Multiple myeloma is a type of cancer that affects plasma cells, which are a type of white blood cell. It causes an abnormal increase in plasma cells in the bone marrow, leading to damage and weakening of the bones, anemia, frequent infections, and other symptoms. The exact cause of multiple myeloma is unknown, but risk factors include age, gender, family history, and certain genetic mutations. The prognosis for multiple myeloma varies depending on several factors, including the stage and type of the cancer, the patient’s age and overall health, and response to treatment. On World Cancer Day today, let’s take this opportunity to raise awareness about this disease.
“Myeloma is a type of bone marrow cancer. Bone marrow is the spongy tissue in the center of some bones that produces the body’s blood cells. It is called multiple myeloma because the cancer often affects many areas of the body, such as the spine, skull, pelvis, and ribs. It affects the plasma cells, which are a type of white blood cell responsible for producing antibodies,” says Dr. M. Srinivas Reddy, Senior Consultant Surgical Oncologist, Kamineni Hospitals, Hyderabad.
Multiple Myeloma is one of the common types of blood cancers accounting for about 8 to 10% of all blood cancers. “Patients of multiple myeloma may suffer from various symptoms like back pain, bone pain, weakness, fatigue, increased propensity to develop various infections, renal failure. Because of these varied clinical manifestations the patients may end up visiting doctors of various specialties like orthopedics, physicians, nephrologists and many other specialties,” says Dr. Mallikarjun Kalashetty, Consultant, Haematology, Haemato Oncology & Bone Marrow Transplantation, Manipal Hospital Old Airport Road.
Multiple myeloma is a relatively uncommon cancer, but its incidence is increasing. It typically affects older people, with the average age of diagnosis being around 70 years old. Despite its increasing incidence, multiple myeloma is often missed due to its subtle symptoms, which can be mistaken for other conditions.
Symptoms
Some of the common symptoms of multiple myeloma include fatigue, weakness, pain in the bones, and frequent infections. However, these symptoms are also common in many other conditions, making it difficult for doctors to diagnose multiple myeloma early on. Myeloma doesn’t usually cause a lump or tumour. Instead, myeloma damages bone and affects the production of healthy blood cells.
Diagnostics
Diagnosing multiple myeloma in present era of cancer diagnosis and therapy is fairly simple and can be achieved promptly. Initial evaluation of patients suspected to have multiple myeloma involves laboratory blood tests to look for the blood components, liver and kidney functions, and also to look for an abnormal cancer related protein called as monoclonal para protein, which can be easily done with basic blood tests called serum protein electrophoresis, serum immunofixation electrophoresis, and free light chain assay. In most cases the diagnosis is confirmed with bone marrow examination. Multiple Myeloma affects the bones, weakens them and makes them prone for fracture. Various imaging techniques are available now to assess the Multiple Myeloma associated bone disease. We also use advanced molecular genetic techniques to risk stratify the cancer and use targeted therapy.
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“A high index of clinical suspicion is important to diagnose multiple myeloma. One of the key tests for multiple myeloma is a blood test that measures the levels of certain proteins in the blood, such as M protein, by immune electrophoresis. This test can help detect multiple myeloma early on, when it is more treatable. Urine analysis shows BenceJones proteins,” adds Dr Reddy.
In addition to blood and urine tests, other tests such as X-rays, MRI scans, and biopsies of bone marrow and kidney can also be used to diagnose multiple myeloma. Most often, a combination of these tests are used to confirm the diagnosis.
Treatment
Treatment of Multiple Myeloma has evolved remarkably in last few decades. “Improved understanding of Myeloma biology has led to advances in diagnosis, prognosis, response assessment, and also has led to the development of plethora of novel agents, immunotherapies, cellular therapies for treatment. These advances have led to very impressive improvements in survival rates of Myeloma patients. Most myeloma patients now have long survival with very good quality of life,” adds Dr Kalashetty.
Not everyone with myeloma needs immediate treatment – for example, the condition may not be causing any problems. Myeloma is sometimes referred to as asymptomatic or smouldering myeloma.
“Medical management of myeloma involves treatment with Chemotherapy, Steroids, Bortezomib, and stem cell transplant. Other supportive medications for treating anemia and bone pains are usually supplemented. Newer analogues of monoclonal antibodies, gene therapy and immunotherapy are increasingly being studied in clinical trials and the treatment of myeloma is evolving better and better,” explains Dr Reddy.
Despite the availability of these treatments, many patients are still not diagnosed in time. Experts suggest that this is due to a lack of awareness about the disease, as well as a lack of access to proper diagnostic tools and trained healthcare professionals at rural areas.
To address this issue, healthcare experts are calling for increased education and awareness about multiple myeloma. They are also advocating for improved access to diagnostic tools and treatments.
In conclusion, multiple myeloma, due to its subtle symptoms, is often missed multiple times before it is finally detected. If you are experiencing any of the symptoms of multiple myeloma, it is important to see a doctor as soon as possible. Early diagnosis is the key to successful treatment and a better outcome for patients.
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