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Multiple myeloma is a type of cancer that develops in a type of white blood cell known as a plasma cell. Healthy plasma cells aid in the fight against infections by producing antibodies that recognize and attack bacteria.
Cancerous plasma cells accumulate in the bone marrow and drive out healthy blood cells in multiple myeloma. Instead of producing beneficial antibodies, cancer cells create aberrant proteins that can lead to difficulties.
Multiple myeloma treatment isn't always required right away. If the multiple myeloma is slow growing and not causing symptoms, your doctor may advise diligent observation rather than early treatment. A variety of therapeutic options are available for persons with multiple myeloma who require treatment.
WHAT ARE THE TYPES OF MULTIPLE MYELOMA?
Multiple myeloma is classified into two types:
Indolent myeloma: This variety normally develops slowly and without obvious signs. It does not produce bone malignancies; instead, it causes minor increases in M protein and M plasma cells.
Solitary plasmacytoma: This type results in the formation of a tumor, most commonly in the bone. It often responds well to treatment, but it must be closely monitored.
WHAT ARE THE SIGNS AND SYMPTOMS OF MULTIPLE MYELOMA?
Multiple myeloma symptoms and signs can vary, and early in the disease, there may be none.
When signs and symptoms do appear, they may include the following:
- Bone discomfort, particularly in the spine or chest
- Nausea
- Constipation
- Appetite loss
- Confusion or mental fogginess
- Fatigue
- Infections that occur frequently
- Loss of weight
- Leg weakness or numbness
- Extreme thirst
WHAT ARE THE CAUSES OF MULTIPLE MYELOMA?
It is unknown what causes myeloma. Myeloma is known to start with one aberrant plasma cell in your bone marrow — the soft, blood-producing tissue that fills the middle of most of your bones. The aberrant cell proliferates fast.
Because cancer cells do not mature and subsequently die like regular cells, they collect and eventually outnumber healthy cell creation. Myeloma cells squeeze out healthy blood cells in the bone marrow, causing exhaustion and an inability to fight infections.
Myeloma cells continue to try to create antibodies, much like healthy plasma cells, but they produce aberrant antibodies that the body cannot employ. Instead, the aberrant antibodies (monoclonal proteins, or M proteins) accumulate in the body, causing complications such as kidney damage. Cancer cells can also cause bone deterioration, increasing the likelihood of a shattered bone.
WHAT ARE THE RISK FACTORS FOR MULTIPLE MYELOMA?
The following factors may increase your risk of developing multiple myeloma:
- Getting older: Multiple myeloma is more common as you become older, with most persons diagnosed in their mid-60s.
- Male gender: Men are more prone than women to develop the condition.
- The black race: Black people are more prone than other races to acquire multiple myeloma.
- Multiple myeloma in the family: You are more likely to develop multiple myeloma if a brother, sister, or parent has the disease.
- Personal history of a monoclonal gammopathy of undetermined significance (MGUS): Because multiple myeloma nearly invariably begins as MGUS, having this condition doubles your risk.
WHAT ARE MULTIPLE MYELOMA COMPLICATIONS?
Multiple myeloma complications include:
- Infections that occur frequently: Myeloma cells impair your immune system's ability to fight infections.
- Problems with the bones: Multiple myeloma can also impact your bones, causing discomfort, bone weakening, and shattered bones.
- Kidney function is impaired: Multiple myeloma can impair kidney function, leading to renal failure.
- Anemia (low red blood cell count): Multiple myeloma can cause anemia and other blood issues because myeloma cells force out normal blood cells.
HOW IS MULTIPLE MYELOMA DIAGNOSED?
Doctors frequently discover multiple myeloma before any symptoms appear. Routine physical examinations, blood testing, and urine tests can all reveal indications of this malignancy.
More testing will be required if your doctor discovers indicators of myeloma in the absence of symptoms. Your doctor can use the following tests to evaluate the progression of the condition and determine whether you require therapy.
Urine and blood tests: M proteins are detected via blood and urine testing. These proteins could be the result of multiple myeloma or another illness. Cancerous cells also produce a protein known as beta-2 microglobulin, which is detected in your blood. Blood testing can also be used to determine the following:
- your bone marrow's plasma cell percentage
- kidney function
- blood cell counts
- calcium levels
- amounts of uric acid
Imaging tests: The following tests can be performed to assess whether multiple myeloma has caused bone damage:
- X-rays
- MRI scans
- CT scans
- PET scans
Biopsy: During a biopsy, a doctor extracts a small sample of bone marrow, which is then tested in a laboratory for malignant cells. Various tests can be used to assess the sorts of abnormal traits in the cells as well as the rate at which the cells multiply.
These tests are performed to detect if you have multiple myeloma or another plasma cell disorder.
MULTIPLE MYELOMA STAGING
If multiple myeloma is discovered during the diagnostic process, doctors will conduct specific tests to evaluate how far it has progressed. This is referred to as cancer staging. Tests look at:
- blood cell counts
- Protein levels in the blood and urine
- blood calcium levels
Multiple myeloma can be staged in two ways:
Durie-Salmon Staging System: This is determined by M protein, calcium, and red blood cell levels, as well as the degree of bone injury.
International Staging System: This is based on blood plasma and beta-2 microglobulin levels.
Both approaches categorize the disease into three phases, with the third being the most severe. Staging assists your doctor in determining your prognosis and treatment options.
WHAT ARE THE TREATMENTS FOR MULTIPLE MYELOMA?
Multiple myeloma has no known cure. There are, however, medicines available to assist alleviate pain, prevent complications, and delay the advancement of the condition. Treatments are only employed if the condition is progressing.
If you don't have any symptoms, your doctor is unlikely to recommend treatment. Instead, your doctor will keep a careful eye on your condition for indicators of illness progression. This frequently entails regular blood and urine tests.
If you want medical attention, the following are popular options:
Targeted therapy: Medication used in targeted therapy blocks a substance in myeloma cells that breaks proteins, causing the cancer cells to die.
Bortezomib (Velcade) and carfilzomib are two medicines that may be utilized during targeted therapy (Kyprolis). Both are given intravenously, or via a vein in your arm.
Biological therapy: Biological therapy drugs target myeloma cells via your body's immune system. Thalidomide (Thalomid), lenalidomide (Revlimid), or pomalidomide (Pomalyst) pills are commonly used to enhance the immune system.
Lenalidomide works similarly to thalidomide but has less negative effects. It appears to be more potent as well.
Radiation therapy: Radiation therapy employs high-energy beams to harm myeloma cells and halt their proliferation. This form of treatment is occasionally used to fast eliminate myeloma cells in a specific part of the body.
It may be done, for example, when a cluster of abnormal plasma cells forms a tumor known as a plasmacytoma, which causes pain or damages bone.
Chemotherapy: Chemotherapy is a type of vigorous chemical therapy that aids in the death of rapidly developing cells, such as myeloma cells. Chemotherapy medications are frequently administered in large quantities, particularly prior to a stem cell transplant. The drugs can be administered intravenously or orally.
Corticosteroids: Myeloma is frequently treated with corticosteroids such as prednisone and dexamethasone. They have the ability to balance the immune system by lowering inflammation in the body, and as a result, they are frequently efficient in killing myeloma cells. They can be taken as pills or administered intravenously.
Stem cell transplants: In stem cell transplants, damaged bone marrow is replaced with healthy bone marrow. The healthy marrow is derived from either a donor's stem cells (allogenic) or your own stem cells (autologous).
Blood-forming stem cells are extracted from the patient's blood prior to the surgery. Radiation therapy or high-dose chemotherapy is then used to treat multiple myeloma.
After the damaged tissue is removed, the stem cells are pumped into your body, where they migrate to the bones and begin rebuilding bone marrow.
Complementary and alternative medicine: Complementary medicine (also known as integrative medicine) has grown in popularity as a means of coping with the symptoms of multiple myeloma and the adverse effects of treatment.
While these treatments cannot treat or cure multiple myeloma, they may help to alleviate some of your symptoms.
Before attempting these therapies, consult with your doctor. You'll want to be certain that they're appropriate for you and your present health situation. Therapies could include:
- acupuncture
- aromatherapy
- massage
- meditation
- relaxing techniques