Understanding Multiple Myeloma: A Guide to Symptoms, Diagnosis, and Modern Treatments

If you or someone you love has been diagnosed with multiple myeloma (MM), or would like to learn more about the disease, this guide will help you understand the condition in clear, accessible terms. 

The most important message: you are not alone. Advances in myeloma care are happening rapidly, and treatment options are more effective than ever before. 

This straightforward guide covers what MM is, key signs and symptoms to recognize, and available treatment options—giving you the knowledge to move forward with hope and confidence. 

What Is Multiple Myeloma? 

MM is a cancer of the plasma cells—a type of white blood cell found in your bone marrow. Plasma cells produce antibodies that fight infection. 

With MM, these plasma cells become abnormal and multiply out of control, crowding out healthy blood-forming cells. They also produce large amounts of a non-functional protein called M-protein. This overgrowth can damage the bones, kidneys, and immune system. 

While MM is a serious diagnosis, it’s important to know that treatment advances are happening rapidly. According to the American Cancer Society, MM is considered a relatively rare cancer, with approximately 36,110 new cases expected in the United States in 2025. The five-year relative survival rate now stands at 62.4%, reflecting significant improvements in recent years. 

Risk Factors and Symptoms of Multiple Myeloma 

While anyone can develop MM, certain factors increase the risk. Age is a key factor — most diagnoses occur in people aged 65 and older. The disease is somewhat more common in men, and it disproportionately affects Black people, who are more than twice as likely to develop this disease compared to white people.  

A family history of plasma cell disorders and certain precursor conditions — such as monoclonal gammopathy of undetermined significance or smoldering myeloma — also increases risk. 

Recognizing symptoms early is crucial. When symptoms do appear, they often follow the “CRAB” pattern:  

• C — Calcium (elevated): Too much calcium in the blood (hypercalcemia) from bone damage can cause extreme thirst, frequent urination, stomach pain, and confusion.
• R — Renal (kidney) problems: Abnormal proteins can damage the kidneys, leading to kidney failure and possible weakness or leg swelling.
• A — Anemia: Too few red blood cells can cause fatigue, weakness, and shortness of breath. Anemia is present in nearly all MM patients at some point.
• B — Bone problems: Bone pain (often in the back or ribs), bone weakness (osteoporosis), and easily broken bones (fractures) are very common. 

If you are experiencing any of these symptoms, it’s essential to consult your doctor immediately. 

Diagnosing Multiple Myeloma 

Testing for MM involves several steps to confirm the diagnosis and assess the extent of the disease. Doctors typically start with blood and urine tests to look for abnormal proteins, known as M-proteins or light chains, produced by myeloma cells. A bone marrow biopsy helps identify and count cancerous plasma cells, while imaging tests such as X-rays, MRI, or PET/CT scans reveal bone damage or lesions. Together, these tests give doctors a clear picture of how myeloma affects the body and help guide the most effective treatment plan. 

Modern Treatment Options: Hope and Progress 

One of the most encouraging aspects of MM today is the ongoing development of new, highly effective treatments. Although doctors have not yet found a cure for the disease, they can often manage it effectively for many years with today’s advanced therapies. Doctors personalize each treatment plan based on the patient’s age, overall health, disease stage, and other individual factors. Below are some of the key approaches.

Drug Therapy (The Core of Treatment): Doctors usually combine several different drugs as part of the treatment plan, including:

• Proteasome inhibitors (e.g., bortezomib, carfilzomib): These drugs interrupt the cell’s recycling center, causing myeloma cells to die.
• Immunomodulatory drugs (e.g., lenalidomide, pomalidomide): These drugs modify the immune system’s interaction with the cancer.
• Monoclonal antibodies (e.g., daratumumab, isatuximab): These target specific markers on the myeloma cells, signaling the immune system to destroy them.
• Steroids (e.g., dexamethasone): Doctors use these medications to control inflammation and directly destroy myeloma cells.

Transplant: For some patients, a stem cell transplant offers the best chance to rebuild healthy bone marrow after intensive cancer treatment, helping the body recover and produce new blood cells.

• Autologous stem cell transplant: The procedure uses high-dose chemotherapy to destroy as many cancer cells as possible. Afterward, doctors rescue the body by returning the patient’s own healthy blood-forming stem cells, collected earlier, to restore bone marrow function and promote recovery

Cutting-Edge Immunotherapies: These are some of the newest developments, often used for patients whose myeloma has returned (relapsed) or is resistant to initial treatments (refractory):

• CAR T-cell therapy: The therapy uses a patient’s T-cells (a type of immune cell) that are collected, genetically modified in a lab to recognize and attack myeloma cells, and then infused back into the patient.
• Bispecific antibodies (e.g., teclistamab, elranatamab): These innovative drugs are essentially two-headed antibodies; one arm binds to an immune cell (T cell) and the other binds to the myeloma cell, bringing them together so the immune cell can destroy the cancer cell. 

Next Steps: Your Partner in Care 

A multiple myeloma diagnosis brings many questions, and you shouldn’t have to find answers alone. At Vail Health Shaw Cancer Center, our specialists combine advanced treatment options with personalized, compassionate care. 

Whether you’re seeking a diagnosis, a second opinion, or exploring treatment options, we’re here to guide you every step of the way. Schedule a consultation with our cancer care team to discuss your or your loved one’s diagnosis and create a treatment plan tailored to your specific needs.