may make a difference for you include:
- eat a healthy diet with a variety of fruits and vegetables, whole grains, and lean proteins
- drink plenty of water or other fluids low in sugar
- stay active and maintain an exercise routine
- take 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 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
According to the
Factors that affect outlook
The median survival rate is not absolute. Several factors affect your survival rate, including:
- Age: Advanced age can negatively impact a person’s survival rate.
- 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.
- Tumor size: The overall size and number of tumors can also affect your prognosis.
Following diagnosis, you should talk to your doctor about your outlook based on your unique situation.
Can stage 3 multiple myeloma go into remission?
Treatments can slow the progression of the stage 3 multiple myeloma and improve symptoms. With effective treatment, a person may see improvements in quality of life as well as life expectancy. With treatment, you could live for 5 or more years even when diagnosed with stage 3 multiple myeloma.
Once your doctor diagnoses you 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 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 that you are able to influence your treatment decisions. Talk to an oncologist who can help you find that path.