Myeloma is cancer of the cells found in the plasma. Ries and colleagues from the National Cancer Institute suggest that the incidence rate in the United States for myeloma is 5.6 per 100,000 a year.
Plasma cells are part of the body’s immune response and release special proteins and antibodies to help the body fight infections. Plasma cells are located in the bone marrow, which is the soft, spongy area inside bones.
Bone Complications
Bone problems are common even in early-stage myeloma. Kyle and colleagues said in the 2003 article “Mayo Clinic Proceedings” that 80 percent of myeloma patients had bone abnormalities on x-ray. The cancer cells cause damage to the bone and prevent repair; this results in a fragile bone, which is prone to fracture. Damage to the spinal cord can result in spinal compression caused by bone fragments. This can result not only in pain, but in nerve symptoms such as leg weakness or bladder problems, and ultimately the patient will no longer be mobile.
The bone damage can release excess calcium into the blood, which is called hypercalcaemia. This can cause nausea, vomiting, constipation, malaise and confusion and lead to kidney problems.
Blood Problems
Anemia, or lack of red blood cells, is one of the most common symptoms of myeloma. As the cancer cells increase within the bone marrow, they crowd out the normal cells, reducing the ability of the bone marrow to produce the red blood cells. Anemia results in the patient feeling weak and breathless. The number of platelets, or cells in the blood that help with clotting, can also be reduced, as they are also manufactured in the bone marrow. This can lead to increased bleeding from the gums and nose and bruising.
The myeloma cancer cells can produce a protein which causes the blood to thicken. This can increase the risk of a stroke, prevent oxygen from reaching some organs or up the chances of myocardial infarction.
Infection
Infections from bacteria, viruses and fungi are common in patients with myeloma due to the decreased cells involved in fighting infection. This can be further exacerbated by a number of the treatments used for myeloma that can reduce the body’s ability to fight infection. The most common cause of death in myeloma patients is infection, especially pneumonia.
Kidney Problems
Twenty-five percent of patients will suffer with kidneys that are not working correctly due to irreversible damage. Various aspects of myeloma can damage kidneys, including hypercalcaemia, which causes the cancer cells to produce a protein which can lodge in the kidneys and cause damage. Further, a number of treatments can also contribute to kidney damage, which if untreated can result in kidney failure requiring dialysis.
References
- SEER Cancer Statistics Review, 1975-2004. Bethesda, MD; National Cancer Institute; Ries LAG et al; 2007
- “Mayo Clinic Proceedings”; Review of 1027 patients with newly diagnosed multiple myeloma. Kyle Ra, et al, January 2003
- "CA: A cancer Journal for Clinicans"; Multiple Myeloma: Charging Toward a Brighter Future; JA Katzel, et al; September-October 2007
