BREAST
CANCER
PROSTATE
CANCER
Multiple Myeloma and Bone Pain
Plasma cells are important to our body in fighting infection. Multiple myeloma refers to an abnormal cancerous growth of plasma cells. These cancer cells collect in numerous places in the bone marrow and hard, outer part of the bone. This year, about 16,000 people in the United State will learn they have this rare and painful disease.1
About 80 percent of patients with multiple myeloma experience bone pain
when they initially seek treatment.2 Multiple myeloma has a
distinct pain pattern. The pain usually occurs in the back or chest and
movement causes the pain to worsen. Patients typically feel less discomfort
at night, except when changing position.2 Tell the doctor about
your pain, when it occurs, and what makes it better and worse.
Multiple myeloma typically affects bones rich in bone marrow: the spine, skull, chest, pelvis and the upper arm and leg bones. Cancer growing in the bone weakens it and may cause fractures. When myeloma locates in the back, the spinal bones may break, causing severe pain and disability.
The doctor typically will order blood and urine tests to check for abnormalities associated with the disease. Normally X-rays will be ordered to look for areas where the bone has worn away, become more porous or broken. If the X-rays do not explain the pain, the doctor also may order computed tomography, magnetic resonance imaging or radionuclide bone scans.
Because multiple myeloma weakens the bones, they may break with little cause. Therefore, patients must exercise caution not to fall or sustain other injuries. But they should walk as much as possible, especially when pain is controlled, to help strengthen their bones. The doctor may recommend surgery to stabilize a bone at risk of breaking or to fix one that has broken.
The treatment goals are intended to control pain and limit progression of the disease. Early on, the doctor may recommend drugs to slow break down of the bones. Patients may receive chemotherapy to kill the cancer cells. Other treatments may include bone marrow transplants and radiation therapy.
Pain
medications are usually ordered, and a pain relieving radiopharmaceutical
therapy may benefit some multiple myeloma patients. This therapy utilizes
a radioactive agent that travels to the bone and provides a high, local
dose of radiation to the cancer cells. This treatment is especially helpful
if the cancer has spread to many sites.
Accurately reporting symptoms and how they affect your daily activities will aid your health care team in caring for you and enhancing your quality of life.
- American Cancer Society. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_
statistics_for_multiple_myeloma_30.asp?sitearea=
Last accessed April 12, 2005. - Abeloff, M. Clinical Oncology, 3rd ed., Orlando, FL: Churchill Livingstone, Inc.; 2004: 2960
