Six little-known warning signs of multiple myeloma after death of Max Payne actor James McCaffery

• Myeloma is a blood cancer that develops from plasma cells in the bone marrow
• It can cause a wide range of symptoms from fractures and bone pain to tiredness

James McCaffrey, an American actor best known for voicing video game character Max Payne, has died following his battle with blood cancer.

The 65-year-old star was reportedly diagnosed with multiple myeloma, a type which arises from plasma cells within bone marrow — the ‘spongy’ substance lurking within bones.

Charities say there are around 6,000 new cases of myeloma per year in the UK, with more than 35,000 cases diagnosed annually in the US.

Here, we break down the warning signs of multiple myeloma. 

Myeloma can cause a wide range of symptoms from fractures and bone pain to tiredness

James McCaffrey, an American actor best known for voicing the video game character Max Payne, has died; seen in 2012

Bone pain

Just like other types of cancer, multiple myeloma may not cause any symptoms in the earliest stages of the disease. 

In fact, doctors sometimes only suspect a patient to have the disease following an abnormal blood or urine test, the NHS says.

But eventually the cancer can cause a wide range of problems, including persistent bone pain.

Dull aches are typically felt in the back, ribs or hips. 

The pain is caused by a large number of plasma cells collecting in one area, which can damage the bones and even cause fractures, Cancer Research UK says.  

What is myeloma?

Myeloma is a type of blood cancer. It develops from plasma cells in the bone marrow.

Plasma cells, made in the bone marrow, are a type of blood cell that makes antibodies to fight infection.

the bone marrow, which is found in the inner part of our large bones, produces different types of blood cells. 

Normal plasma cells make proteins called antibodies, these respond to infections and help to kill bacteria and viruses.

But when myeloma develops it causes a change in the DNA of plasma cells.

This causes abnormal plasma cells, which divide and multiply, to make abnormal types of antibodies which are not able to fight infections. 

This type of cancer doesn’t form a lump or a tumour, but instead causes problems sue to the abnormal build up of abnormal plasma cells.

This can cause tiredness, headaches, dizziness, bone pain, fractures and bleeding. 

Source: Cancer Research UK 

In some cases affecting the spine, it can cause pins and needles and numbness.

Tiredness

Although it might sound like a cold, feeling extremely tired, weak and breathless is another potential warning sign of myeloma.

Fatigue is caused by a lack of red blood cells.

Just like with bone pain, it happens because of the exceptional build-up of plasma cells in the bone marrow, effectively crowding out the ‘normal’ red cells.

Extreme thirst

Constantly feeling thirsty could also be a sign of the disease.

As well as crowding out ‘normal’ blood cells, the build-up of abnormal plasma cells can directly damage the bones.

When bones get damaged, they release calcium into the blood — known medically as hypercalcemia.

Symptoms of this include feeling thirsty, sick, tired, stomach pains and needing to pee frequently, according to the NHS.

Additionally, it can cause constipation and confusion and, if it is not treated, lead to extreme drowsiness.

Blurred vision

On top of all the above, never-ending headaches, dizziness and blurred vision might all be subtle signs of multiple myeloma.

The NHS says this trifecta is down to the cancerous cells producing excess proteins that cause blood to thicken, which is known as hyperviscosity. 

When the blood thickens too much it is unable to flow freely through the body’s blood vessels, which can block the very thin channels in the brain and trigger the symptoms.

Bruising and unusual bleeding

Warning signs of myeloma can also include strange bruises and unusual bleeding, such as nose bleeds, bleeding gums and even heavy periods.

Actor Kevin Dillon took to his Instagram to pay his respects, writing, ‘James McCaffrey we were lucky to have known you. my best friend you will be missed’

He is widely celebrated for his iconic portrayal of Max Payne, the titular character in the acclaimed video game series.

1994’s Viper was another big show for the actor, where he one was one of the leads fighting crime with the help of a Dodge Viper RT/10 roadster.

Abnormal bruising and excessive bleeding can happen as a result of the build-up of plasma cells in bone marrow.

Just like how they crowd out red blood cells, the over-production of plasma can stop the production of platelets, according to Cancer Research UK. 

Platelets work by clumping together and forming a clot to stop the bleeding. With less of them, bruising and bleeding is more likely. 

But CRUK says this symptom is ‘quite rare’ for myeloma.  

Repeated infections 

Suffering from frequent viral or bacterial infections can be another warning sign.

That’s because the cancer causes an over-production of cancerous plasma cells and abnormal antibodies, that can’t work as they normal would to prevent infections. 

Plasma cells are a vital part of the body’s immune system.

Normal, healthy plasma cells make antibodies, which fight-off viruses and bacteria.

Additionally, the excess of plasma cells overcrowd the bone marrow and means there is not enough space for making normal white blood cells, which are also part of the body’s defence system against bugs.

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