Cancer starts when cells begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas. To learn more about how cancers start and spread, see What Is Cancer?

Multiple myeloma is a cancer of plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system.The immune system is made up of several types of cells that work together to fight infections and other diseases. Lymphocytes (lymph cells) are one of the main types of white blood cells in the immune system and include T cells and B cells. Lymphocytes are in many areas of the body, such as lymph nodes, the bone marrow, the intestines, and the bloodstream.

When B cells respond to an infection, they mature and change into plasma cells. Plasma cells make the antibodies (also called immunoglobulins) that help the body attack and kill germs. Plasma cells, are found mainly in the bone marrow. Bone marrow is the soft tissue inside bones. In addition to plasma cells, normal bone marrow is also the home for other blood cells such as red cells, white cells, and platelets.

In general, when plasma cells become cancerous and grow out of control, this is called multiple myeloma. The plasma cells make an abnormal protein (antibody) known by several different names, including monoclonal immunoglobulin, monoclonal protein (M-protein), M-spike, or paraprotein.

There are, however, other plasma cell disorders that also have abnormal plasma cells but do not meet the criteria to be called active multiple myeloma. These other plasma cell disorders include:

• Monoclonal gammopathy of uncertain significance (MGUS)
• Smoldering multiple myeloma (SMM)
• Solitary plasmacytoma
• Light chain amyloidosis.

Multiple myeloma features

Low blood counts

In multiple myeloma, the overgrowth of plasma cells in the bone marrow can crowd out normal blood-forming cells, leading to low blood counts.

• This can cause anemia (a shortage of red blood cells). People with anemia become weak and fatigued.
• Multiple myeloma can also cause the level of platelets in the blood to become low (called thrombocytopenia). This can lead to increased bleeding and bruising.
• Another condition that can develop is leukopenia (a shortage of normal white blood cells). This can lead to problems fighting infections.

Bone and calcium problems

Myeloma cells also interfere with cells that help keep bones strong. Bones are constantly being remade to keep them strong. Two kinds of bone cells work together to keep bones healthy and strong:

• Osteoclasts break down old bone
• Osteoblasts lay down new bone

Myeloma cells make a substance that tells the osteoclasts to speed up dissolving the bone. So old bone is broken down without new bone to replace it, making the bones weak and easy to break. Fractured bones are a major problem in people with myeloma. This increase in bone break-down can also raise calcium levels in the blood. Problems caused by high calcium levels are discussed in Signs and Symptoms of Multiple Myeloma.

Infections

Abnormal plasma cells cannot protect the body from infections. As mentioned before, normal plasma cells produce antibodies that attack germs. In multiple myeloma, the myeloma cells crowd out the normal plasma cells, so that antibodies to fight the infection can’t be made. The antibody made by the myeloma cells does not help fight infections. That’s because the myeloma cells are just many copies of the same plasma cell – all making copies of the same exact (or monoclonal) antibody.

Kidney problems

Myeloma cells make an antibody that can harm the kidneys, leading to kidney damage and even kidney failure.

Other Plasma Cell Disorders

Monoclonal gammopathy

A monoclonal gammopathy is when plasma cells make too many copies of the same antibody. It is usually found on a routine blood test when looking for other conditions. Although people with multiple myeloma have a monoclonal gammopathy, not everyone with monoclonal gammopathy has multiple myeloma. It can also occur in other diseases, such as Waldenstrom macroglobulinemia and some lymphomas. It can also occur in a disorder known as monoclonal gammopathy of undetermined significance (MGUS), which does not cause problems like multiple myeloma does. However, some people with MGUS will eventually go on to develop multiple myeloma or other diseases.

Monoclonal gammopathy of undetermined significance

In monoclonal gammopathy of undetermined significance (MGUS), abnormal plasma cells make many copies of the same antibody (called a monoclonal protein). However, these plasma cells do not form an actual tumor or mass and do not cause any of the problems seen in multiple myeloma. MGUS usually does not affect a person’s health. It doesn’t cause weak bones, high calcium levels, kidney problems, or low blood counts. It’s most often found when a routine blood test finds a high level of protein in the blood and further testing shows the protein is a monoclonal antibody. In MGUS, the number of plasma cells may be increased, but they still make up less than 10% of the cells in the bone marrow.

MGUS is not considered cancer, but it is sometimes called pre-malignant because some people with MGUS will eventually develop cancers such as multiple myeloma, lymphoma, or amyloidosis. Each year, about 1% of people with MGUS develops one of these diseases. The risk is higher in people whose protein levels are particularly high. Patients with MGUS don’t need treatment, but they are watched closely to see if they get a disease that does need to be treated, such as multiple myeloma.

Solitary plasmacytomas

A plasmacytoma is a type of abnormal plasma cell growth that is cancerous. Rather than many tumors in different locations as in multiple myeloma, there is only one tumor, hence the name solitary plasmacytoma.

A solitary plasmacytoma often develops in a bone. When a plasmacytoma starts in other tissues (such as the lungs or other organs), it is called a solitary extramedullary or extraosseus plasmacytoma. Solitary plasmacytomas are most often treated with radiation therapy. Sometimes surgery may be used. As long as no other plasmacytomas are found later on, the patient’s outlook is usually excellent. However, since many people with a solitary plasmacytoma will develop multiple myeloma, these people are watched closely for signs of this disease.

Smoldering multiple myeloma (SMM)

Smoldering multiple myeloma (SMM) is an early or asymptomatic (no symptoms) myeloma that is not causing any problems. People with smoldering myeloma have some signs of multiple myeloma, such as any of the following:

• A large amount of plasma cells in the bone marrow
• A high level of monoclonal immunoglobulin (monoclonal protein) in the blood
• A high level of light chains (small protein segments also called Bence Jones protein) in the urine.

But, they have normal blood counts, normal calcium levels, normal kidney function, no bone or organ damage, and no signs of amyloidosis.

People with smoldering multiple myeloma do not need treatment right away, because the disease can take anywhere from many months to years to become active (symptomatic) myeloma. Some people may have very slow disease that never becomes active myeloma. SMM is an area of active research. There are SMM that have high risk features that put them at a greater chance of turning into active myeloma and studies are being done to see if they should be reclassified as “active” myeloma or if they should start treatment sooner. People with SMM are also watched closely for signs of myeloma.

Light chain amyloidosis

Light chain amyloidosis is also a disorder of abnormal plasma cell growth, but with lower amounts of abnormal plasma cells in the bone marrow compared to multiple myeloma.

Monoclonal proteins (antibodies) are made up of joined protein chains – 2 short light chains and 2 longer heavy chains. In light chain amyloidosis, abnormal plasma cells make too many light chains which are shorter and weigh less than the heavy chains. The light chains build up in tissues as an abnormal protein known as amyloid.

The buildup of amyloid in certain organs can enlarge them and affect the way they work. For example, when amyloid builds up in the heart, it can cause an irregular heart beat and cause the heart to enlarge and get weaker. A weak heart can lead to a condition called congestive heart failure, with symptoms like shortness of breath and swelling in the legs. Amyloid in the kidneys can cause them to work poorly. This may not cause symptoms early on, but the poor kidney function may be found on blood tests. If it gets worse, it can lead to kidney failure. See Signs and Symptoms of Multiple Myeloma.

Other names for light chain amyloidosis include AL and primary amyloidosis.

Light chain amyloidosis is only one of the diseases where amyloid builds ups and causes problems. Amyloidosis can also be caused by a genetic (hereditary) disease called familial amyloidosis. Long-standing (chronic) infection and/or inflammation can also cause amyloidosis. This is known as secondary or AA amyloidosis. This document does not talk about these other kinds of amyloidosis.

Waldenstrom macroglobulinemia (WM)

The cancer cells in people with WM are similar to those of multiple myeloma and non-Hodgkin lymphoma (NHL). Multiple myeloma is considered a cancer of plasma cells, and non-Hodgkin lymphoma is a cancer of lymphocytes. WM cells have features of both plasma cells and lymphocytes.

WM cells make large amounts of a certain type of antibody (immunoglobulin M, or IgM), which is known as a macroglobulin. Each antibody (protein) made by the WM cells is the same, so it is called a monoclonal protein, or just an M protein. The buildup of this M protein in the body can lead to many of the symptoms of WM, including excess bleeding, problems with vision, and nervous system problems. Even though WM has a monoclonal gammopathy and is sometimes grouped into other plasma cell disorders, it is considered a type of NHL. Another name for WM is lymphoplasmacytic lymphoma. Treatment for WM includes drugs used to treat multiple myeloma and NHL.

For more details, see Waldenstrom Macroglobulinemia .

Survival rates tell you what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. They can’t tell you how long you will live, but they may help give you a better understanding about how likely it is that your treatment will be successful. Some people will want to know the survival rates for their cancer, and some people won’t.

What is a 5-year survival rate?

Statistics on the outlook for a certain type of cancer are often given as 5-year survival rates. The 5-year survival rate is the percentage of people who live at least 5 years after being diagnosed with cancer. For example, a 5-year survival rate of 90% means that an estimated 90 out of 100 people who have that cancer are still alive 5 years after being diagnosed. Keep in mind, however, that many of these people live much longer than 5 years after diagnosis.

Remember that all survival rates are estimates – your outlook can vary based on a number of factors specific to you.

Survival rates don’t tell the whole story

Survival rates are often based on previous outcomes of large numbers of people who had the disease, but they can’t predict what will happen in any particular person’s case. There are a number of limitations to remember:

• The numbers below are among the most current available. But to get 5-year survival rates, doctors have to look at people who were treated at least 5 years ago. As treatments are improving over time, people who are now being diagnosed with multiple myeloma may have a better outlook than these statistics show.

• These statistics are based on when the cancer was first diagnosed. They do not apply to cancers that later come back or spread, for example.

• The outlook for people with multiple myeloma varies by the stage (extent) of the cancer – in general, the survival rates are higher for people with earlier stage cancers. But other factors can also affect a person’s outlook, such as their age and overall health, and how well the cancer responds to treatment. The outlook for each person is specific to his or her circumstances.

Your doctor can tell you how these numbers apply to you.

Survival rates for multiple myeloma

Remember, these survival rates are only estimates – they can’t predict what will happen to any individual person. We understand that these statistics can be confusing and may lead you to have more questions. Talk to your doctor to better understand your specific situation.

The numbers below are the approximate median survival using the Revised International Staging System of just over 3,000 myeloma patients treated between 2005 and 2012. These survival times are measured from the point that treatment, such as chemotherapy, first started. Since 2000 the percent of patients living five years after diagnosis has been increasing. Treatment since then has improved considerably and modern survival results are likely to be better.

Revised International Staging System	Median Survival
Stage I	Has not been reached
Stage II	83 months
Stage III	43 months

Some patients with multiple myeloma have no symptoms at all. Others can have common symptoms of the disease including:

Bone problems

• Bone pain, which can be in any bone, but is most often in the back, the hips, and skull
• Bone weakness, either all over (osteoporosis), or where there is a plasmacytoma
• Broken bones (fractures), sometimes from only a minor stress or injury

Low blood counts

Shortages of red blood cells, white blood cells, and blood platelets are common in multiple myeloma and might lead to other symptoms.

• Anemia: A reduced number of red blood cells that can cause weakness, a reduced ability to exercise, shortness of breath, and dizziness.
• Leukopenia: Too few white blood cells that can lower resistance to infections such as pneumonia.
• Thrombocytopenia: When blood platelet counts are low which may cause serious bleeding even with minor scrapes, cuts, or bruises. .

High blood levels of calcium

High levels of calcium in the blood (called hypercalcemia) can cause:

• Extreme thirst, leading to drinking a lot
• Urinating (peeing) a lot
• Dehydration
• Kidney problems and even kidney failure
• Severe constipation,
• Abdominal (belly) pain
• Loss of appetite
• Weakness
• Feeling drowsy
• Confusion

If the level of calcium gets high enough, you can even slip into a coma.

Nervous system symptoms

If myeloma weakens the bones in the spine, they can collapse and press on spinal nerves. This is called spinal cord compression and can cause

• Sudden severe back pain
• Numbness, most often in the legs
• Muscle weakness, most often in the legs.

This is a medical emergency and you should contact your doctor right away or go to the emergency room. If spinal cord compression is not treated right away, there is a possibility of permanent paralysis. 

Nerve damage

Sometimes, the abnormal proteins produced by myeloma cells are toxic to nerves. This damage can lead to weakness and numbnessand sometimes a “pins and needles” sensation. This is also called peripheral neuropathy. 

Hyperviscosity

In some patients, large amounts of myeloma protein can cause the blood to “thicken.” This thickening is called hyperviscosity. It can slow blood flow to the brain and cause:

• Confusion
• Dizziness
• Symptoms of a stroke, like weakness on one side of the body and slurred speech

Patients with these symptoms should call their doctor. Removing the protein from the blood using a procedure called plasmapheresis can rapidly reverse this problem. (Note: This is not something that can be treated with drugs known as “blood thinners.”)

Kidney problems

Myeloma protein can damage the kidneys. Early on, this doesn’t cause any symptoms, but signs of kidney damage may be seen on a blood test or a urine test. As the kidneys start to fail, they lose the ability to get rid of excess salt, fluid, and body waste products. This can lead to symptoms such as:

• Weakness
• Shortness of breath
• Itching
• Leg swelling.

Infections

Myeloma patients are much more likely to get infections. When someone with myeloma gets an infection, they may be slow to respond to treatment. That person may stay sick for a long time. Pneumonia is a common and serious infection seen in myeloma patients.

Signs and symptoms of light chain amyloidosis

Patients with amyloidosis (discussed in What Is Multiple Myeloma?) can have some of the same problems as patients with myeloma, such as kidney problems and nerve damage. They can also have other problems, such as:

• Heart problems: The heart may enlarge and become weaker. In some people, the heart becomes so weak that fluid builds up in the lungs, making them feel short of breath. Fluid may also build up in the legs and feet (edema). This is called congestive heart failure.
• Enlarged liver: The person may feel the liver below the right ribs. When this gets large it can press on the stomach so the person feels full after eating only a small amount of food.
• Enlarged tongue: When amyloid builds up in the tongue it can get larger. This can lead to problems swallowing and problems breathing during sleep (sleep apnea).
• Skin changes: Changes in the color or texture, easy bruising, and bleeding into the skin around the eyes (“raccoon eyes”)
• Kidney problems
• Carpal tunnel syndrome: Which causes numbness and weakness in the hands.

Cancer survivors can be affected by a number of health problems, but often their greatest concern is facing cancer again. If a cancer comes back after treatment it is called a recurrence. But some cancer survivors may develop a new, unrelated cancer later. This is called a second cancer. No matter what type of cancer you have had, it is still possible to get another (new) cancer, even after surviving the first.

Unfortunately, being treated for cancer doesn’t mean you can’t get another cancer. People who have had cancer can still get the same types of cancers that other people get. In fact, certain types of cancer and cancer treatments can be linked to a higher risk of certain second cancers.

Survivors of multiple myeloma can get any type of second cancer, but they have an increased risk of:

• Acute myeloid leukemia (AML)
• Myelodysplastic syndrome (MDS)

Follow-up after multiple myeloma treatment

Patients with multiple myeloma need to see their doctors regularly. Treatment often doesn’t cure this cancer, but can cause it to regress or go away for a time. If the cancer comes back or worsens, treatment may begin again. Let your doctor know about any new symptoms or problems, because they could be caused by the myeloma or by a new disease or second cancer.

Can I lower my risk of getting a second cancer?

There are steps you can take to lower your risk and stay as healthy as possible. For example, multiple myeloma survivors should do their best to stay away from all tobacco products and tobacco smoke, as smoking increases the risk of many cancers.

To help maintain good health, multiple myeloma survivors should also:

• Achieve and maintain a healthy weight
• Adopt a physically active lifestyle
• Consume a healthy diet, with an emphasis on plant foods
• Limit consumption of alcohol to no more than 1 drink per day for women or 2 per day for men

These steps may also lower the risk of some cancers.

See Second Cancers in Adults for more information about causes of second cancers.

Multiple myeloma is a relatively uncommon cancer. In the United States, the lifetime risk of getting multiple myeloma is 1 in 132 (0.76%).

The American Cancer Society’s estimates for multiple myeloma in the United States for 2018 are:

• About 30,770 new cases will be diagnosed (16,400 in men and 14,370 in women).
• About 12,770 deaths are expected to occur (6,830 in men and 5,940 in women).

Visit the American Cancer Society’s Cancer Statistics Center for more key statistics.

A risk factor is anything that changes a person’s chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposing skin to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for lung cancer and many other cancers. But risk factors don’t tell us everything. People who have no risk factors can still get the disease. Also, having a risk factor, or even several, does not mean that a person will get the disease.

Here are a few risk factors that could affect someone’s chance of getting multiple myeloma.

Age

The risk of developing multiple myeloma goes up as people get older. Less than 1% of cases are diagnosed in people younger than 35. Most people diagnosed with this cancer are at least 65 years old.

Gender

Men are slightly more likely to develop multiple myeloma than women.

Race

Multiple myeloma is more than twice as common in African Americans than in white Americans. The reason is not known.

Family history

Multiple myeloma seems to run in some families. Someone who has a sibling or parent with myeloma is more likely to get it than someone who does not have this family history. Still, most patients have no affected relatives, so this accounts for only a small number of cases.

Obesity

Being overweight or obese increases a person’s risk of developing myeloma.

Having other plasma cell diseases

People with monoclonal gammopathy of undetermined significance (MGUS) or solitary plasmacytoma are at higher risk of developing multiple myeloma than someone who does not have these diseases.

Scientists still do not know exactly what causes most cases of multiple myeloma. However, they have made progress in understanding how certain changes in DNA can make plasma cells become cancerous. DNA is the chemical that carries the instructions for nearly everything our cells do.

• Some genes (parts of our DNA) contain instructions for controlling when our cells grow and divide. These genes that promote cell growth are called oncogenes.
• Others genes that slow down cell growth or make cells die at the right time are called tumor suppressor genes.

Cancers can be caused by mistakes, or defects, in the DNA called mutations that turn on oncogenes or turn off tumor suppressor genes.

Recent studies have found that abnormalities of some oncogenes (such as MYC) develop early in the course of plasma cell tumors. Changes in other oncogenes (such as the RAS genes) are more often found in myeloma cells in the bone marrow after treatment, and changes in tumor suppressor genes (such as the gene for p53) are associated with spread to other organs.

Myeloma cells also show abnormalities in their chromosomes. In human cells, DNA is packaged into chromosomes. Although normal human cells contain 46 chromosomes, some cancer cells may have extra chromosomes (called a duplication) or have all or part of a chromosome missing (called a deletion). One common finding in myeloma cells is that parts of chromosome number 17 are missing. These deletions appear to make the myeloma more aggressive and resistant to treatment.

In about half of all people with myeloma, part of one chromosome has switched with part of another chromosome in the myeloma cells. This is called a translocation. When this occurs in a crucial area next to an oncogene, it can turn the oncogene on.

Researchers have found that patients with plasma cell tumors have important abnormalities in other bone marrow cells and that these abnormalities may also cause excess plasma cell growth. Certain cells in the bone marrow called dendritic cells release a hormone called interleukin-6 (IL-6), which stimulates normal plasma cells to grow. Excessive production of IL-6 by these cells appears to be an important factor in development of plasma cell tumors.

It’s difficult to diagnose multiple myeloma early. Often, multiple myeloma causes no symptoms until it reaches an advanced stage. Sometimes, it might cause vague symptoms that at first seem to be caused by other diseases. Sometimes, multiple myeloma is found early when a routine blood test shows an abnormally high amount of protein in the blood.

People with MGUS (monoclonal gammopathy of unknown significance) or solitary plasmacytoma are at risk of developing multiple myeloma and have regular bloodwork to monitor for it. Multiple myeloma may be diagnosed sooner in those people than those who did not have MGUS or a solitary plasmacytoma. 

It’s important to have frank, open discussions with your cancer care team. They want to answer all of your questions, so that you can make informed treatment and life decisions. For instance, consider these questions:

When you’re told you have multiple myeloma

• Where is the cancer located?
• Has the cancer spread beyond where it started?
• What is the cancer’s stage (extent), and what does that mean?
• Will I need other tests before we can decide on treatment?
• Do I need to see any other doctors or health professionals?
• If I’m concerned about the costs and insurance coverage for my diagnosis and treatment, who can help me?

When deciding on a treatment plan

• What are my treatment options?
• What do you recommend and why?
• How much experience do you have treating this type of cancer?
• Should I get a second opinion? How do I do that? Can you recommend someone?
• What would the goal of the treatment be?
• How quickly do we need to decide on treatment?
• What should I do to be ready for treatment?
• How long will treatment last? What will it be like? Where will it be done?
• What risks or side effects are there to the treatments you suggest? Are there things I can do to reduce these side effects?
• How might treatment affect my daily activities? Can I still work full time?
• What are the chances the cancer will recur (come back) with these treatment plans?
• What will we do if the treatment doesn’t work or if the cancer recurs?
• What if I have transportation problems getting to and from treatment? 

During treatment

Once treatment begins, you’ll need to know what to expect and what to look for. Not all of these questions may apply to you, but asking the ones that do may be helpful.

• How will we know if the treatment is working?
• Is there anything I can do to help manage side effects?
• What symptoms or side effects should I tell you about right away?
• How can I reach you on nights, holidays, or weekends?
• Do I need to change what I eat during treatment?
• Are there any limits on what I can do?
• Can I exercise during treatment? If so, what kind should I do, and how often?
• Can you suggest a mental health professional I can see if I start to feel overwhelmed, depressed, or distressed?
• What if I need social support during treatment because my family lives far away?

After treatment

• Do I need a special diet after treatment?
• Are there any limits on what I can do?
• What other symptoms should I watch for?
• What kind of exercise should I do now?
• What type of follow-up will I need after treatment?
• How often will I need to have follow-up exams and imaging tests?
• Will I need any blood tests?
• How will we know if the cancer has come back? What should I watch for?
• What will my options be if the cancer comes back?

Along with these sample questions, be sure to write down some of your own. For instance, you might want more information about recovery times. Or you may want to ask about clinical trials.

Keep in mind that doctors aren’t the only ones who can give you information. Other health care professionals, such as nurses and social workers, can answer some of your questions. To find out more about speaking with your health care team, see The Doctor-Patient Relationship.

For some people with multiple myeloma, treatment can remove or destroy the cancer. The end of treatment can be both stressful and exciting. You may be relieved to finish treatment, but it’s hard not to worry about cancer coming back. This is very common if you’ve had cancer.

For other people, the cancer might never go away completely. Some people may get regular treatment with chemotherapy and other drugs, radiation therapy, or other treatments to try and help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. Life after multiple myeloma means returning to some familiar things and making some new choices.

Follow-up care

During and after treatment, it’s very important to go to all follow-up appointments. During these visits, your doctors will ask about symptoms, examine you, and order blood tests or imaging studies such as CT scans or x-rays. Follow-up is needed to see if the cancer has come back, if more treatment is needed, and to check for any side effects. This is the time for you to talk to your cancer care team about any changes or problems you notice and any questions or concerns you have.

Almost any cancer treatment can have side effects. Some last for a few weeks to several months, but others can be permanent. Don’t hesitate to tell your cancer care team about any symptoms or side effects that bother you so they can help you manage them.

Ask your doctor for a survivorship care plan

Talk with your doctor about developing a survivorship care plan for you. This plan might include:

• A suggested schedule for follow-up exams and tests
• A schedule for other tests you might need in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
• A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
• Diet and physical activity suggestions
• Reminders to keep your appointments with your primary care provider (PCP), who will monitor your general health care

Keeping health insurance and copies of your medical records

Even after treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think about their cancer coming back, this could happen.

At some point after your cancer treatment, you might find yourself seeing a new doctor who doesn’t know about your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.

Can I lower my risk of multiple myeloma progressing or coming back?

If you have (or have had) multiple myeloma, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements.

Adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight might help, but no one knows for sure. However, we do know that these types of changes can have positive effects on your health that can extend beyond your risk of myeloma or other cancers.

About dietary supplements

So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of cancer progressing or coming back. This doesn’t mean that no supplements will help, but it’s important to know that none have been proven to do so.

Dietary supplements are not regulated like medicines in the United States – they do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you’re thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that might be harmful.

If the cancer comes back

If the cancer does recur at some point, your treatment options will depend on where the cancer is located, what treatments you’ve had before, and your health. For more information on how recurrent cancer is treated, see Treatment Choices for Multiple Myeloma, by Stage.

For more general information on recurrence, you may also want to see Understanding Recurrence.

Second cancers after treatment

People who’ve had multiple myeloma can still get other cancers. In fact, multiple myeloma survivors are at higher risk for getting some other types of cancer. Learn more in Second Cancers After Multiple Myeloma.

Getting emotional support

Some amount of feeling depressed, anxious, or worried is normal when multiple myeloma is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others. Learn more in Life After Cancer.