Diagnosing Multiple Myeloma

Alicia M. Henao Uribe, MD with a patient.

Multiple myeloma is a cancerous disease of the bone marrow that arises on white blood cells. It typically affects those over 60 years of age and is not a curable disease. Since bone marrow produces red blood cells, white blood cells and platelets, it is easy for this disease to spread and infect other areas of the body.

“The classic presentation of multiple myeloma is anemia, bone disease and bone fractures, renal dysfunction and increased calcium in the bloodstream,” says Alicia M. Henao Uribe, MD, oncologist at Cape Medical Oncology, a Saint Francis Medical Partner location. “Since its symptoms are so specific, we usually have patients referred by nephrologists, internists and orthopedic surgeons to find if the patient has multiple myeloma.”

Multiple myeloma is typically diagnosed by a bone marrow biopsy, which is a painless, outpatient procedure. Doctors may utilize other testing such as PET scans to determine where the disease has spread through the body and how aggressive the disease is.

“This is an important step so we can determine what kind of treatments we have to offer patients,” Henao explains. “Based on test results, the patient’s age and performance status, we will have an idea of how the patient will tolerate treatments.”

Since multiple myeloma affects an older population, it is important to determine whether a patient is eligible or non-eligible for highly aggressive treatments. Highly aggressive treatments usually include combinations of chemotherapy and bone marrow transplant.

“After the bone marrow transplant, we put the patient on maintenance therapy with oral medications to increase the time the disease is dormant,” Henao explains. “Although it is not curable, patients can experience long-term remissions — even fifteen to twenty years.”

Patients who are non-eligible for aggressive treatment, typically those older with additional underlying conditions, will receive less aggressive chemotherapies and switch to maintenance therapies without a bone marrow transplant.

“Though not easy to diagnose and not curable, multiple myeloma has good treatment options that allow a patient to look forward to long-term remission,” says Henao.

For more information on cancer treatment options, visit our Cancer Institute webpage.