Multiple myeloma is a form of blood cancer that begins in the bone marrow and gradually moves to other parts of the body. Bone marrow is a spongy tissue inside the bones, where the body makes plasma cells and blood cells. When the condition occurs, these cells start crowding out the healthy cells in the bone marrow and build up to form a tumor. Usually, there is more than one tumor found when the disorder is diagnosed; hence the name, “multiple myeloma”. A specialist like a cancer oncologist would be the best source of diagnosis for a condition such as this.

It is not yet known what causes multiple myeloma, but scientists believe that the disease is linked to the changes in the DNA. Besides, it is also seen that blood cancer affects people in their later ages and those who have a family history of the condition. Being overweight or having another type of plasma cell disease can also heighten the risk of multiple myeloma.

Symptoms of Multiple Myeloma

The symptoms of multiple myeloma can be difficult to detect in its early stages. While some patients might show signs like weakness, fatigue, pain in the bones in the back, skull, or ribs, others might not show any symptoms of the disease at all. In most cases though, the person would often feel very thirsty, experience restlessness, confusion, loss of appetite, nausea, vomiting, weight loss, and/or numbness in the legs. People with multiple myeloma are also seen to get infections and fevers often, along with frequent urination problems. If you’re experiencing a combination of these symptoms it may be best to visit a nearby affordable health clinic.

Multiple myeloma can also affect the body in various ways. For instance, the condition can make the bones weak and brittle, while it can lower the count of healthy blood cells in the body.

  • If the count of red blood cells goes down, it would lead to anemia, a condition where the patient would feel exhausted, dizziness, short of breath, weakness, etc.
  • If the count of white blood cells goes down, it would lead to leukopenia, a condition where the patient would be prone to infections like pneumonia and other diseases.
  • If the count of platelets goes down, it would lead to thrombocytopenia, a condition where the body of the patient would take much longer to heal from injuries.

Multiple myeloma can also cause excessive calcium in the blood, which can lead to abdominal pain, dehydration, drowsiness, constipation, urination problems, etc. At the same time, the condition can also affect the kidneys and lead to weakness, itchiness, exhaustion, inflammation in the legs, etc.

Diagnosis of Multiple Myeloma

It is very important to consult with an expert at the nearest community healthcare center to diagnose the condition and start the treatment as soon as possible. To diagnose the disorder, the doctor would assess your medical history and symptoms, and recommend a few tests to check the severity of the condition. The common diagnostic tests for multiple myeloma include:

  • Complete blood count test
  • Chemistry profile
  • Beta2 microglobulin
  • Antibody/immunoglobulin levels and types
  • Serum protein electrophoresis
  • Immunofixation electrophoresis
  • Serum-free light chain assay
  • Urinalysis
  • Urine protein level
  • Urine protein electrophoresis
  • Bone X-ray
  • Bone marrow biopsy or aspiration
  • Karyotyping and Fluorescence in Situ Hybridization (FISH)

After checking the results of the tests, the doctor would create a treatment plan depending on how much blood cancer has spread in your body. There are four stages of multiple myeloma.

  • Smoldering myeloma – This is the earliest form of blood cancer when the blood cells and kidney functions are normal and there is no bone damage either.
  • Stage I – This is the stage where the myeloma cells have just started to disturb the healthy cells in the bone marrow. There is no bone damage seen in this stage though.
  • Stage II – This is the stage where the myeloma cells start to build up in the bone marrow and start growing. An imbalance in the healthy blood cells can be seen in this stage.
  • Stage III – This is the stage where the number of myeloma cells has grown and the tumors have inflicted damages to some areas of the bone. The calcium level in the blood would be very high here and the patient would start experiencing more symptoms of the disorder.

Treatment of Multiple Myeloma

The treatment option for the patient depends upon the stage of multiple myeloma. The commonly recommended treatment options for cancer include:

  • Immunomodulatory drugs – These medications work by triggering certain immune cells that stop the growth of myeloma cells.
  • Proteasome inhibitors – These drugs stop the protein complexes from removing old proteins from the blood cells and replacing them with healthier protein cells. This leads to the amassing of old proteins, which kills the cancer cells.
  • HDAC inhibitors – These drugs prevent myeloma cells from producing the histone deacetylase protein, which in turn stops the malignant cells from growing.
  • Monoclonal antibodies – These immunotherapy medications work by boosting the immune system to fight myeloma cells. The drugs bring antibodies into the body that target specific proteins to kill myeloma cells.

Chemotherapy – These drugs are used to treat cancer by killing the malignant cells. However, they can also kill a few healthy cells around the myeloma cells, which can lead to some serious side effects.

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    About the Author

    Dr. Ghassan M. Al-Jazayrly, MD

    A graduate of University of Aleppo Faculty of Medicine, Dr. Al-Jazayrly or, as he is colloquially known: Dr. AJ, is an oncologist and hematologist of a Complete Care Community Health Center (CCCHC) with more than 36 years of experience. In recent years, he’s been involved with a non profit organization known as Every Woman Counts (EWC) which provides free breast and cervical cancer screening and diagnostic services to California’s underserved populations in order to eliminate health disparities for low-income individuals.

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