What is Multiple Myeloma?
Myeloma, also referred to as multiple myeloma, is a type of bone marrow cancer. Bone marrow is the spongy tissue located at the centre of some of the bones in our body and its main function is to produce blood cells.
To be exact, multiple myeloma is a cancer of the plasma cells. Plasma cells are white blood cells that produce antibodies to fight infections. In multiple myeloma, these cells will grow too much and eventually crowd out the other normal cells in the bone marrow that produce red blood cells, platelets, and other white blood cells which are all essential components of the blood.
The term “multiple myeloma” is derived from how the disease affects several areas of the body, such as the spine, skull, pelvis and ribs.
What are the Risk Factors of Multiple Myeloma?
The exact causes of multiple myeloma are not known. However, it was found that there is a close link between multiple myeloma and a medical condition known as monoclonal gammopathy of unknown significance (MGUS).
MGUS occurs when there is an excess of protein molecules, immunoglobulins, in the blood. There are usually no symptoms, and this condition does not require treatment. In the UK, 1 in every 100 people with MGUS goes on to develop multiple myeloma each year. There is no known method to delay or to prevent this situation from happening, hence people with MGUS are scheduled for routine tests to check for the presence of cancer.
Other risk factors associated with multiple myeloma include: -
• Adults over the age of 60
o Most cases are diagnosed at around the age of 70;
o Cases affecting people under the age of 40 are rare;
• Black people
o The risk is approximately twice as common when compared to the white and Asian populations;
• Men;
• Overweight / Obesity; and
• People with a family history of MGUS or multiple myeloma.
What are the Symptoms Associated with Multiple Myeloma?
Multiple myeloma, in the early stages, usually do not exhibit any symptoms. The disease is often only suspected or diagnosed following a routine blood or urine test. It is important to note that myeloma does not usually cause a lump or a tumour but instead, it damages the bones and affects the production of healthy blood cells.
As such, in the later stages of the disease, multiple myeloma will result in a wide range of symptoms including: -
- A persistent bone pain, usually in the back, ribs or hips;
- Blurred vision, dizziness or headaches as a result of thickened blood (hyperviscosity);
- Bruising and unusual bleeding i.e., frequent nosebleeds, bleeding gums and heavy periods;
- High levels of calcium in the blood (hypercalcemia) which may lead to a series of symptoms i.e., extreme thirst, stomach pain, frequent urination, constipation or confusion;
- Kidney problems;
- Repeated infections;
- Tiredness, weakness and shortness of breath as a result of anaemia;
- Weak bones that break (fracture) easily;
- When this affects the spine, it may cause a cluster of symptoms i.e., pins and needles, numbness and weakness in the legs and feet, and inability to control bladder and bowel. When these symptoms are present, an emergency investigation is often warranted; and
- Weight loss
Multiple myeloma is often only detected when a blood or urine test is done for another condition. A higher than normal level of protein may be an indication of the disease.
When the symptoms suggest that a person may have multiple myeloma, a physician may order for more tests to be done. These tests may include: -
- Blood chemistry tests;
- Bone marrow biopsies;
- Complete blood count;
- Imaging tests i.e., bone x-ray, CT scan, MRI scan, and PET scan;
- Quantitative immunoglobulins; and
- Urine tests.
The treatment for multiple myeloma is often aimed at controlling the condition for several years. However, most cases of multiple myeloma cannot be cured. Research is still ongoing to discover newer treatment options to cure the condition.
Common treatment options include: -
- Anti-myeloma medications to destroy the myeloma cells or to control the cancer when it comes back (relapses); and
- Other medications and procedures aimed at preventing and treating the symptoms brought about by the disease i.e., bone pain, fractures, and anaemia.
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