Everything You Need to Know About Multiple Myeloma
Every year, over 20, 000 Americans get diagnosed with multiple myeloma. Multiple myeloma is a type of cancer that usually starts from the bone marrow. The plasma cells in your bone marrow get altered. Plasma cells are a kind of white blood cells that help to recognize foreign elements in your body. Once the body recognizes foreign elements, it activates antibodies to fight against the foreign substances.
If you have been diagnosed with multiple myeloma, it means that cancer cells have multiplied in your bone marrow such that they have overcome the healthy blood cells. This is to such an extent that your healthy cells are no longer able to fight off antibodies. Moreover, your body will now start producing toxic substances that will destroy your kidneys. This will lead to other signs and symptoms.
If you know the early signs and symptoms of multiple myeloma, then you can be able to detect it when it is still in its early stages. This will help you to get medical intervention in time.
Multiple Myeloma’s Effect on Your Body
Normal cells in the body mature and then die. However, this does not happen when it comes to cancer cells. Cancer cells keep living and they accumulate in the body. When it comes to multiple myeloma, the cancer cells keep multiplying and they eventually overcome the healthy cells in the bone marrow. This can lead to you becoming anemic, exhausted all the time and getting frequent infections.
The myeloma cancer cells produce toxic substances in the body. These are referred to as monoclonal proteins. When these proteins build up in your body, they can eventually damage your kidneys.
Multiple Myeloma Causes
Scientists are still not sure what causes multiple myeloma. However, they know that multiple myeloma happens when genetic errors take place in the DNA of plasma cells. This results in the cells multiplying fast and overproducing one type of antibody (immunoglobulin).
It is hard to prevent this type of cancer since it is hard to avoid the risk factors. Risk factors include having an immune disorder, radiation, certain kinds of viruses, family history, age and harmful chemicals. Therefore, at the moment, there is no known way of preventing this disease from occurring.
Multiple Myeloma Types
There are two main types of multiple myeloma:
Indolent Myeloma. Also referred to as Inactive myeloma, this type of disease does not have any noticeable outward symptoms. It develops gradually and does not damage the bones in any way. However, you will notice a little increase in the amount of M protein and M plasma cells.
Solitary Plasmacytoma. Also referred to as inactive myeloma, this results in the formation of a tumor in the body, most frequently on the bone. Even though it is quite responsive to treatment, you need to be closely monitored if you have it.
Multiple Myeloma Symptoms
Everyone is different and the symptoms experienced might greatly vary from one individual to another one. In addition, you are unlikely to notice any symptoms when the cancer is in the early stages. You are more likely to experience symptoms when the disease has advanced.
Some of the most common symptoms of multiple myeloma include:
Exhaustion. You will frequently feel tired. This is because the cancer cells have overtaken your healthy cells, making your body to work extra hard to fight off the disease.
Bone Problems. Since myeloma can hamper the growth of new bone cells, it can lead to you having issues with your bones. For instance, your bones might ache, become weak or break.
Kidney Damage. The toxic proteins that are produced by myeloma cells can lead to kidney damage or even kidney failure.
Anemia. You will get anemic given that myeloma cells crowd out healthy blood cells. This will reduce red blood cells count and white blood cells count.
Getting Sick Often. Since you have fewer antibodies, your body will find it more challenging to fight off infections.
Other signs that might show you have myeloma include:
- Throwing up
- Being disoriented
- Feeling dizzy
- Experiencing pain, especially in your abdomen or back
- Feeling thirsty
- Losing weight
- Loss of appetite
- Your legs getting swollen
- Urinating frequently
- Numbness in your legs or weakness
Who’s at Risk of Developing It?
There are several elements that might increase your chances of getting this disease.
Age. A lot of people who have been diagnosed with this disease are over 65 years old. Only 1% of people who had multiple myeloma were under the age of 35 years. This is according to The American Cancer Society.
Race. Blacks are more likely to develop multiple myeloma as compared to Caucasians.
Gender. more men than women are likely to develop this cancer.
Weight. According to The American Cancer Society, people who are overweight are at a higher risk of getting this disease as compared to people who are not obese.
Family Medical History. You are four times more likely to get this disease if someone in your family has had it. Nevertheless, family history accounts only for a small number of people who have had this illness. You are unlikely to inherit this disease from your parents.
Monoclonal Gammopathy of Undetermined Significance. The Mayo Clinic states that 3% of people over 50 years old have MGUS. Multiple myelomas can start off as MGUS.
Occupation. People in some occupations are at a slightly higher risk of getting multiple myeloma in comparison to people in other industries. This includes cosmetologists, firefighters and people who work in the agricultural, petroleum and leather industry.
Chemicals. Exposure to certain kinds of agricultural and industrial chemicals increases your risk of getting this disease. This includes herbicides, pesticides, heavy metal, petroleum products and different kinds of dust, such as asbestos.
Keep in mind that there are some people who develop this disease even without having any clear risk factors. Each patient is unique. In some cases, several factors interact with each other to lead to the development of this disease.
Multiple Myeloma Stages
In case you are diagnosed with multiple myeloma, the doctor should be able to tell you whether it is stage 1, 2 or 3. Stage 3 is the fatal stage as it is the most advanced stage of the disease. If you have stage 3 multiple myeloma, then you will be given an average of 29 months to live.
Stage 1. You might be a little anemic and have some amount of M protein in your blood.
Stage 2. You will be more anemic, have large amounts of M protein in your blood and some bone damage.
Stage 3. Large amounts of M protein, anemia, kidney damage
The doctor will use the Revised International Staging System (RISS) to know which stage of cancer you have.
Here are the factors that are used to determine myeloma stages:
- The quantity of albumin in the blood
- Level of LDH in the blood
- The quantity of beta 2 macroglobulin in the blood
- Gene abnormalities that are specific to this kind of cancer
Factors That Affect Survival Rate
The survival rates provided are just the average. Some people might live longer or shorter than this. Here are some of the factors that affect survival rate:
Age. The older you are, the lower your chances of survival. Younger people with this disease are more likely to survive longer than younger ones.
The Rate of Cell Growth. If your cells are growing at a fast rate, then it means that the cancer cells are likely to outgrow your healthy cells much faster. This means that your condition is likely to deteriorate much faster.
How Healthy Your Kidneys Are. This disease tends to affect your kidneys and damage them. If you were already having kidney problems prior to developing this disease, then it is quite likely that your condition will deteriorate much faster. Also, if the disease affects your kidneys badly, then this will make your situation worse.
Chromosomal Changes. In case your chromosome changes or there are abnormalities, then it is likely to affect you negatively.
How is Multiple Myeloma Diagnosed?
Your doctor will have to run several tests to help determine whether you have this disease. If they find out that you have multiple myeloma, then they will even be able to tell you whether it is stage 1, 2 or 3. There are so many signs of this disease that you cannot be able to see with your naked eyes that is why it is important to carry out the tests.
The doctor will use the International Staging System to determine what stage the cancer is in.
The free light chain blood test is reliable and it can be able to diagnose the disease in its early stages. A lot of people have abnormal protein levels in their blood for many months or even years without knowing it. When this disease is diagnosed early, you can minimize the chances of organ damage.
For a biopsy to be done, the doctor will make a small incision on your hip and then insert a long thin needle into your hip bone marrow, so as to get a sample of the bone marrow. Before the need is inserted, local anesthesia will be administered, so that the area around your hips gets numb. You might also be made to go to sleep before the test is done. The bone marrow sample obtained will then be analyzed in a lab to check for any abnormal plasma cells in the bone marrow.
Other Biopsy Tests
In case you have a swollen lymph node or you have a tumor, a long thin needle will be inserted in the tumor or lymph node and a small sample removed. The sample will then be tested to check for cancer cells.
Bone x-rays can be done to check if there is any damage to the bones that have been caused by myeloma cells. A bone survey or skeletal survey will be done. This is basically an x-ray of most of the bones in the body.
A CAT scan is an x-ray that takes pretty detailed pictures of your entire body. This scan can help the doctor see if there is any kind of damage to your bones that might have been caused by myeloma cells.
This test uses special sugar and a camera to check the internal parts of your body. When it is inserted in your body, the sugar will highlight the areas where the cancer is situated.
This test is like a CAT scan in that it takes detailed photos of the body. However, in this case, MRI does not use x-rays to take photos like in the case of CAT scans; rather, it uses radio waves and strong magnets to take photos. Photos of the bones and the bone marrow will then be analyzed.
The University of Kansas did a research that resulted in the development of a small plastic chip that can be used to do a blood test for multiple myeloma. This chip is as small as a credit card and it is as effective as doing a bone biopsy.
In this test, blood is drawn from the patient and then tested. It is much cheaper than getting a biopsy done. This research was published in Integrative Biology. According to Steven Soper, the lead researcher and also a professor of Chemistry and Mechanical Engineering at KU and also a member of the University of Kansas Cancer Centre, they have been doing this research for 10 years to find a blood test for detecting different cancers. From the results obtained from the blood test, the doctor will even be able to know the multiple myeloma is at which stage and the best type of drug for the patient to use to treat it. The doctor will also be able to monitor the patient on a regular basis even if the disease is in remission.
According to Doctor Robert Kyle, a professor of medicine and laboratory medicine at the Mayo Medical School, you should get diagnosed if you have anemia but there are no known causes for this. Also, if your bones are aching or your kidneys stop functioning properly, yet you do not have high blood pressure or even diabetes.
Blood Count Test
Most people who have this disease will have a low red blood cell count.
Your urine and blood will be drawn to test for antibodies. Most people who have multiple myeloma have high levels of antibodies.
Blood Chemistry Test
This will be done to check how your kidneys are functioning. It will check the levels of calcium, potassium, sodium and other chemicals that can be found in your blood.
What’s Next After Diagnosis?
Once you get diagnosed with this disease, you will need to get lots of care from a team of doctors. The doctors will work together to come up with a treatment plan that is aggressive enough to deal with cancer.
This team includes:
A Medical Oncologist. An oncologist is a doctor who has specialized in treating cancer using medical interventions such as chemotherapy.
Orthopedic Surgeon. This is a surgeon who specializes in treating bones using surgical intervention.
Bone Marrow Transplant Specialist. This is a specialized cancer doctor whose focus is on carrying out bone marrow transplants.
Radiation Oncologist. This doctor treats cancer using radiation.
Other specialists that you might also work with includes
- Social worker
If the disease is still in its early stages, you might not necessarily need immediate treatment. When you have stage 3 of multiple myeloma, then the treatment administered will mainly help to minimize the discomfort that the disease is causing. Treatment can help to prevent cancer from growing.
Here are some of the treatment methods used:
This is a standard treatment that is administered to all cancer patients. This therapy destroys cancer cells in the body. The specific agents that are used in chemotherapy for multiple myeloma are doxorubicin hydrochloride and alkylating agents.
Chemotherapy Side Effects
Chemotherapy has so many side effects:
- Loss of hair
- Developing sores in your mouth
- Loss of appetite
- Frequent infections
- Bleeding and getting bruised easily
However, once you stop chemotherapy, you will no longer experience these side effects. Talk to your doctor, so that they can help you deal with the symptoms experienced.
This option is best used during the early stages of the disease. During radiation, high energy rays are used to destroy the cancer cells. This treatment is often used in myeloma cases which have failed to respond to other kinds of treatments, yet they are causing you lots of pain.
Radiation Side Effects
- The skin around the area that is being treated will change
Stem Cell Transplant
The main aim of this surgery is to remove your bone marrow, which has cancer and replace it with healthy bone marrow that does not have cancer. But before the surgery is done, you might be required to get high doses of chemotherapy.
These drugs include lenalidomide, thalidomide, and pomalidomide. The main aim of these medicines is to help your body fight off cancer.
This includes medicines like prednisone and dexamethasone. The main function of these medicines in the body is to minimize swelling in the body and stabilize the immune system.
Protease inhibitors kill off the cancer cells by preventing the cells from growing. They do this by taking advantage of any abnormalities that might be in the myeloma cells. Examples of protease inhibitors include carfilzomib and bortezomib.
It’s quite likely that your doctor will not just put you on one treatment; rather they are going to combine different treatments to increase chances of success. For instance, you might be out on protease inhibitors, immunomodulatory drugs, and corticosteroid.
Before you start treatment, it is essential that you talk to the doctor about all the possible options and what to expect during treatment. You might also want to get a second opinion, so as to put you at ease about which treatment option you go for.
This therapy is used to help minimize complications caused by this disease and the treatments used. For instance, in order to help you maintain your bone strength, bisphosphates can be prescribed to help keep your bones strong.
What to Expect After Treatment
At the moment, there is no known cure for this disease. However, more research is being done in this area to come up with treatments that will completely eliminate cancer.
Even though you might not get completely cured after treatment, you might have remission. During such times, you can go for long periods of time when you are okay and do not need any medical intervention. But if the illness does not go into remission, you will have to continue with your regular treatment plan. This includes undergoing chemotherapy, using drugs, radiation etc.
Whether you are in remission or you are on treatment, it is important that you undergo frequent check-ups. During the checkup, the doctor will ask about any symptoms that you might be feeling. They will then do a number of tests, such as blood tests, x-rays or CT scans.
What if Multiple Myeloma Doesn’t Respond to Treatment?
There are some cases where cancer might fail to respond to treatment at all. When this is the case, you will have to weigh the benefits of continuing treatment versus the advantages of stopping treatment. It is best that you consult your doctor before you decide what to do. In case you choose to stop treatment, be sure to get supportive care to help you deal with the pain and symptoms that you will be experiencing.
In case you opt not to continue with treatment, it is best that you opt for palliative care. While this will not prevent the disease from progressing, it will help in relieving the symptoms experienced. This will greatly improve the quality of your life. The end goal of this care is to ensure that your life is as comfortable as possible as your life nears the end. For instance, you will get pain medication and medication to control nausea. You can also get palliative care even when you are undergoing treatment like chemotherapy. This will help you to deal with the side effects of treatment.
Palliative care involves a number of things. This includes counseling, occupational therapy, nutritional therapy, drug therapy and physical therapy.
In addition, you can ask your doctor about clinical trials in case you are not responding to regular treatment. You must know that there are no promises in clinical trials, but it can also work for you, this is because scientists are always coming up with new experimental drugs that can be used to treat the condition. The doctor will refer you to a clinical trial specialist. Participating in clinical trials can help to lengthen your life.
If the disease progresses to the point of being terminal, your doctor might recommend that you get hospice care. This can happen in a nursing home or even in your home. You do not necessarily have to be bedridden to get hospice care. You can live your life to the fullest for as long as possible. Hospice care focuses on relieving the symptoms of the disease, such as nausea, vomiting, and pain. You will have to stop any cancer treatment that you are undergoing.
You might want to try out other complementary treatments that your doctor might not have mentioned in addition to the medical treatments that you are getting. The main aim of these complementary treatments is to help give you relief from your symptoms.
When you have multiple myeloma, chances are that you will not have an appetite and you will struggle to eat. Since this disease causes anemia, eat foods that are rich in iron, such as raisins, kale, red meat and broccoli and lots of tropical fruits.
Since this disease might also cause kidney damage, minimize foods that can be hard on your kidneys, such as alcohol, salt, protein, and potassium. Also, reduce water intake if kidney damage is severe.
Reduce the amount of calcium, since calcium levels in your blood, will be high as a result of damage to your bones.
Also, eat cooked foods, since raw foods increase your risk of getting infections since your immunity is low. This includes raw vegetables.
Exercise more on a regular basis. This will help to build up your muscle strength, as this tends to decline when you are undergoing treatment. However, make sure to do exercises that are not too hard on your body. Start with less intense exercises like walking.
Doing relaxation techniques like yoga and meditation can help to relieve your symptoms. It will also help to calm down your mind, as well as your body.
This is quite helpful when it comes to helping you get relief from pain. It will also help you if you have depression and anxiety. It also minimizes nausea that comes about as a result of cancer treatment.
There are different kinds of herbs that you can use to help you deal with the symptoms of this disease.
- Curcumin, which is found in turmeric, is believed to kill cancer cells or cause tumors to die.
- Astragalus is Persian and Chinese medicine. It is quite effective when it comes to restoring white blood cells that have been attacked by myeloma.
- Goldenseal has antibacterial properties that are great at fighting off infections. It is good to use it because of your reduced immunity that makes you susceptible to infections. It is also aids in digestion.
- Cayenne pepper has capsaicin that helps the myeloma medications that you take the fight off this disease.
- Acupuncture will help you deal with the side effects that you might get from treatment, such as nausea and vomiting, insomnia, dry mouth and hot flashes.
- Vitamins can help you deal with the fatigue that you will feel and lack of energy.
- You need to rest a lot, so as to recoup your energy. Also, get plenty of sleep. Before you try out any alternative treatment, it is best that you first talk to your doctor and ask for their advice about what you want to use.
It is important that you get support to help you deal with this disease. This includes support for family members as well. You can join support groups near you or even find online support groups.
You will need a lot of psychological support due to the emotions that this kind of cancer can evoke in you. In case the treatment you undergo is successful and the cancer is destroyed from your body, you will still have to deal with the worry of cancer coming back in addition, if the disease does not go away, you will still need regular treatments. This can cause lots of stress on you. Therefore, it is important that you get psychological help and support from a professional, as well as from your friends and relatives.
Even though this disease does not have a cure, do not get discouraged. This is even if you have a relapse after you had started getting better. You can explore different kind of treatments that are available. If your body does not respond to one kind of treatment, try out others and figure out what works for you. It is possible for you to still live for a long time even with this disease, provided you are getting the required treatment to help keep the disease under control. Always talk to your doctor to know what is going on with your help and seek a second or even third opinion if necessary.
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