MYELOMA

MYELOMA

Myeloma is a type of cancer that affects plasma cells. Plasma cells are a type of white blood cell found in bone marrow, which is the soft tissue inside most of your bones that produces blood cells. Myeloma occurs when an abnormal plasma cell develops in the bone marrow and reproduces itself very quickly. The rapid reproduction of malignant, or cancerous, myeloma cells eventually outweighs the production of healthy cells in the bone marrow. As a result, the cancerous cells begin to accumulate in the bone marrow, crowding out the healthy white blood cells and red blood cells.   What Are The Symptoms Of Myeloma? These symptoms are generally referred to by the acronym CRAB, which stands for:

  • calcium
  • renal failure
  • anemia
  • bone damage
High levels of calcium in the blood come from affected bones leaking calcium. Too much calcium can cause:
  • extreme thirst
  • nausea
  • vomiting
  • upset stomach
  • loss of appetite
Confusion and constipation are also common symptoms of increased calcium levels. Kidney failure can be caused by high levels of M protein in the body. Anemia is a condition in which the blood doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body. This happens when cancerous cells outnumber red blood cells in the bone marrow. Anemia often causes fatigue, dizziness, and irritability. Bone injuries and fractures occur when cancerous cells invade the bone and bone marrow. These lesions appear as holes on X-ray images. They often cause bone pain, especially in the:
  • back
  • pelvis
  • ribs
  • skull
  • Additional symptoms of multiple myeloma may include:
  • weakness or numbness, especially in the legs
  • unintentional weight loss
  • confusion
  • problems with urination
  • nausea
  • vomiting
  • repeated infections
  • vision lossor vision problems
What Are The Risk Factors For Myeloma? People have a higher risk of developing myeloma if they’re:
  • male
  • over age 50
  • African-American
  • overweight or obese
  • exposed to radiation
  • employed in the petroleum industry
How Is Multiple Myeloma Diagnosed?   Doctors often detect multiple myeloma before any symptoms are present. Routine physical exams, blood tests, and urine tests can uncover evidence of this cancer. More tests will be needed if your doctor finds signs of myeloma when you don’t have symptoms. Using the following tests, your doctor can monitor the progression of the disease and determine whether you need treatment. Blood and urine tests Blood and urine tests are used to check for M proteins. These proteins may be caused by multiple myeloma or other conditions. Cancerous cells also make a protein called beta-2 microglobulin, which can be found in the blood. Blood tests can also be used to assess:
  • the percentage of plasma cells in the bone marrow
  • kidney function
  • blood cell counts
  • calcium levels
  • uric acid levels
Imaging tests X-rays, MRI scans, or CT scans can be used to determine whether bones have been damaged by multiple myeloma. Biopsy During a biopsy, your doctor removes a small sample of bone marrow with a long needle. Once a sample is obtained, it can be checked for cancerous cells in a laboratory. Various tests can determine the types of abnormalities in the cells and how quickly the cells are multiplying. These types of tests are used to determine whether you have multiple myeloma or another condition. If multiple myeloma is found, the tests can show how far it’s progressed. This is known as staging the cancer. Staging Multiple myeloma is staged by looking at:
  • blood cell counts
  • protein levels in blood and urine
  • calcium levels in the blood
The results of other diagnostic tests may also be used. There are two ways to stage multiple myeloma. The Durie-Salmon system is based on the levels of M protein, calcium, and red blood cells as well as the degree of bone damage. The International Staging System is based on the levels of blood plasma and beta-2 microglobulin. Both systems divide the condition into three stages, with the third stage being the most severe. Staging helps your doctor determine your outlook and treatment options. How Is Multiple Myeloma Treated? There’s no cure for multiple myeloma. However, there are treatments that can help ease the pain, reduce complications, and slow the progression of the disease. Treatments are only used if the disease is getting worse. Your doctor is unlikely to suggest treatment if you aren’t experiencing any symptoms. Instead, your doctor will closely monitor your condition for signs that the disease is progressing. This often involves regular blood and urine tests. If you need treatment, common options include the following: Targeted therapy Targeted therapy medications block a chemical in myeloma cells that destroys proteins, causing the cancer cells to die. The drugs that may be used during targeted therapy include bortezomib (Velcade) and carfilzomib (Kyprolis). Both are administered intravenously, or through a vein in your arm. Biological therapy Biological therapy medications use your body’s immune system to attack myeloma cells. The pill form of thalidomide (Thalomid), lenalidomide (Revlimid), or pomalidomide (Pomalyst) is usually used to boost the immune system. Lenalidomide is similar to thalidomide, but it has fewer side effects. It also appears to be more potent. Chemotherapy Chemotherapy is an aggressive form of drug therapy that helps kill fast-growing cells, including myeloma cells. Chemotherapy drugs are often given in high doses, especially before a stem cell transplant. The medications may be given intravenously or taken in pill form. Corticosteroids Corticosteroids, such as prednisone and dexamethasone, are often used to treat myeloma. They can balance the immune system by reducing inflammation in the body, so they’re often effective in destroying myeloma cells. They can be taken in pill form or given intravenously. Radiation therapy Radiation therapy uses strong beams of energy to damage myeloma cells and stop their growth. This type of treatment is sometimes used to kill myeloma cells quickly in a certain area of the body. For example, it may be done when a cluster of abnormal plasma cells form a tumor called a plasmacytoma that causes pain or destroys bone. Stem cell transplants Stem cell transplants involve replacing diseased bone marrow with healthy bone marrow from a donor. Before the procedure, blood-forming stem cells are collected from your blood. The multiple myeloma is then treated with radiation therapy or high doses of chemotherapy. Once the diseased tissue can be destroyed, the stem cells can be infused into your body, where they move into the bones and start rebuilding bone marrow. What Are The Complications Associated With Multiple Myeloma? Multiple myeloma can cause many complications, but they’re usually treatable:
  • Back pain can be treated with medications or a back brace.
  • Kidney complications are treated with dialysis or a kidney transplant.
  • Infections can be treated with antibiotics.
  • Bone loss can be slowed or prevented with drug therapy.
  • Anemia can be treated with erythropoietin. This medication stimulates the body to produce more red blood cells.