While a lot of people are aware of the symptoms of Multiple Myeloma, often sadly because they experience them, many don’t know why the symptoms appear. The causality is actually kind of simple when you think about it. We know that the cancer affects the bone marrow, and most understand that our bone marrow manufactures the type of cells that make up the blood. In most adults, the only place bone marrow is active is in the skull, shoulders, spine, ribs, pelvis, and hips. It isn’t active in the arms and legs, hands and feet. Bone marrow makes our red and white cells and also our platelets.
Red cells carry oxygen through the body, white cells fight off infection, and platelets are responsible for clotting. The cancer that affects bone marrow causes a reduction of white cells, a condition called anemia. It reduces the red cells and platelets as well. So right off the bat we can make the relationship between Multiple Myeloma and low energy levels, increased bruising and bleeding, and less effective breathing. The bruising and slight bleeding of the nose is a result of reduced platelet count. Low energy and being more easily winded and tired is the result of reduced red cells. The decrease in white cells causes greater susceptibility to infection, causing more frequent illness.
The pain of Multiple Myeloma is most noted for is in the bones, and primarily where bone marrow is more active. So the likelihood is for pain to appear in the skull, shoulders, spine, ribs, pelvis, and hips as noted above. Thye cancer is also noted for a greater incidence of bone fractures, and this is a little harder to explain. But it basically goes like this: the body builds and shapes our bone structures using what’s called osteoclasts and osteoblasts. Osteoclasts build bone and osteoblasts dissolves it. Those suffering Multiple Myeloma experience a disturbance in the balance mapped by genetics and this allows the osteoblasts to be more active than the osteoclasts. What happens is that areas of bone will lose definition and mass. When viewed through x-ray, the bone material looks like gauze or cheesecloth, rather than the normal appearance of solidity. The bone material becomes brittle, and that makes it more prone to fracture. Think of an M&M sitting in a warm room and you’ll have a good idea of how the bones become.
Because of the cancer, lesions appear. These are the areas where the osteoblasts have gone to town. In the skull, they appear to be small holes from pinhead size up to dime sized in x-rays. Tumors can also appear, and these are formed by the overproduction of cells, a primary feature of cancer in general. The effects on the bones is affects the nerve endings and the result is pain. Most often that pain is equated with motion, but the more advanced the damage, the more likely that pain can appear seemingly without cause. Most often, people experience pain in the lumbar area of the spine, and write it off to strain. This is one reason that Multiple Myeloma can be fairly progressed before it’s diagnosed.
The worst type of fracture associated with Multiple Myeloma is spinal compression. The bone becomes too weak to support the weight and stresses impinging upon it. It’s not too hard to see why this is considered the worst kind of fracture; it’s incredibly painful, involving many nerves. It can also lead to paralysis, as the spinal cord is involved and can be damaged in the collapse.
Symptoms of Multiple Myeloma follow a certain logic, as should be evidenced here. But having these symptoms doesn’t mean that you have cancer, there are many other explanations for them. Only a doctor can diagnose Multiple Myeloma and that’s done through testing for Bence Jones proteins in the blood and urine, PET scans and x-rays, and perhaps bone marrow aspiration or biopsy, among other indicators.