How and why does multiple myeloma damage bones?


According to medical journalist Laura Beil, “Malignant plasma cells affect the remodeling of bone, causing overproduction of the natural substances that dissolve bone.  When plasmacytomas (the scientific term for myeloma related tumors or lesions) form inside bones, the affected bones can develop soft spots or holes.  Although these lesions can affect any bone, pain appears to be most common in the back, ribs and hips.”

A simple, lay woman’s interpretation of myeloma bone involvement.  I like it!

She goes on to mention something we all already knew.  That “sometimes bones can become so weak they easily fracture.”

OUCH!  Been there, done that!  A few more thoughts…

Although large bones with the most marrow tend to be damaged first, myeloma lesions can also form in the skull and below the elbow or knee.  So make sure X-ray bone surveys cover the head, forearms, hands, shins and feet.

Also, did you know plasmacytomas can form in muscle as well as bone?

In this case, an MRI or PET scan is the best way to confirm the presence of soft tissue plasmacytomas.

Personally, I don’t trust X-rays for tracking multiple myeloma damage anyway.  While my spinal X-rays only showed a hairline crack in my T-12 vertebra before I was initially diagnosed, a subsequent MRI revealed a number of bones that literally looked like Swiss cheese.

So while bone surveys are a standard way to track extensive and existing bone damage that has calcified over time, they aren’t great at detecting new or soft tissue damage.

The moral here:  Any multiple myeloma patient who detects  any new, persistent bone pain should talk with their specialist about having the area scanned, not just X-rayed.


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