Tom Brokaw's Multiple Myeloma Diagnosis and What This Blood Cancer Is

What Brokaw chose to make public

Tom Brokaw was diagnosed with multiple myeloma in August 2013. He kept it quiet at first, including from colleagues at NBC News. In 2015 he published a memoir about it, "A Lucky Life, Interrupted," and spoke with NBC News as the book came out. He said that after months of specialized treatment he was in remission. He also described how he approached his own care: "I was able to put together a kind of team approach. And that worked very well for me."

That is his account, from that moment. This article does not go further into his health, then or now. What follows is about the disease.

One cell type, gone wrong

Your bone marrow makes plasma cells. Plasma cells are white blood cells with one job: making antibodies, the proteins that tag germs for destruction. A healthy marrow holds a broad mix of them, each tuned to a different threat.

In myeloma, one plasma cell copies itself over and over. The copies crowd the marrow and pump out a single useless antibody, called an M protein or monoclonal protein. That protein is the fingerprint doctors look for.

The National Cancer Institute groups these diseases as plasma cell neoplasms, and it draws lines between them:

• MGUS, short for monoclonal gammopathy of undetermined significance. An M protein is present in the blood, marrow plasma cells are under 10%, and there are no myeloma findings. It is not cancer.
• Smoldering myeloma. Marrow plasma cells run between 10% and 60%, with a high M protein, but no organ damage yet.
• Plasmacytoma. A single tumor of plasma cells, either in bone or in soft tissue. NCI notes soft tissue plasmacytomas most often appear in the tonsils, nasopharynx, or paranasal sinuses.
• Multiple myeloma. Widespread disease with damage to the body.

The four letters that define active disease

Doctors decide myeloma needs treatment when it starts breaking things. The shorthand is CRAB, and NCI lists the thresholds:

• C, calcium. Blood calcium is high, because myeloma dissolves bone and releases it.
• R, renal. Kidney function drops, with creatinine above 2 mg/dL.
• A, anemia. Hemoglobin falls below 10.0 g/dL, because the marrow is crowded out.
• B, bone. Holes appear in bone, called lytic lesions, or a bone gives way.

That is why myeloma so often shows up as back pain and fatigue rather than as a lump.

When to get checked

There is no screening test for myeloma. NCI's patient page offers none. Myeloma is usually caught because a routine blood test looks odd or a bone hurts in a way that will not settle. These are the specific signals worth a call:

• Bone pain in the back or ribs that lasts more than a few weeks, is present at rest or at night, and is not tied to an injury. This matters more after age 50.
• A bone that breaks after a minor fall or with no clear cause at all.
• Anemia on a routine blood count with no explanation, especially hemoglobin under 10.0 g/dL.
• A creatinine above 2 mg/dL on a routine panel in someone with no known kidney disease.
• High blood calcium, which can bring thirst, frequent urination, constipation, muscle weakness, and confusion.
• Frequent infections, or fevers with no source.
• Easy bruising or bleeding, or new weakness in the arms or legs.

Any one of these has ordinary explanations far more often than it has myeloma. The point is not to panic. It is to get the pattern looked at rather than living with it.

How myeloma is actually found

The workup is more layered than most cancers, because there is no single tumor to biopsy. NCI lists the pieces.

Blood and urine are tested for immunoglobulins, using serum protein electrophoresis to separate proteins and find the M protein, and a serum free light chain assay to measure antibody fragments. A 24-hour urine collection catches light chains passing through the kidneys.

Bone marrow aspiration and biopsy, usually from the back of the hip, give the plasma cell percentage. That sample also goes for cytogenetic analysis and FISH, a test that lights up specific chromosome changes, plus flow cytometry.

Imaging maps the bone. That means a skeletal survey, MRI, CT, PET, or PET-CT. A standard blood count and chemistry panel round it out.

Staging that ignores tumor size

Myeloma is not staged by how big a tumor is, because it is everywhere in the marrow at once. NCI describes the Revised International Staging System, which uses blood markers and genetics instead.

Stage I means beta-2-microglobulin under 3.5 mg/L and albumin at or above 3.5 g/dL, with no high-risk features. In the data NCI cites, median survival for that group had not been reached when the analysis was done. Stage III means beta-2-microglobulin at or above 5.5 mg/L plus either a high LDH or high-risk chromosome abnormalities, with a median survival of 43 months. Stage II is everything in between, at 83 months.

Those medians describe groups of patients treated years ago. They are not a forecast for an individual, and they are not fixed.

What treatment looks like

NCI describes a sequence. Induction therapy comes first, usually three or four drugs from different classes given together, because myeloma resists single agents.

For people well enough for it, an autologous stem cell transplant may follow. The patient's own blood stem cells are collected and stored, high-dose chemotherapy clears the marrow, and the stored cells are returned to rebuild it. Maintenance therapy, given at lower intensity for a long stretch, follows.

Bone protection, kidney protection, and infection prevention run alongside all of it. Myeloma is generally described as treatable but not curable, which is why the plan is built for years rather than weeks.

Where the numbers stand

These figures describe populations. For 2026 the American Cancer Society projects 36,000 new myeloma cases in the United States and 10,850 deaths, about 1.7% of new cancers, and SEER publishes those projections. In NCI's own SEER counts the largest share of new cases, 32.7%, falls in the 65 to 74 age group.

The direction of travel is the part worth holding onto. NCI's guidance for clinicians states that newer biological therapies and better salvage options have pushed median survivals to more than 10 years. That is a group figure, not a promise. But it is a very different sentence than the one that could have been written thirty years ago.

Sources

• NCI: Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ) — Health Professional Version
• NCI: Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ) — Patient Version
• SEER Cancer Stat Facts: Myeloma
• NBC News: Tom Brokaw on treating cancer and making it a family cause