How Multiple Myeloma Affects Your Bones
Bone Care With Multiple Myeloma
If you have multiple myeloma, taking care of your bones is an important part of your treatment plan. The disease can raise your chances of breaks and other problems. But you have ways to keep bone damage at bay and protect your skeletal health.
Cancer Starts in Your Bone Marrow
Multiple myeloma starts in the bone marrow, specifically within the plasma cells (a type of white blood cell that makes antibodies). This location puts your bones directly in harm's way as the cancer cells grow and multiply in the very place your bones get their strength.
Cancer Cells Crowd Out Bone Builders
As cancer cells grow, they crowd out cells that nourish your bones and keep them strong. This disrupts the normal process that maintains healthy bones, leaving your skeletal system vulnerable to damage and unable to repair itself properly.
Bones Become Soft and Break Easily
When cancer cells take over your bone marrow, this can lead to soft bones that are prone to fracture. Your bones lose their normal strength and density, making them much more likely to break from everyday activities that wouldn't normally cause problems.
X-rays Show Bone Damage
Before you start any treatments to curb bone loss, you'll want to get a clear idea of how your bones are doing. Your doctor will likely suggest you get X-rays to look for damage like holes or thin spots that multiple myeloma may have already caused.
Advanced Scans Find Early Problems
To assess bone health before treatment, doctors may use imaging like X-rays, PET, or MRI to check for damage. The gold-standard test for density is the DEXA scan, which measures bone mineral density in the hip and spine, revealing thin spots or holes. Advanced imaging can help your doctor catch damage in its earliest stages when it's easier to treat.
Medications to Slow Bone Breakdown
Your doctor may prescribe drugs called bisphosphonates, such as pamidronate and zoledronic acid. They slow down the activity of osteoclasts -- cells that break down bone. That allows bone-building cells called osteoblasts to move in and strengthen your bones. Studies show these drugs cut the number of fractures in people with multiple myeloma.
Radiation May Help
Radiation kills cancer cells that have moved into your bones, which opens up new space for healthy bone cells to grow. Once the cancer cells are gone, your bones will naturally grow back thicker and stronger. This targeted treatment focuses on problem areas.
Spine Surgery for Severe Damage
Your doctor may find areas of moderate to severe bone damage in your vertebrae, the row of small bones that make up your spine. If this happens to you, you'll need immediate treatment so you can stay mobile and pain-free through various procedures.
Procedures to Strengthen Vertebrae
One way to stabilize your spine is called vertebroplasty. Your doctor injects a cement-like substance directly into a hollowed-out vertebra to shore it up. Another procedure, kyphoplasty, uses a tiny balloon to create space before adding cement.
Exercise Helps Fight Bone Problems
Sticking to a fitness routine is a good way to keep your ability to move around if you have bone problems that cause pain and stiffness. Weight-bearing exercise, such as walking, also helps build up and strengthen your bones.
Eat Calcium-Rich Foods
It's smart to eat calcium-rich foods like milk, cheese, and yogurt, which will help strengthen your bones as you fight multiple myeloma. These foods provide the building blocks your bones need to stay as strong as possible during treatment.
Supplements For Your Bones
For an extra bone boost, your doctor may suggest a calcium supplement of 1,000-1,200 milligrams a day. In addition, vitamin D supplements of 800-1,000 international units a day can help lower your chances of breaking a bone. Check with your doctor before taking supplements.