Multiple myeloma is a type of blood cancer. It forms in plasma cells, which are made in the bone marrow, and causes cancer cells there to rapidly multiply. These cancer cells eventually crowd out and destroy healthy plasma and blood cells in the bone marrow.
Plasma cells are responsible for producing antibodies. Myeloma cells can cause the production of abnormal antibodies, which can cause the blood flow to become slow. This condition is also characterized by the existence of multiple tumors.
It most often occurs in bone marrow with the most activity, which can include the marrow in bones, such as the:
- pelvic bones
What are Lytic Lesions?
Also known as bone lesions or osteolytic lesions, lytic lesions are spots of bone damage that result from cancerous plasma cells building up in your bone marrow. Your bones can’t break down and regrow (your doctor may call this remodel) as they should. This makes them thin and creates areas of abnormal bone. Almost everyone who has multiple myeloma will have bone lesions at some time.
In normal bone, the process of bone remodeling keeps your bones healthy and strong. Special cells called osteoclasts break down old bone. Osteoblasts lay down new bone in its place.
With myeloma, the cancerous plasma cells (called myeloma cells) make chemicals called osteoclast activating factors (OAFs). These OAFs tell the osteoclasts to break down bone faster than usual, so old bone is broken down faster than new bone is made.
This causes bone lesions, and they can make your bones weak and break more easily.
Signs that multiple myeloma is affecting your bones include:
Pain. Bone pain is a common symptom. You usually feel it when you move but not when you’re still.
Where does it hurt? You may feel pain in your
Osteopenia. This means thin bones. This can cause a dull general pain or a more local ache.
Lytic lesions. This is the loss of pockets of bone, which can also cause dull overall aches or pain at a specific place.
Bone fractures. As bones thin, they break more easily.
Spinal compression. if a vertebra in your spine breaks, the damaged bone can press on your spinal cord and cause sharp, shooting pains in your limbs.
Malignant spinal compression. A tumor pressing on your spinal cord can also cause back pain that slowly gets worse. It might feel like a tight band around your chest and belly. It can also move down to your legs and bottom.
Spinal collapse. More than one broken vertebrae can cause your spinal column to collapse. It could be a dull ache, a sharp pain in your ribs and belly, or a shooting pain that moves up and down your leg.
Kyphosis. If your spine collapses, you can get a curve in your back that leads to chronic back pain.
Hypercalcemia. As bone is destroyed, your system gets swamped with calcium. It can lead to pain and problems like constipation and vomiting.
Peripheral neuropathy. Myeloma or its treatments can damage your nerves and lead to this condition, which causes tingling, numbness, and sometimes a sharp burning or jabbing pain in various body parts.
Sometimes, the abnormal proteins produced by myeloma cells are toxic to nerves. This damage can lead to weakness and numbnessand sometimes a “pins and needles” sensation. This is also called peripheral neuropathy.
In some patients, large amounts of myeloma protein can cause the blood to “thicken.” This thickening is called hyperviscosity. It can slow blood flow to the brain and cause:
- Symptoms of a stroke, like weakness on one side of the body and slurred speech
Patients with these symptoms should call their doctor. Removing the protein from the blood using a procedure called plasmapheresis can rapidly reverse this problem. (Note: This is not something that can be treated with drugs known as “blood thinners.”)
Myeloma protein can damage the kidneys. Early on, this doesn’t cause any symptoms, but signs of kidney damage may be seen on a blood test or a urine test. As the kidneys start to fail, they lose the ability to get rid of excess salt, fluid, and body waste products. This can lead to symptoms such as:
- Shortness of breath
- Leg swelling.
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