Published: Sept 25, 2021
The end stages of multiple myeloma refer to a phase in which the disease has progressed significantly and no longer responds to standard multiple myeloma treatments. At this point, cancerous plasma cells have extensively affected the bone marrow, blood, bones, kidneys, and immune system. For people with multiple myeloma, the focus in late stages often shifts from aggressive therapy to palliative care, comfort, and preserving quality of life.
It’s important to understand that the signs of end-stage multiple myeloma vary widely. Some individuals experience rapid symptom progression, while others live with late stage multiple myeloma for months or even years with supportive care.
Learn more about multiple myeloma and its final stages in the comprehensive guide from Immunity Therapy Center below.
What Is Multiple Myeloma?
Cancer, in general, refers to the abnormal, uncontrolled growth of otherwise healthy cells. That uncontrolled growth can eventually take nutrients from healthy cells, cut off oxygen to tissues and organs, and potentially spread to other parts of the body.
Multiple myeloma is a type of blood cancer that specifically affects plasma cells. Plasma cells are a type of white blood cell that are a mature form of B cells. B cells are a type of lymph cell, and when they notice any harmful microbes or potential infections, they change into plasma cells. Much like other blood-forming cells, plasma cells are found primarily in your bone marrow, which is the soft tissue found in your bones.
Plasma cells are responsible for making antibodies, also known as immunoglobulins, in response to an infection. Antibodies work to properly identify and eliminate harmful bacteria and viruses. With multiple myeloma, the cancerous plasma cells continue to create antibodies (known as monoclonal immunoglobulin, monoclonal protein, or M-spike) Still, these antibodies are abnormal and unable to identify or protect the body from outside threats in the same way, which severely diminishes your natural immune functions.
Signs and Symptoms of Multiple Myeloma
Multiple myeloma can be difficult to identify for a lot of reasons. In some multiple myeloma patients, the initial symptoms may be mild or easy to mistake for other common conditions. In its earliest stages, multiple myeloma may manifest as smoldering multiple myeloma.
Smoldering multiple myeloma is considered by many experts as a precancerous condition, and it is not alarming in itself. It typically does not present with any symptoms, and it may not require any treatment beyond regular monitoring. In some myeloma patients, smoldering myeloma may not even progress to active multiple myeloma.
When multiple myeloma does manifest symptoms, some common symptoms include:
- Nausea
- Constipation
- Fatigue
- Unintended weight loss and loss of appetite
- Confusion and mental fog
- Weakness or numbness in your legs and extremities
- Excessive thirst
Impact of Multiple Myeloma on Blood Cells, Bone Health, and Immune Function
Remember, plasma cells are created in the bone marrow. Overgrowth of plasma cells can crowd out other blood cells, leading to a low blood count. A lack of viable red blood cells, known as anemia, can cause a wide range of symptoms, from dizziness and weakness to shortness of breath. Multiple myeloma may also cause low platelet counts. Platelets are cells that help form clots in wounds. Low blood platelets can lead to wounds that keep bleeding as well as frequent bruising.
Multiple myeloma can also lead to bone pain. Cancerous plasma cells can interfere with bone formation and maintenance. Substances produced by abnormal plasma cells can stimulate osteoclasts, which break down old bone. With so much bone getting broken down without new bone to replace it, you may experience bone pain, and you may even be more susceptible to fractures.
The breakdown of bone material can also contribute to higher levels of calcium in your blood, also known as hypercalcemia. This can lead to a wide range of issues, and if left untreated, high calcium levels can potentially lead to a coma.
As plasma cells are so necessary to the immune system, abnormal plasma cells can have a massive impact on your immune function. As mentioned, malignant plasma cells do create antibodies, but these antibodies are abnormal and don’t perform the same function as regular antibodies.
With fewer viable antibodies, your body struggles to fight off microbial threats. You may get sicker more often and for longer periods. Simple illnesses or infections may become severe and dangerous.
Signs of End-Stage Multiple Myeloma
In the final stages of multiple myeloma, symptoms typically intensify as cancerous plasma cells crowd out healthy blood-forming cells in the bone marrow. This disrupts normal production of red blood cells, white blood cells, and platelets, leading to widespread complications.
Common signs of end-stage multiple myeloma include:
- Increased Bone Pain: As the disease progresses, bone pain often becomes more intense and frequent, requiring stronger pain management strategies.
- Severe Fatigue: Patients may feel extremely tired, making it difficult to perform daily activities, and this fatigue is not typically relieved by rest.
- Frequent Infections: The immune system weakens, leading to an increased risk of infections, which can be more severe and take longer to recover from.
- Weight Loss and Loss of Appetite: Many patients experience significant weight loss and a decrease in appetite, often requiring nutritional support to maintain health.
- Kidney Dysfunction: Kidney problems, including kidney failure, are common in end-stage multiple myeloma, potentially necessitating dialysis or other supportive treatments.
- High Levels of Calcium in the Blood: This can lead to various symptoms, including nausea, thirst, and confusion, and requires careful medical management to prevent serious complications.
How Symptoms Progress and Why They Vary
Multiple myeloma progresses differently for each person. Some individuals live with multiple myeloma for years, moving slowly through the stages of multiple myeloma, while others reach an advanced stage more quickly.
Factors that influence progression include:
- Age and overall health
- Extent of bone and kidney involvement
- How well the disease initially responds to treatment
- Presence of complications such as kidney failure or infections
This variability is why survival statistics and life expectancy estimates are general guides and not predictions for any one person.
Final Stages of Multiple Myeloma
By the final or end stages of multiple myeloma, cancer has progressed to other parts of the body beyond just the plasma cells in your bone marrow. By this point, cancer has not responded to treatment, and the disease will eventually lead to death.
Note that this is not an official staging designation. Staging is a process that occurs in conjunction with diagnosis as a means of determining the progression of the cancer and its spread and severity. Staging is necessary to determine proper modes of treatment and typically ranges from stage I to stage III for multiple myeloma. The “final stage” of multiple myeloma simply refers to cancer that has become terminal.
With the final stages of multiple myeloma, you can typically expect all of the signs and symptoms to ramp up. Unlike the early stages of smoldering myeloma, everything is noticeable. For example, symptoms may:
- Spread to your kidneys as proteins created by the malignant plasma cells lead to kidney damage
- Worsen your kidney function altogether, which prevents them from properly filtering out body waste, excess salt, and unnecessary fluids
- Include experiencing neurological symptoms
- Wear down and weaken bones. This includes bone material in your spine. Severe bone breakdown can result in your spine bones collapsing and pressing down on spinal nerves, a condition known as spinal cord compression
- Cause severe back pain, which can lead to numbness and weakness in the legs. If left untreated, the damage can result in permanent paralysis
In the final stages of multiple myeloma, your doctor may recommend treatments that can keep cancer under control, but many treatments can come with side effects or otherwise take a physical toll. Usually, by this point, your best option is palliative care, which helps to manage the symptoms of the disease.
Supportive and Palliative Care in End-Stage Multiple Myeloma
When multiple myeloma reaches an end stage, the goal of care often becomes symptom relief, comfort, and maintaining dignity. Palliative care focuses on managing symptoms, reducing pain, and supporting emotional and psychological well-being.
Palliative care can help with:
- Pain management for bone disease
- Fatigue and weakness
- Emotional distress and anxiety
- Coordination of care among the medical care team
In some cases, hospice care or end-of-life care may be appropriate to ensure comfort and support for both patients and families.
Treating Multiple Myeloma
Can multiple myeloma be cured? Immediate treatment may not be necessary or helpful for people with smoldering multiple myeloma. While there is no known cure for active multiple myeloma, there is a wide range of treatments available that can effectively eliminate cancer cells and prevent them from replicating.
- Targeted therapy: This is a common form of treatment for multiple myeloma. Targeted drug treatments look for specific genes, proteins, and tissue environments associated with cancer. This can help to identify and eliminate cancer without harming healthy tissues.
- Immunotherapy: This is also a common choice of treatment. Your immune system can struggle to find cancer cells. Many cancer cells have mechanisms that allow them to hide in plain sight. Immunotherapy works by boosting your natural immune system to better identify cancerous cells and properly dispose of them.
- Bone Marrow Transplant: Surgery is typically not necessary or useful for multiple myeloma. Your doctor may recommend a bone marrow transplant. This involves removing all of your cancerous bone marrow and replacing it with stem cells that can regrow normal bone marrow tissue.
Holistic Approach to Multiple Myeloma
At Immunity Therapy Center, we provide multiple myeloma natural therapies designed to complement medical care. For those exploring how to treat multiple myeloma naturally, our approach focuses on immune support, inflammation management, and comfort, never replacing physician-directed treatment.
Our alternative therapies aim to address not only the physical symptoms of multiple myeloma but also the emotional and psychological impact of the disease. If you or a loved one is navigating the final stages of multiple myeloma, reach out to ITC to learn more about how our alternative therapies might benefit your treatment plan.
Written By: Dr. Pablo Orozco
Dr. Pablo Orozco is a Board Certified Medical Doctor from Universidad Autónoma de Baja California.
Dr. Orozco has been a treating physician at the Immunity Therapy Center for more than 3 years providing daily on site patient care. He works with patients on a daily basis and guides them through the treatment process. Dr. Orozco’s passion for Alternative Cancer Treatments along with his commitment to patient care is key to insure that our patients have the best experience and results possible.
Sources:
- Cancer.org. What Is Multiple Myeloma? https://www.cancer.org/cancer/multiple-myeloma/about/what-is-multiple-myeloma.html
- Cancer.org. Signs and Symptoms of Multiple Myeloma. https://www.cancer.org/cancer/multiple-myeloma/detection-diagnosis-staging/signs-symptoms.html
- My Myeloma Team. End-Stage Myeloma: What You Need To Know. https://www.mymyelomateam.com/resources/end-stage-myeloma-what-you-need-to-know
- Cancer.net. Multiple Myeloma: Types of Treatment. https://www.cancer.net/cancer-types/multiple-myeloma/types-treatment
