Although uncommon, multiple myeloma is the most common primary bone cancer, according to the American Academy of Orthopaedic Surgeons. This cancer can cause problems with bone breakdown and bone formation, as well as cause disturbances in blood calcium levels. While multiple myeloma is not curable, there are treatments to help control the cancer and relieve symptoms of complications, including those related to fluctuations in calcium levels.
Significance
Multiple myeloma is a rare cancer. According to the American Cancer Society, in 2010 in the United States, a little more than 20,000 individuals were diagnosed with the disease, and over 10,000 people died from it. Less than one percent of diagnoses are in individuals younger than 35 years old, and the majority of people diagnosed are over 65 years of age, says the American Cancer Society.
Features
In multiple myeloma, there is an abundance of abnormal plasma cells. Plasma cells are found in the bone marrow, and in this cancer, the plasma cells take up too much space in the bone marrow, leaving normal blood-forming cells out, says the American Cancer Society. The cancer cells also interfere with bone formation. Myeloma cells promote the breakdown of old bone without signaling for new bone to be made. This causes a release of calcium into the bloodstream; too much calcium in the blood can cause a variety of health complications. Bones also become weakened and more prone to fracture.
Considerations
As multiple myeloma progresses, more and more calcium may be released into the blood, causing a condition called hypercalcemia. The University of Arkansas Myeloma Institute for Research and Therapy states that, in approximately 15 percent of myeloma cases, hypercalcemia is present at diagnosis. Signs of abnormally high blood calcium levels include nausea, confusion, fatigue, frequent urination or constipation, says the American Academy of Orthopaedic Surgeons. Too much calcium in the blood can also cause kidney problems because the kidneys have the burden of excreting extra calcium.
Treatment
In addition to treating multiple myeloma with chemotherapy, radiation, biologic therapies and stem cell transplant, drugs called bisphosphonates may be used. Bisphosphonates do not attack the cancer, but help bones stay strong by slowing down the breakdown of bone that myeloma can cause. According to the American Cancer Society, the most common bisphosphonates for myeloma are pamidronate, or Aredia; and zoledronic acid, also called Zometa. The drugs are given intravenously and help prevent further bone damage. Treating hypercalcemia may involve drinking plenty of fluids and taking medications to help lower blood calcium levels, says the National Cancer Institute.
Warning
Individuals with multiple myeloma should contact a physician immediately if they have symptoms of hypercalcemia, as this can be a dangerous condition. Talking to the oncology care team can help provide information on how to reduce the risk of developing hypercalcemia and options to help treat abnormal calcium levels.
References
- American Cancer Society: What are the key statistics about multiple myeloma?
- American Cancer Society: What are the risk factors for multiple myeloma?
- American Cancer Society: What is multiple myeloma?
- American Academy of Orthopaedic Surgeons: Multiple myeloma/Plasmacytoma
- University of Arkansas: Myeloma Institute for Research and Therapy: Symptoms
- National Cancer Institute: What you need to know about multiple myeloma: Supportive care
