Multiple myeloma is a cancer of the plasma cells, a type of white blood cell that plays an important role in the immune system. Normally, plasma cells help fight infection. They collect in the bone marrow,--the spongy, soft center of the bones--and then move into the bloodstream, where they circulate throughout the body. This cancer is called "multiple" myeloma because it affects many sites within the bones.
Risk Factors
People who are over 65 years old are most likely to get multiple myeloma. Men have a higher risk than women, and African Americans are twice as likely as whites to develop this cancer, according to MayoClinic.com People with a family member with the disease also have a higher risk.
Symptoms
According to MayoClinic.com, the symptoms of multiple myeloma are not the same in each patient. Most patients do not have symptoms early in the disease. One of the most common symptoms is bone pain, which occurs in the back, pelvis, ribs, and skull. Another telling sign is unexplained bone fractures. Because the immune system is not working properly, patients may easily get infections, including pneumonia, sinusitis, and bladder or kidney infections. They may feel fatigued and numb in the legs. Sudden weight loss can be another sign of multiple myeloma.
Classification
Multiple myeloma is described in four types: smoldering, Stage I, Stage II, and Stage III, according to the National Cancer Institute. Smoldering multiple myeloma is early disease without symptoms, which has not yet damaged the body. Stage I is early disease with symptoms, such as damage in one bone. It is slowly progressing or stable. Stage II and III is active myeloma that is advanced, with more myeloma cells throughout the body.
Laboratory Findings
To confirm the diagnosis of multiple myeloma, doctors perform laboratory tests. The presence of abnormal proteins called monoclonal proteins, or M proteins, is a key indicator. High levels of calcium in blood is another. The levels are elevated because calcium from the affected bones leaks into the bloodstream. Patients with excessive calcium levels may feel thirsty, nauseated, or less hungry. They may experience excessive urination or increased constipation.
Treatment
Although there is no cure, multiple myeloma responds well to treatment. Many patients are able to return to their normal routine after therapy. Standard treatment options are chemotherapy and radiation. According to the American Cancer Society, combining chemotherapy with other agents, such as a steroid or immunomodulating agent, is more effective than a single agent alone. External beam radiation therapy is used to prevent paralysis if the vertebrae are affected. According to the American Cancer Society, stem cell transplantation is increasingly employed to treat multiple myeloma, particularly for younger patients in good health, although some hospitals use it for patients up to the age of 70. There are two types of stem cell transplant: autologous, which uses stem cells collected from the patient prior to high-dose chemotherapy, and allogenic, which uses cells collected from an individual with a similar genetic profile, usually a relative.
References
- MayoClinic.com: Multiple myeloma
- American Cancer Society: Chemotherapy and Other Drugs
- American Cancer Society: Stem Cell Transplantation
- National Cancer Institute: What You Need to Know About Multiple Myeloma
