Multiple myeloma is a notoriously difficult cancer to diagnose. "The reason is because sometimes the symptoms are non-specific," says Dr. Nina Shah, hematologist at UCSF. This means that its symptoms are so generalized and subtle that they could be a variety of different complaints and your physician won't immediately check for cancer. Multiple myeloma results from overproduction of plasma cells, a specific immune cell in the bone marrow. This produces a number of symptoms including:
- Anemia–Low levels of circulating red blood cells caused by the overproduction of plasma cells. These cancerous cells, known as myelomas, hinder the production and decrease the effectiveness of other immune cells, such as red blood cells. The anemia can cause weakness, fatigue, dizziness, shortness of breath, and problems with blood clotting.
- Bone fractures–Patients are more susceptible to fractures than the general population and may experience repeated breaks in their bones. This is because the myeloma cells release abnormal proteins into the body that activate the cells that break down bones and deactivate the cells that build up bones. If the bones of the spine become involved, injury to the spinal cord can cause pain and numbness in the arms and legs.
- Kidney failure–Abnormal proteins found in the blood or urine which are produced by myeloma cells may cause kidney damage and eventually failure
- Urinary issues–the damage to the kidney can also cause problems with urination
- Confusion–confusion is caused by high levels of calcium in the blood, a condition called hypercalcemia. This occurs because damage to bones causes calcium to be released into the bloodstream.
- Recurrent infection–multiple myeloma compromises the immune system because cancerous plasma cells can crowd out and impair the function of healthy immune cells. In some cases, recurrent infections may be the first apparent symptom of multiple myeloma. The most common infection is pneumonia.
"Patients presenting with any of those symptoms, we tend to workup very quickly for multiple myeloma," explains Dr. Shah. If you have any of these symptoms and suspect that you may have multiple myeloma, ask your physician whether you should run some tests.
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