What is myeloma

Myeloma, also called multiple myeloma, is a type of blood cancer. When describing different types of cancer, we usually refer to the part of the body that the cancer cells originate from – like the breast, prostate, bowel or lung. These are all ‘solid tumour’ cancers. Blood cancers are different because they develop in the bone marrow.

I was blindsided when my doctor said I had myeloma. It was such a shock, I’d never heard of myeloma before.

– Bruno, Western Australia

Understanding plasma cells, bone marrow and immunoglobulins

Bone marrow is the spongy material found in the centre of larger bones in our bodies and serves as the production centre of blood cells, which include red blood cells, white blood cells and platelets. 

Myeloma originates from a specific white blood cell called a plasma cell. Plasma cells are found in bone marrow, where they form part of our immune system. Healthy plasma cells produce antibodies, also called immunoglobulins, to help fight infection and disease.

In myeloma, damage occurs to the DNA (chromosomes) of developing plasma cells, causing them to transform into cancerous myeloma cells. These damaged cells start to multiply and spread, crowding out the bone marrow so it can’t make enough red and white blood cells and platelets.

Instead of making helpful immunoglobulins to fight infection and disease, the myeloma cells make and release an abnormal type of immunoglobulin, called monoclonal (M) protein or paraprotein.

Paraprotein has no useful function in the body, and can build up in your blood and urine, where it can cause some of the symptoms of myeloma. Myeloma is often diagnosed and monitored by measuring this paraprotein. Myeloma is also classified into different types and subtypes depending on the type of paraprotein the myeloma cells make. 

To read more about paraprotein and the different types of myeloma see our page Types of myeloma

How does myeloma develop?

All people who eventually develop myeloma initially had a non-cancerous precursor condition called Monoclonal gammopathy of undetermined significance (MGUS). People with MGUS produce a low level of paraprotein in their blood or urine that does not cause any symptoms or damage to the body, and does not need any treatment. Most people live with MGUS without ever realising they have it. 

See our MGUS page to read more about this condition.

Some people discover that they have abnormal plasma cells in their bone marrow and a measurable paraprotein in their blood or urine, but otherwise feel well and have no symptoms. This is called smouldering myeloma or asymptomatic myeloma. Similar to MGUS, this early phase of myeloma does not require treatment. However, the risk of progression to myeloma that requires treatment is higher, and closer monitoring is therefore needed. 

See our Smouldering myeloma page to read more about this condition.

To learn more about how myeloma develops from MGUS to Smouldering myeloma to active myeloma listen to the below podcast episode.

What causes myeloma?

Although there has been a large amount of research into the  potential triggers for myeloma, no definite causes have been confirmed.

Some risk factors that could increase your chances of developing myeloma include:

• Your age (myeloma is more common in people aged 60 years and over)
• Exposure to certain chemicals, radiation and viruses 
• A weakened immune system

Myeloma is not thought to be hereditary (passed down genetically in families). However, you are more likely to develop myeloma if you have a family member who has been diagnosed, although this is very rare. 

There are no screening tests for myeloma and no way of predicting who will develop a paraprotein.

Is myeloma curable?

Myeloma is often considered as a chronic or ongoing condition that people live with over the longer term. After initial treatment, it will return, when it does it will need different types of treatment to help get it under control until it returns again. This is sometimes called a relapsing-remitting cancer and makes it different from many other cancers.  

While myeloma currently cannot be cured, there are many treatments that are able to slow its progress, put it into remission or plateau phase, control symptoms, and give you the best quality of life for as long as possible.

With many new developments in its treatment and management, the outlook for myeloma is improving all the time. Research is continuing to develop new treatments and find ways to use existing treatments more effectively. These advances are having a very positive impact on survival rates, and people with myeloma are now living longer than ever before. 

To read more about why myeloma relapses, see our page When myeloma returns

I’ve learned to just get on with whatever comes my way and not let myeloma define who I am.

– Fiona, Victoria