What You Need To Know About Multiple Myeloma

Multiple myeloma is a relatively rare form of cancer, though it’s the second most common blood cancer in the United States. It affects the plasma cells, which are responsible for creating the antibodies that guard the body against infection. In 2021, it’s expected to affect almost 35,000 people and cause over 12,000 deaths.

Like other types of cancer, early diagnosis can increase survival rates. However, the disease doesn’t always produce symptoms and when it does, people don’t relate them to myeloma. In fact, many patients end up getting a diagnosis when getting unrelated blood tests.

What Is Multiple Myeloma?

Multiple myeloma is a cancer that alters the plasma cells in the bone marrow (the soft tissue in the center of the bones). Being a type of white blood cells, plasma cells’ function is to create antibodies – a protein that helps fight the pathogens that cause diseases. But when these cells become cancerous, they pile up in the bone marrow, produce abnormal antibodies, and form tumors that weaken the bones and prevent the bone marrow from generating healthy cells.

There are several types of myeloma. These include:

• Monoclonal Gammopathy of Undetermined Significance (MGUS) – Abnormal cells don’t have an impact on your health and treatment is not necessary. Progression rates towards active myeloma are minimal.
• Smoldering Myeloma – Essentially the second stage of the illness. There are more abnormal cells in the bone marrow, and while there are still no symptoms, the progression of the disease is faster.
• Solitary Plasmacytoma – Abnormal cells produce only one bone tumor, usually removable. This is a kind of active myeloma.
• Light Chain Myeloma – This happens when the myeloma cells don’t make a whole antibody (they’re just in the light chains of the protein).
• Active Multiple Myeloma – The symptomatic stage of the illness.

Early Signs and Symptoms

The earliest signs of multiple myeloma appear in the blood, which is why it’s often detected first in blood tests. Given that the cancerous cells are in the bones, common symptoms include:

• Brittle bones
• Frequent infections
• Limb weakness
• Bone pain
• Excessive bruising
• Difficulty breathing
• Fatigue

Since myeloma affects the body’s ability to produce healthy blood, complications often include:

• Hypercalcemia – An increase of calcium in the blood that can cause dehydration, cramps, drowsiness, mental fogginess, abdominal pain, arrhythmia, kidney failure and even coma.
• Spinal cord compression – Occurs when the weakened bones collapse over the spinal nerves. This is a painful condition that numbs the legs and can result in paralysis if untreated.
• Peripheral neuropathy – Abnormal proteins can be toxic to the nerves and cause numbness, weakness, and tingling.
• Hyperviscosity – Abnormal proteins can thicken the blood and reduce the blood supply in the eyes or in the brain, producing visual disturbances and neurological symptoms.
• Anemia – Red cells carry oxygen to the other cells in your body, so not having them in the right amount can lead to shortness of breath, dizziness, and fatigue.

Treatment Options

Treatment for multiple myeloma depends on whether the disease has progressed to the stage in which symptoms are present. Sometimes, in the early stages, physicians recommend a watch and wait approach, which involves frequent check-ups, but no treatment. However, the following treatments can be used:

• Targeted therapy – Drug therapy that targets specific components of the cancerous cells. Patients often take two to three as part of a “cocktail.”
• Biological therapy – Medications that support the body’s immune system to suppress cancer growth
• Chemotherapy – To kill cancerous cells. Extremely high doses of chemotherapy are used before bone marrow transplants
• Bone marrow transplant – Healthy bone marrow is taken from a suitable donor and implanted in the myeloma patient’s bones
• Stem cell transplant –  New, healthy blood-forming stem cells are given after high-dose chemotherapy.

If you’re experiencing any symptoms, contact your doctor. Although an early diagnosis doesn’t guarantee a better prognosis, healthcare professionals can monitor the disease and help devise a plan.