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Treating Bone Complications in Multiple Myeloma

Summary & Participants

Multiple myeloma is a type of blood cancer that causes specialized blood cells to grow out of control. The cancerous cells in the bone marrow damage bone, causing pain and other serious complications. Tune in to learn how these bone problems are treated and prevented.

Medically Reviewed On: July 21, 2008

Webcast Transcript

ANNOUNCER: Multiple myeloma is a cancer that originates in the bone marrow. When it spreads and attacks the bone itself, it can cause extensive complications for those living with this disease. But doctors have several treatments available to help reduce and prevent these complications.

SUNDAR JAGANNATH, MD: Multiple myeloma is a blood cancer. It involves one of the white blood cells called plasma cell. When the cancer cells, the plasma cells grow rapidly inside the bone marrow, they can destroy the bone architecture internally.

Another way I would look upon this like termite growing inside wood. The cancer cells start growing inside, they eat the bone and cause the bone to get weak. Then even the day-to-day activity, the stress on the bone can cause fracture of the bone.

ANNOUNCER: Though other cancers can spread to the bone, the damage caused by multiple myeloma can be worse because it involves all the bones, where blood is being formed.

SUNDAR JAGANNATH, MD: In this particular cancer, the bone is eaten by the osteoclasts but there is no new bone formation or repair mechanism, because the repair mechanism is suppressed. Whereas in solid tumors such as breast cancer or lung cancer when they go to the bone and start growing there, they will cause bone destruction, but the body will normally try to wall off those cancer cells by producing new bone around them.

ANNOUNCER: When the disease begins to damage the bone, the first symptom is usually pain.

SUNDAR JAGANNATH, MD: The patient could have a cough or sneeze and can feel a sharp pain on the side of the chest due to a rib fracture. Or they could be lifting some weight and suddenly they have a severe back pain because of a compression fracture of the vertebra or the spine in the back.

ANNOUNCER: Managing pain is an important first step in treating multiple myeloma.

SUNDAR JAGANNATH, MD: The pain relief should be approached in two ways. One is to give immediate pain relief, episodic and you can do that by using codeine-morphine type in short acting form but if the patient has a constant back pain, unable to lie down, unable to sleep, unable to rest, then you want to make sure the patient gets 24 hour pain relief by using long acting pain medication.

ANNOUNCER: Other treatment options include: chemotherapy to treat the underlying cancer cells. Radiation therapy is sometimes used for a localized area where there is bone destruction and pain. But drugs known as bisphosphonates, are the mainstay of therapy to treat and prevent, further bone complications.

JAMES BERENSON, MD: Bisphosphonates are a class of drugs that shut down the cell that drives bone loss. That is called the osteoclast. So when that cell becomes inactive, the pac man if you will, that gobble up bone are no longer available to do that.

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