Blog Everything You Should Know About Multiple Myeloma

Everything You Should Know About Multiple Myeloma



Myeloma is cancerous disease caused by abnormal production of plasma cells.

Myeloma, also known as Kahler’s disease is rare cancerous disorder which prominently affects the bones by making them fragile and prone to breakage on encountering slightest injuries. It subsequently affects the normal functioning of other organs mainly kidneys. Despite the fact that the disease is incurable albeit the survival term can however be extended by befitting treatments and the progress can be slowed to some extent if recognized in the early stages. The genesis of the disease is unknown as it happens abruptly without showing symptoms initially.

Multiple Myeloma meaning

Our blood has three constituents the red blood cells, white blood cells and blood platelets and this disease is characterized by formation of malignant white blood cells which outcast red blood cells. Generally what happens is cells multiply and die, but these WBCs proliferate abnormally causing blood cancer. Excessive production of plasma cells may either lead to local collection of cancerous cells (plasmacytoma) or frank multiple myeloma, when these cell count turns out to be more than 10% of bone marrow. Plasma cells are associated with fighting infections and foreign bodies but when produced more than body’s requirement, complications arise. In this disease the WBCs also know as plasma cells found in the bone marrow reproduce at a faster pace. When produced in excess they may either spill out of the bone marrow and spread disastrously to other organs or form tumors and invade the bone marrow. These Plasma cells produce monoclonal protein which passes on to the blood and starts accumulating in the bones causing bone lesions. These cells surpass the count of red blood cells causing short fall which leads to “bone marrow failure”. Like normal cells abnormal cells also generate antibodies but the antibodies produced by them are profuse which have detrimental effects on the organs.

MYELOMA CAUSES:

The exact cause still remains unknown. A single abnormal cell instigates the whole process of reproduction of myeloma cells. These cells multiply rapidly causing cancer. The disease shows varied symptoms and progress may be dawdling (smoldering multiple myeloma). Some doctors link multiple myeloma with Monoclonal Gammopathy of Undermined Significance (MGUS) in which the M-protein is found in the blood when blood or urine tests are carried out. This condition may turn into blood cancer later, though the stage is considered safe and can be cured. Multiple myeloma is an extension of MGUS  if it revives by any chance in future.

WHO ARE MORE AT RISK?

  • People above 60 years of age
  • Who are frequently exposed to radiations
  • Generally affects males
  • Workers of petroleum and chemical factories
  • If family history of myeloma persists.

SYMPTOMS:

People at varied stages and different age groups show diverse symptoms but early diagnosis help combating the disease and reducing the ravage that may come with detection at a later stage. The disease’s symptoms are abbreviated as CRAB-

  • Calcium – Hypercalcaemia, large quantities of calcium enter the blood stream through leaking bones.
  • Renal disorder- kidney dysfunction or failure due to excessive release of m proteins which leads to clogging of renal veins restricting the filtration process.
  • Anemia- a condition where the healthy red blood count reduces so oxygenated blood does not reach various parts of the body.
  • Bone fragility- bone density decreases and chances of bone rupturing increases.

Thus the symptoms depicted are:

  • Bone tenderness
  • Weight loss
  • Pathologic bone fractures
  • Chronic tingling in bones
  • Persistent pain in the back, ribs, pelvic region, spinal cord compressions
  • Tooth mobility
  • Bone lesions and abrasions, clearly seen as holes in the bones in xray
  • Weakness of arms and legs
  • Numbness of arms and legs
  • Prone to frequent infections and fever
  • Breathing difficulty
  • Weakness and exhaustion
  • Easy bruising and bleeding

In addition, increase in the calcium levels ( hypercalcemia ) causes the following symptoms-

  • Severe thirst
  • Excessive urination
  • Nausea or vomiting
  • Constipation
  • Fatigue and enervation
  • Muscle tenderness and cramps
  • Discomposure
  • Brittle bones
  • Confusion and trouble thinking

If you feel any of the above symptoms and they are consistent, do get them checked with your doctor.

DIOGNOSIS:

  1. Some people might not show symptoms at early stages and indispensably don’t feel the need of treatment, also the symptoms might vanish after sometime. But in some cases the symptoms may worsen over time and immediate diagnosis is required. Doctor may advise some routine blood and urinary tests to keep a check on –
  • Red blood cell count
  • Levels of calcium in the blood
  • Low levels of albumin
  • Unusual protein production
  1. Bone marrow biopsy- in this a sample of your bone marrow is tested to see the abnormal growth of plasma cells.
  2. Imaging tests such as X-ray, CT scans, MRI to detect bone lesions if any.
  3. Serum protein Electrophoresis
  4. Immunofixations Electrophoresis

TREATMENTS

Treatments options vary for different age groups and stages. As the treatment varies from person to person, it is important to discuss side effects, duration of therapy with treating hematoncologist before starting any new drug. Treatments available are:

  • CHEMOTHERAPY
  • IMMUNOTHERAPY
  • AUTOLOGOUS STEM CELL TRANSPLANT- This therapy is given to patients below 65 years of age, wherein a part of stem cells are harvested, then the diseased bone marrow is treated with high dose of chemotherapy, high dose of chemotherapy helps in achieving high kills of myeloma cells with greater toxicity and post chemo the stem cells are infused which assist in healthy growth of new plasma cells. Post transplant the patient takes about 14- 20 days to recover.
  • RADIOTHERAPY- A cluster of cancerous cells usually in the form of tumor is detected.

FOLLOWUPS:

After the treatment the patient is kept under medical supervision and routine checkups are done in order to hunt down any traces of the proteins which may lead to relapse of the disease.

Regular urine and blood tests are conducted, bone marrow examination and PET scans are done. 

PREVENTION

Eat healthy- if you are unfortunately diagnosed with the disease, what can be done from your end is eat healthy foods, include right amount of proteins, vitamins and minerals in your diet.

Exercise- exercise on a regular basis. Avoid performing drills which are too strenuous and physically burdening. Light exercises, yoga and meditations are advised to keep the mind calm.

Gather support- in the time of such predicament, try and remain close to your loved ones for emotional support and healthy tangibility. The disease is fatal but whatever time you are left with cherish it.

– Dr. Gaurav Dixit
Consultant – Hemato Oncology

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