Myeloma: diagnosis and management

Preventing bone problems from starting

Myeloma can damage your bones by causing too many plasma cells to be produced in the bone marrow, which can lead to pain and fractures. To reduce the chance of this happening, you should be offered a kind of medicine called a bisphosphonate. The exact one you take will depend on which works best for you and causes you the fewest side effects.

Rarely, bisphosphonates can cause a condition called osteonecrosis of the jaw. This can cause pain, swelling, infection and serious damage to your jaw. The risk is higher if you have any dental work (such as having a tooth removed) while taking bisphosphonates.

Having any dental work you need before you start myeloma treatment can lower your chance of jaw damage, so your care team may refer you to a dentist straightaway. This may not be possible if you need to start myeloma treatment urgently, but you should still be referred as soon as possible.

Treating problems in bones other than your spine

If you have bone problems and are not already taking a bisphosphonate, you should be offered one.

You may also be offered medical procedures, surgery and/or radiotherapy to treat bone problems.

If you start feeling pain again or a tumour in your bone regrows after you have had radiotherapy, you may be offered another course of radiotherapy to treat this.

Treating problems in your spine

If you have spine problems and are not already taking a bisphosphonate, you should be offered one. You should also be offered medicines to help with pain.

You may be offered surgery and/or radiotherapy to treat spine problems caused by myeloma. You may also be offered surgery and a back support (also called a brace) to help with pain.