Multiple myeloma is a type of cancer forming in white blood cells referred to as plasma cells. The body fights infections with healthy plasma cells capable of creating antibodies for recognizing and attacking germs. When the individual has multiple myeloma, there is an accumulation of cancerous plasma cells in the bone marrow forcing out the healthy blood cells.
Instead of the production of important antibodies, abnormal proteins are produced by the cancer cells often resulting in complications. Treatment for this disease is not always required immediately. If the multiple myeloma is not causing any symptoms and is slow-growing, close monitoring may be recommended as opposed to immediate treatment.
When treatment is necessary, there are a variety of options to help control multiple myeloma. This condition is also referred to as Kahler's disease. Although there is currently no cure, treatments are available to slow the spread of the disease. In some cases, the symptoms will disappear.
When multiple myeloma is in the earlier stages, symptoms might not be present or they can be extremely mild. The effects for everyone with multiple myeloma are different. The most general symptoms of the disease include:
• Extreme thirst
• Frequent fevers and infections
• Loss of appetite
• Pain in the bones including the skull, ribs, and back
• Weight loss
• Nausea and vomiting
• Changes in urinary patterns including frequency
• Numbness most frequently in the legs
The impact of multiple myeloma on the body varies including bones becoming weak and easily breakable. Since blood is made by the bone marrow, the disease can impact the number of healthy blood cells in the body. When there is a shortage of red blood cells, it is called anemia. This condition can result in shortness of breath, weakness, and dizziness.
A shortage of white blood cells is referred to as leukopenia. This condition makes infections easy to get including pneumonia. Recovery from an infection generally requires more time. Thrombocytopenia is a shortage of platelets. This condition makes it more difficult for wounds to heal and causes excess bleeding for minor cuts. Multiple myeloma can also result in excess calcium in the blood resulting in:
• Stomach pain
• Loss of appetite
• Frequent urination
• A coma can result if the condition is severe
The combination of high calcium levels and multiple myeloma can be harmful to the kidneys abd make it more difficult to filter blood. The body can become unable to eliminate excess waste, fluid and salt causing the following symptoms.
• Shortness of breath
• Swelling in the legs
There is no definitive answer for what causes multiple myeloma. If you fit into any of the following categories, you are more likely to get this disease.
The risk of multiple myeloma increases with age. The majority of people diagnosed with this disease have reached their middle 60s. The American Cancer Society released data showing fewer than one percent of all individuals diagnosed are less than 35 years of age.
If one of your parents or siblings has been diagnosed with multiple myeloma, you have a higher risk than an individual with no history of the disease in their family. Despite this, the number of multiple myeloma cases diagnosed with a family history remains small.
African-Americans have double the risk of developing this disease than Caucasians.
The risk of developing multiple myeloma is higher for obese and overweight individuals.
Women are less likely to develop this disease than men.
In nearly every instance, this disease started as MGUS or monoclonal gammopathy of undetermined significance. This condition is diagnosed when M proteins are present. Approximately three percent of every American above 50 has MGUS.
As the disease advances, complications often result including:
When normal blood cells are pushed from the bone marrow to be replaced with cancer cells, the result can be blood problems such as anemia.
As the healthy plasma cells are crowded out by myeloma cells, the body starts to lose the ability to fight infections.
Myeloma cancer cells produce harmful antibodies called M proteins. This can cause kidney damage, issues with kidney function and result in kidney failure.
Common complications of this disease include broken bones, weakened bones and bone pain. Eroding and damaged bones can increase the level of calcium in the blood. Higher levels can affect the ability of the kidneys for filtering waste.
Multiple myeloma is often detected by physicians before the presence of symptoms. This type of cancer can be found with urine tests, blood tests, and physical exams. If signs of this disease are found, additional tests are necessary. The progression of the disease can be monitored by a physician to determine when treatment is required. Urine and blood tests are performed to look for M proteins.
Several conditions including multiple myeloma can cause these proteins. The beta-2 microglobulin protein is made by cancerous cells and located in the blood. Blood tests are important for assessing:
• Plasma cell percentage within the bone marrow
• Blood cell count
• Levels of uric acid
• Kidney function
• Calcium levels
When a biopsy is performed, the physician removes a small bone marrow sample using a long needle. Once obtained, the sample is sent to a lab to check for cancerous cells. The types of abnormalities located within the cells and the rate of multiplication can be determined by conducting various tests.
These tests show if the individual has multiple myeloma or a different condition. If the test is positive for multiple myeloma, tests are performed to determine the progression of the disease.
Imaging tests are used to determine if there is bone damage from multiple myeloma. This includes CT scans, MRI scans and X-rays.
The staging of multiple myeloma includes:
• Blood cell counts
• Levels of calcium in the blood
• Protein levels in the urine and blood
• Diagnostic testing results
Multiple myeloma can be staged in two different ways. The basis for the Durie-Salmon system is the levels of red blood cells, calcium and M protein in addition to the amount of bone damage. The basis for the International Staging System is beta-2 microglobulin and blood plasma levels. The condition is divided into three stages for both systems. The most severe is the third stage.
Multiple myeloma currently has no cure. Several different treatments have been developed to slow progression, decrease complications, and help with the pain generated by the disease. Treatments will not be used until the disease starts to get worse. If there are no symptoms, the physician will probably not recommend treatment.
The physician generally monitors the individual to determine when the disease progresses. In most cases, regular urine and blood tests are used to monitor multiple myeloma. Once treatment becomes necessary, one or more of the following options are generally used.
Medications used for biological therapy have been developed to attack myeloma cells using the immune system of the individual. The majority of medications are available in pill form and are used for boosting the immune system. Although most of these types of medications are similar, some are more potent than others and the side effects are different.
Medications used for targeted therapy block the chemical located within myeloma cells responsible for the destruction of proteins. The result is often the death of the cancer cells. There are several different drugs used for targeted therapy that can be given in a vein in the arm or intravenously.
Corticosteroids are frequently used for the treatment of multiple myeloma. Corticosteroids help by balancing the immune system through a reduction in inflammation. This makes them effective for the destruction of myeloma cells. Corticosteroids are given intravenously or in pill form.
One of the most aggressive types of drug therapy is chemotherapy or chemo. Chemo helps destroy fast-growing cells such as myeloma cells. The doses of chemotherapy drugs are high. This is especially true if the drugs are administered prior to a stem cell transplant. The drugs are administered in pill form or intravenously.
Radiation therapy involves the use of strong energy beams for damaging myeloma cells while preventing their growth. Radiation therapy is used to quickly kill myeloma cells in a specific part of the body.