Multiple Myeloma: What It Is, Causes, Symptoms, Treatment, & Types

What Is Multiple Myeloma?

Multiple myeloma is a type of blood cancer that starts in plasma cells, a kind of white blood cell found in the bone marrow. Plasma cells make antibodies to fight infection. But with multiple myeloma, plasma cells develop errors and build up in your bone marrow. These abnormal plasma cells multiply uncontrollably and crowd out healthy blood-forming cells.

Multiple myeloma can damage the bones, weaken the immune system, and affect kidney function. Common symptoms include bone pain, fatigue, frequent infections, anaemia, and elevated calcium levels in the blood. While it is generally not curable, modern treatments can slow the progression, relieve symptoms, and improve quality of life.

What Are the Types and Stages of Multiple Myeloma?

Multiple myeloma can be classified based on the type of abnormal antibody (immunoglobulin) produced by the cancerous plasma cells:

Types of Multiple Myeloma

Pre-Cancerous and Early Stages

How Common Is Multiple Myeloma in India?

The prevalence of myeloma in India is about 1 in 100,000 people based on clinical studies. The prevalence is rising, primarily due to a surge in urban cases. Moreover, the study also shows myeloma in the Indian population is diagnosed almost 10 years earlier compared to Western countries.

A clinical study analysing 255 newly diagnosed patients revealed the following:

• The average age at diagnosis is 55.4 years

• Men comprise 67% of patients

• 65.1% had advanced-stage disease at the time of diagnosis

The last point suggests that many Indians are being detected at a fairly advanced stage of multiple myeloma, which could be due to a lack of awareness among the populace.

What Are the Symptoms of Multiple Myeloma?

In the early stage (the smouldering phase), patients often feel fine. Symptoms start to develop with progressive disease, which include the following:

What Causes Multiple Myeloma?

Some of the causes that increase the risk of myeloma are:

• Age: Those over 50 are more likely to be diagnosed.

• Sex: Myeloma is more prevalent in males.

• Family History: If a patient’s mother, father, brother, or sister has been diagnosed, there is a slightly greater risk that the patient can get myeloma.

• Overweight: Excessive body fat results in an inflammatory condition in the body and can increase the risk.

• Contact with Certain Chemicals: Prolonged contact with petrol products, pesticides or industrial chemicals may increase the risk.

• Radiation Exposure: Being exposed to high doses of radiation over a longer period of time while working in certain types of jobs may contribute to the development of myeloma.

What Are the Complications of Multiple Myeloma?

Some of the complications associated with myeloma include:

• Severe Anaemia: Low red blood cell count results in excessive tiredness and weakness.

• Kidney Failure: M protein blocks the filters of the kidney, the most common complication among diagnosed Indian patients.

• Bone Fractures: The presence of myeloma forms cavities in bones. Fractures of the spine could compress the nerves, causing paralysis.

• High Calcium (Hypercalcaemia): As bone is broken down, the calcium leaks into the blood, causing nausea, confusion, constipation, and cardiac abnormalities.

• Severe Infections: As immunity decreases, the patient can be susceptible to pneumonias and other fatal infections.

• Nerve Damage: The condition can cause pain and numbness in the hands and feet (and also certain medicines may have the same effect).

• Thickened Blood: M protein in large amounts may cause the blood to thicken, leading to headaches, blurred vision, and dizziness.

When Should I See My Healthcare Provider?

You must visit your doctor if you suffer from:

• Back pain, rib pain, or hip pain that does not ease

• A fracture from a trivial fall or a small knock

• An ongoing tiredness not improved with rest

• Recurrent infections (particularly chest infections)

• Weight loss over several weeks that is unexplained

• Frothy urine, swollen ankles, and/or reduced urine production

• Increased thirst, urination, and unexplained confusion

• Tingling or numbness of the fingers and toes without an obvious cause

How Is Multiple Myeloma Diagnosed?

Since multiple myeloma mimics other conditions, doctors dely on a combination of diagnostic tests. There is no single test for confirming myeloma. Usually, the following tests are carried out for diagnosis:

Diagnostic Quick Reference

A haematologist then puts all the results together to make a diagnosis.

How Is Multiple Myeloma Managed?

The treatment adopted is based on age, health, disease stage, and the myeloma's genetic type. Common methods include:

For Younger or Fitter Patients (Transplant-Eligible)

Step 1 - Induction Therapy: First, patients are given several drugs, typically including four different kinds of cancer drugs, to reduce the myeloma cell count.

Step 2 - Autologous Stem Cell Transplant (ASCT): This includes:

• The patient’s own stem cells (which produce healthy blood cells) are extracted and then stored away.

• Then, high-dose chemotherapy is used to wipe out most of the remaining myeloma cells.

• Once done, the collected stem cells are infused back into the patient's body to restore healthy blood.

Step 3 - Maintenance Therapy: A continuing course of drugs is given after ASCT to keep the myeloma from recurring. These may be continued for several years.

Previously mentioned studies show that22% of Indian patients lived for ten or more years after ASCT.

For Older or Frailer Patients (Transplant-Ineligible)

Patients who can’t tolerate high-dose chemotherapy need to be treated with gentler, highly effective targeted drug treatment to preserve their quality of life. CAR T-Cell therapy is reserved for relapsed/refracted patients only.

Supportive Care

• Bone Strengthening Injections: These aim to reduce bone pain and the risk of fractures.

• Radiotherapy: Used for specific areas of bone that are causing significant pain.

• Dialysis: When the kidneys fail to function optimally.

• Blood Transfusion: Given to address anaemia during treatment.

What Is the Prognosis for Multiple Myeloma?

The prognosis of multiple myeloma depends on the stage of the disease, the patient's age, overall health, genetic risk factors, and response to treatment.

In India, survival outcomes are steadily improving, thanks to better access to modern treatments and specialised cancer care. Some patients with standard-risk disease may live for 8–10 years or longer with appropriate treatment and follow-up, while outcomes may be less favourable in high-risk or advanced-stage cases.

Early diagnosis, timely treatment, adherence to therapy, and regular monitoring are important for improving prognosis. Since every patient's situation is unique, the treating haematologist or oncologist can provide the most accurate outlook based on individual disease characteristics.

Can Multiple Myeloma Be Prevented?

Though multiple myeloma cannot be completely prevented, the following measures can help minimise the risk of developing the disease and its progression:

• Maintain a healthy body weight

• Wear protective gear when handling pesticides, solvents, or industrial chemicals.

• Go for regular check-ups for MGUS and smouldering myeloma

• Do regular blood tests for M protein after 50, especially with a family history of myeloma.

• Review unexplained symptoms like back pain, fatigue, and infections to ensure early diagnosis.

Does Health Insurance Cover Multiple Myeloma?

Yes, most comprehensive health insurance plans in India cover the treatment of myeloma. In most cases, the following are covered:

• Hospitalisation for chemotherapy or transplant.

• Diagnostic tests like blood tests, bone marrow biopsy, and CT/MRI scans.

• Medications during hospitalisation or in authorised daycare.

• Autologous stem cell transplant is increasingly covered in critical illness plans or cancer plans.

• Radiation for bone lesions.

• Blood transfusions and dialysis are relevant to myeloma.

Myeloma is generally treated as a pre-existing condition once diagnosed, and therefore, standard policies normally require a waiting period of up to 3 years before a policyholder can claim settlements. However, some critical illness plans, tailored for cancer can cover it earlier. Always refer to your policy details to remain informed about coverage inclusions and exclusions.

How Much Health Insurance Coverage Is Needed for Multiple Myeloma Treatment?

A cover of ₹10 to ₹25 lakh may suffice for initial diagnosis, regular chemotherapy, and shorter hospitalisation. Costs in a private Indian hospital for a stem cell transplant could range from ₹15 to ₹30 lakh, including the transplant cost, consumables, and the patient's hospital stay.

For cases requiring long-term maintenance therapy at advanced or relapsed stages, expenses can exceed ₹25 lakh, depending on the stage and hospital. Based on the given expenses, a coverage of ₹20 to ₹30 lakh is usually recommended. Choosing suitable plans by comparing those with cancer riders, critical illness cover, or daycare chemotherapy is beneficial.