What is Myeloma?
In order to understand the answer of “what is myeloma?”, you need to know that it is also named as multiple myeloma, or Kahler’s disease. It is a form of blood cancer that affects the plasma cells of the blood. Healthy plasma cells are produced in the bone marrow and they play a vital role in the immune system by making antibodies that help fight off infection.
Multiple myeloma causes abnormal growth of the plasma cells, resulting in cancerous cells eventually outnumbering normal blood cells in the bone marrow. These cancerous plasma cells produce abnormal proteins, rather than antibodies, that can lead to complications, including frequent infections, bone issues, impaired kidney function, and/or anemia.
Symptoms of Multiple Myeloma
In most cases, there are no signs and symptoms of early stage multiple myeloma. When signs and symptoms occur, they vary, and may include:
- Pain in bones, especially in the rib and spine area
- Fragile bones
- Digestive disorders (i.e. constipation or diarrhea)
- Decreased appetite
- Frequent infections that persist
- Numbness in the arms and legs
- Feeling thirsty all the time
Causes of Multiple Myeloma
It’s hard to pinpoint a specific cause for this cancer, with most researchers believing it is the result of genetic factors. However, there are risk factors that may trigger this cancer, including:
- Age (over 65 years)
- Male sex
- Black race
- Family history of multiple myeloma
- Previous history of a monoclonal gammopathy of undetermined significance (MGUS)
How is It Diagnosed?
In some cases, myeloma is diagnosed incidentally when a blood test is ordered for an unrelated condition. In other cases, your signs and symptoms may point towards a diagnosis of multiple myeloma. There are various diagnostic tests and procedures that may be performed to diagnose multiple myeloma, including:
- Blood tests. Results may show: M proteins, beta-2-microglobulin, high levels of calcium, low red blood cell count, high level of total protein with low levels of albumin.
- Urine tests. Results may show: M proteins (Bence Jones proteins).
- Exams. They will perform an examination of the bone marrow
- Imaging. This can include an x-ray, CT scan, MRI, or positron emission tomography (PET scan).
If these diagnostic tests and procedures determine that you have myeloma, your disease will be classified as stage 1 to 4 and will also be assigned a risk category indicating the aggressiveness of the cancer, which helps to determine treatment and prognosis.
Understanding the Treatments
Unfortunately, there is no cure for multiple myeloma, however, there are various treatments available to help slow the progression of the disease and reduce the associated symptoms. If you don’t have any symptoms, your oncologist may decide to monitor you closely rather than initiating treatment.
If you have symptoms, your oncologist will develop a treatment plan based on your health in general and past medical history. If you are at high-risk, they may suggest a clinical trial for more effective treatment.
Some of the standard treatment options include:
Chemotherapy drugs are used to kill fast-growing myeloma cells. It can be administered intravenously or taken in the form of pills. It’s typically prescribed before a bone marrow transplant. Chemotherapy drugs that are used to treat multiple myeloma may be:
- Bendamustine (Treanda)
- Cyclophosphamide (Cytoxan)
- Doxorubicin (Adriamycin)
- Etoposide (VP-16)
- Liposomal doxorubicin (Doxil)
- Melphalan (Alkeran, Evomela)
- Vincristine (Oncovin)
Dexamethasone and prednisone are corticosteroids that can be taken through IV or orally. They are used to control the body’s immune system and slow the progress of multiple myeloma.
Targeted therapy attacks specific abnormalities within the cancer cells. Carfilzomib (Kyprolis), bortezomib (Velcade), and ixazomib (Ninlaro) are drugs that restrict the multiple myeloma cells from breaking down proteins. As a result, it slows down the multiplication process. Monoclonal antibody is another type of targeted drug that attaches itself to specific proteins of the cancer cells causing them to die.
These drugs boost your body’s immune system to fend off multiple myeloma cells. They also prevent cancer cells from forming new blood vessels causing them to starve and die. Biologic drugs are taken orally and include:
- Thalidomide (Thalomid)
- Lenalidomide (Revlimid)
- Pomalidomide (Pomalyst)
Bone Marrow Transplant
Doctors may prescribe bone marrow transplant, commonly called a stem cell transplant. During this procedure, the abnormal cells in your bone marrow are replaced by healthy bone marrow. Before the treatment, some of the blood-forming stem cells in the bone marrow are separated, frozen, and stored. Stem cells can also be collected from a donor.
Next, you will receive a very high dose of chemotherapy and sometimes radiation. This completely destroys all of the cells in the bone marrow along with the multiple myeloma cells. Then, the doctor puts the saved or donated stem cells into your bloodstream through a catheter tube. These stem cells replace the destroyed bone marrow and start generating new blood cells. This process may take several weeks to refresh all of the blood cells.
This treatment may help you live longer, but unfortunately, it does not cure multiple myeloma. Additionally, it can compromise your immune system and make you vulnerable to infections.
Radiation therapy uses high-energy beams to shrink tumors (plasmacytoma) and stop cancer cells from multiplying.
Clinical Trials for Multiple Myeloma
If you are not responding to the aforementioned treatments, your doctor may suggest you consider a clinical trial, as there is ongoing advanced research to fight multiple myeloma.
Taking Care of Yourself
Living a healthy lifestyle can help you fight multiple myeloma. Your body needs to stay nourished for the treatment to work effectively. You may want to consider consulting a dietitian to develop a meal plan that is suited for you. Additionally, staying active is crucial for your physical and mental health – it is also good for your bones! But do not overdo it, and ensure you get plenty of rest as well.
It’s important to remember that you will need a lot of motivation to get through chemotherapy and other cancer treatments. Joining a support group, or seeking out the help of a counselor can help you get through this difficult time.
Although multiple myeloma is incurable, with proper treatment, it is manageable. Some patients can live for a lengthy period of time with few symptoms. For others, things may turn worse very quickly. It’s important to discuss all treatment options with your oncologist to determine the best treatment plan for your condition.