In March, people all over the world come together to raise awareness on myeloma, a type of blood cancer that affects millions each year. Here’s what you need to know about it, and actions you can take to support survivors this month.
What is it?
Myeloma is a type of cancer that begins in the bone marrow, which is the spongy tissue in the centre of bones. The bone marrow is responsible for producing blood cells. Myeloma is often known as multiple myeloma because it generally affects multiple bones in the body, such as those in the ribs, skull, and spine. In fact, 90% of people have multiple affected areas by the time they are diagnosed. Multiple myeloma can also be known as Kahler’s disease.
The bone marrow produces a type of white blood cell known as a plasma cell that helps fight infections. It produces antibodies, which are important for the immune system. Myeloma affects the production of plasma cells, causing a buildup of immunoglobulin – a protein – which damages organs. They can also release harmful chemicals which weakens your bones, creating lytic lesions. Myeloma can also cause excess production of plasma cells, which can reduce the production of other blood cells, and also cause plasma cells to spill out of the bone marrow and harm the rest of the body. Cancerous plasma cells produce an abnormal protein called the M protein which can cause tumours and damage the bones, kidneys, and weaken the immune system.
There are two types of multiple myeloma:
- Indolent myeloma involves small increases in M proteins throughout the body, and spreads slowly. It often doesn’t exhibit symptoms.
- Solitary myeloma causes a bone tumour to form in one or more areas of the body. It is generally easier to treat.
Multiple myeloma is a rare cancer, but it is often diagnosed late and has a high mortality rate, so it’s important to watch out for symptoms.
What causes it?
There is no known cause for multiple myeloma, but there are risk factors. You are at a higher risk for myeloma if:
- You are male. Myeloma affects men much more than it does women. Unfortunately, this is not a preventable factor.
- You are above the age of 45. Myeloma becomes increasingly common with age, especially beyond the age of 60. It’s a good idea to begin regular screenings in adulthood.
- You are African-American. It is twice as common in black people than in other races.
- You have a family member with myeloma. It can be inherited, since it is a genetic mutation. Other hereditary cancers running in the family can also increase your chances.
- You are overweight. Maintaining a healthy diet and weight is an important prevention method for any form of cancer, including myeloma.
- You have been diagnosed with MGUS. MGUS (monoclonal gammopathy of unknown significance) is a condition where you have an excess of immunoglobulins in your blood. Though the condition on its own is not harmful, it can lead to myeloma.
- You have been exposed to radiation. Radiation can cause genetic mutations, which can lead to multiple different cancers, including multiple myeloma.
The majority of these factors can be prevented, so if you fit into any of these categories, it is important to talk to your doctor about regular cancer screenings for an early diagnosis.
Are there symptoms?
Early-stage myeloma usually doesn’t have noticeable symptoms, but later on, you may be affected by the following:
- Prolonged pain or tenderness in the bones, usually in the back, shoulders, hips, and/or ribs
- Low blood cell counts
- Weakened bones and common fracturing
- Spinal fractures
- Spinal cord compression. Symptoms of this are pins and needles, numbness of the back, legs, and feet, and difficulty controlling the bowels and bladder. This is a medical emergency – if you exhibit these symptoms, see a doctor immediately.
- Shortness of breath
- Weakened immune system and repeated infections
- Kidney pain and bladder problems
- Repeated bruising/bleeding
- Hypercalcaemia (high levels of calcium in the blood)
- Constant thirst
- Stomach pains/an upset stomach
- Frequent urination
- Thickened blood
- Weight loss and a lack of appetite
If you notice multiple of these symptoms as a constant presence in your life, notify your GP.
How can I be diagnosed?
The first step to a diagnosis is a blood test. This allows your doctor to test calcium levels, protein levels, and blood counts. Urine tests can also help in detecting M proteins and checking for kidney problems.
If the doctor finds abnormalities, you may be asked to go through scans, including MRIs, CTs, or X-rays. These can detect tumours, weakened bones, and other bone problems.
To confirm, you will go through a biopsy. The doctor will take samples of bone marrow and examine them in a lab to detect cancer cells and, potentially, tumours.
These tests combined will give the doctor an overview of the cancer, its stage, and ideal treatments. The sooner it is diagnosed, the more likely it is that the treatment will be effective.
What treatments are available?
There is no cure for multiple myeloma.
Asymptomatic, or smouldering, myeloma is when the cancer causes no complications to the body, so it doesn’t require treatment. Other forms, though, should be treated as soon as possible.
Chemotherapy is a common treatment that involves ingesting medicines that kill cancer cells. It may have side effects like nausea and hair fall, but is effective, especially for older patients. Chemotherapy may require you to take pills or injections.
Immunotherapy helps strengthen your immune system and can help it fight off the cancer, reducing external infections. It is taken as a series of medications and is usually combined with other treatments.
The most preferred course of treatment for multiple myeloma is a stem cell transplant that replaces damaged bone marrow with healthy bone marrow.
What else can I do?
As a patient, make sure to monitor your symptoms and inform your medical team if you notice any abnormal activity. Talk to your friends and family and take care of your mental as well as your physical health.
If you have a friend or family member with multiple myeloma, make sure to support them through their difficult journey.
Wear a burgundy ribbon or wristband to show your support for myeloma patients and survivors. Share reliable information – like this post – on social media and spread the word to raise awareness. Make sure to monitor your own symptoms and risks, and take action to prevent multiple myeloma.
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