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A disease of the bone marrow — well treatable today, even if it usually does not vanish entirely.
Also known as: multiple myeloma · plasmacytoma · Kahler’s disease
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A cancer of certain immune cells in the bone marrow (plasma cells). They produce a non-functional protein and damage bone at the same time. Typical signs: stubborn bone and back pain, fractures without major cause, anaemia with fatigue, frequent infections, raised calcium and declining kidney function. Mostly affects people over 60. Not curable, but often well controlled over many years.
The treatment plan is not made by one person alone but in a round of surgery, oncology, radiology, pathology and radiotherapy. You may ask what was discussed there and which alternatives came up.
Before a big decision it is planned for in many clinics, and the records belong to you. It costs one to two weeks — acceptable in almost every course, and one asks about that if it is urgent.
It is today part of the treatment and not its opposite: it lessens the exhaustion, keeps muscle and bone and improves how the treatment is tolerated. Begin with guidance, less on bad days, but not nothing at all.
Unintended weight loss worsens how any treatment is tolerated. Restrictive diets do more harm than good here — with loss of appetite, dietary advice helps early, not only once kilos are already gone.
By the clock rather than as needed works better and needs less overall. Fear of dependence is the wrong adviser in this situation — untreated pain costs sleep, appetite and strength.
Psycho-oncological support, social advice for insurance and work, and the question of who takes on what at home. This is no emergency measure but belongs at the start — and the relatives belong in it.
This illness attacks both. Drinking enough protects the kidneys, drugs to protect the bone are part of the treatment, and new back pain with loss of strength in the legs is an emergency.
A threadworm can stay silent in the gut for decades and, under cortisone, biologicals or other immune suppression, flood lung and bloodstream. Anyone who ever went barefoot in the tropics or subtropics is looked for beforehand with a blood test — one effort, and it prevents the worst course this worm has.
Myeloma is not so far regarded as curable, but as controllable over a long time: from a few years it has become ten years and more for many with today’s combinations. Treatment runs in blocks, followed by maintenance that continues for as long as it works. Bisphosphonates protect the bone and reduce fractures — they do not act against the tumour. Protecting the kidney is a part of its own: drinking plenty and avoiding anti-inflammatory painkillers.
Almost always there is a preceding state without symptoms, found in about three in a hundred people over fifty; it turns into myeloma at about one per cent a year. Four signs lead to the diagnosis: high calcium, impaired kidney, anaemia, bone lesions. With today’s combinations many live ten years and longer — twenty years ago it was a few years.
Lasting pain in spine, ribs or pelvis that stays or grows at rest and lying down — unlike ordinary back pain, which changes with movement and position.
A vertebra that collapses when bending, a rib that breaks with coughing, a loss of height over months.
Tiredness and pallor from the anaemia; much thirst, frequent urination, constipation and drowsiness from a raised calcium. This combination belongs looked at quickly.
The kidneys are often involved. Lasting foam in the urine, swollen ankles and declining kidney values belong to the picture — and that is the part that gains most from early treatment.
The loss of muscle mass helps decide how well a treatment is tolerated. Enough protein spread across the day, together with movement, is the part one holds oneself.
Without vitamin D only a fraction of the calcium from food is taken up. It is the value that is most often too low with bone and joint complaints.
The building material itself. Better from food than from a tin: hard cheese, yoghurt, calcium-rich mineral water, almonds, broccoli and fortified plant drinks.
Belong in the workup of an anaemia that is otherwise too quickly put down to the illness or the treatment. Both are easy to measure and easy to supplement.
Activates the proteins that build calcium into bone. Green leafy vegetables and fermented foods cover it — under coumarin blood thinning the amount stays steady rather than swinging.
The one point that is reversed here: in this condition the calcium in the blood is often already too high, because bone is being broken down. Extra calcium therefore does not belong without knowing the value.
High-dose vitamin C cancels certain treatments for this condition in the laboratory — bortezomib is inhibited by it. That is one of the few cleanly documented cases in which a vitamin weakens a therapy.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
The high calcium here does not come from the parathyroid — this hormone is low, because the bone is being broken down by the tumour cells themselves. Exactly that combination places the finding.
The anaemia has two reasons: crowded-out marrow and a damaged kidney that makes less EPO. This is why iron alone often does not help here.
Bone breakdown already releases calcium; blood levels are often raised. So supplementation is not given as a rule here but decided by measurement — unlike in osteoporosis.
The protein fragments burden the kidneys. 2–3 litres a day is the usual target, if heart and kidneys allow — this is set with the treating team.
The claim usually rests on the PET scan: weakly radioactive glucose is injected, and the tumour lights up. That shows tumour cells take up sugar faster than the tissue next to them — not that eaten sugar feeds them. You come to a PET scan fasting, and the tumour lights up anyway; the body keeps blood sugar within narrow limits by itself. It cannot be starved out this way. There is an established link nonetheless, but it runs through body fat: in 2016 the International Agency for Research on Cancer (IARC) reviewed the available studies and found sufficient evidence, for thirteen cancers, that absence of excess weight lowers the risk. That concerns prevention — it is not an answer to where an existing illness came from.
Movement is wanted, but the bones are fragile. Impact loading and strong twisting of the spine are avoided — physiotherapy decides which exercises are possible.