Frequently Asked Questions + Multiple Myeloma

1. What is multiple myeloma?


Multiple myeloma is a cancer of a plasma cell, a type of white blood cell in the bone marrow. Plasma cells are the cells in the bone marrow that produce

antibodies and play a key role in immune function. Multiple myeloma is cancerous growth of these plasma cells.

2. Do we know what causes myeloma and are there any specific risk factors?


Unfortunately, we do not know what causes multiple myeloma. Some groups that

may have an increased risk of multiple myeloma include patients exposed to radiation or chemicals such as benzine and insecticides. There also are some theories that genetic factors and viral infections may also influence the risk of multiple myeloma.

3. What are some of the ways that multiple myeloma can affect the body?


Multiple myeloma can affect organs such as the bone, the bone marrow, kidneys, and the nerves among others. The way that multiple myeloma can harm these organs is via an accumulation in the affected organ of an abnormal protein known as the M protein which represents a monoclonal protein produced by the plasma cells. M proteins serve no useful function and their accumulation is responsible for some of the manifestations of multiple myeloma such as kidney damage, thickness of the blood predisposing to blood clots, or bleeding problems. In addition, multiple myeloma can result in bone loss throughout the body as well as areas of specific bone destruction on radiographs called lytic bone lesions. The bone loss and erosion can lead to osteoporosis and fractures. It can also result in an abnormally high calcium level in the blood leading to a cancerous condition known as malignant hypercalcemia.


4. What are some of the symptoms of multiple myeloma?  


The symptoms of multiple myeloma basically relate to the effect of the M protein or the plasma cells in the affected location in the body. For example, the effects on the bone can cause bone pain or bones that break easily. The effects on the bone marrow are due to replacement of the normal bone marrow which can subsequently lead to fewer normal blood cells. Fewer white blood cells (leukopenia) can predispose a person to infection. Fewer red blood cells (anemia) result in a patient being more weak, tired, or short of breath than usual. Fewer platelets (thrombocytopenia) can cause a predisposition to bleeding. Involvement of the nervous system can lead to numbness, tingling, or muscle weakness. Since multiple myeloma is a type of blood cancer, it can lead to the usual symptoms that any cancer can cause such as fatigue, weakness, and weight loss.

5. Can multiple myeloma be cured?

Multiple myeloma is usually considered treatable rather than curable. Multiple myeloma has a more favorable prognosis than other malignancies because treatments are often effective in putting patients into remission for a prolonged period of many years. The outlook for multiple myeloma has also improved because numerous new and novel treatments have come on the market within the past five years – all of which are available at New Jersey Cancer Care.  While it is uncommon for multiple myeloma to be cured, there is the possibility for cure with very radical therapies such as CAR-T cell therapy or allogeneic bone marrow transplant. Because these treatments are often only utilized in younger patients and multiple myeloma is most often diagnosed in elderly patients, these more complicated therapies are not commonly utilized treatments.

6. What are some of the ways that multiple myeloma can be treated?


Multiple myeloma, given its complexity, can be managed with a number of different treatment pathways that are usually combined for more effective therapy. Medicines used in multiple myeloma include antibodies, other immunotherapies such as immunomodulator therapies, specific cell cycle treatments known as proteasome inhibitors, steroids no different from the steroids that are used in other diseases, traditional chemotherapy and treatments directed at chemicals specific to myeloma known as targeted therapy.  These are usually used in combination and the selection of which therapies that would be best for each individual patient depends upon the specific biologic characteristics and genetic features of their disease. This is known as a tailored approach to treatment and myeloma is one of the malignancies for which individualized treatment approaches have been the standard of care for a number of years. 

Finally, many patients with multiple myeloma receive a treatment known as an autologous bone marrow transplant in which the patient’s own bone marrow or stem cells are stored prior to the procedure. Prior to the transplant (in this case, the return of the patient’s own tissue rather than a donor’s tissue), the treating medical oncologist tries to eradicate as much myeloma from the patient as possible but during this process also causes severe damage to the patient’s normal bone marrow. The autologous bone marrow transplant itself then consists of returning the patient’s own healthy harvested bone marrow back to reconstitute the bone marrow. This is done at specialized centers which fortunately for patients at New Jersey Cancer Care would include the John Theurer Cancer Center (JTCC) at Hackensack University Medical Center and as will be noted below, their myeloma team and our oncology division’s physicians often collaborate on these cases for optimal myeloma management. 

7. How is multiple myeloma uniquely managed at New Jersey Cancer Care?


One of the advantages of obtaining treatment for multiple myeloma at New Jersey Cancer Care is its Cancer Program’s affiliation with the John Theurer Cancer Center (JTCC) at Hackensack University Medical Center. This enables us to treat myeloma in a collaborative fashion where the patient, except for the time if an autologous bone marrow or stem cell transplant is warranted, is treated primarily at New Jersey Cancer Care – the patient’s exceptional community hospital where they are familiar with the facility and its medical care providers. Here at New Jersey Cancer Care, we work with the JTCC myeloma team to get patients the best state of the art care and, often for many of the patients, this includes enrollment in their autologous transplant program. This approach, combining standard multiple myeloma therapies with autologous transplants, has resulted in improved results for patients with multiple myeloma throughout the country and it has been very satisfying for medical oncologists to see the prognosis of this relatively common hematologic malignancy continue to improve year after year. If there is any concern by your primary care physician that you may have multiple myeloma, a member of the oncology division at New Jersey Cancer Care would be readily available to make an appointment to see you as soon as possible and do the appropriate workup to confirm or refute the diagnosis and then recommend therapy as appropriate depending upon the results. 

Multiple myeloma is just one of many cancers that are managed expertly at Hackensack Meridian Health New Jersey Cancer Care, and our oncology team is prepared to meet the challenge should you or a family member be diagnosed with this serious condition. The New Jersey Cancer Care patients with multiple myeloma thus benefit from the best of both worlds: access to tertiary care center expertise at JTCC while receiving the convenience and warmth of their neighborhood hospital. This, along with the improved prognosis of multiple myeloma over the past ten years with newer drugs all available here, makes New Jersey Cancer Care the ideal site for treatment of our community patients with this serious disease.