When plasma cells in the bone marrow begin to form in abundance, it starts affecting the area by causing cancer in plasma cells, the whole condition is known as multiple myeloma. Plasma cells come under the category of White blood cells.
Plasma cells are situated in the bone marrow and lymph nodes basically and round or oval in shape with spongy soft texture (14-20 micrometres size). Plasma cells’ job is to form antibodies in bone marrow if talk more specifically then. In multiple myeloma, these cells spread very fast in bone marrow due to the production of this normal and mature cell that instantly also affects red blood cells. This condition is not very common, about 5-6 people in 100,000 are suffering from multiple myeloma. Multiple myeloma is seen in people with age 65 or above. People with age 40 or less have rare chances of getting myeloma
Chiefly there are two types in multiple myeloma
- Asymptomatic myeloma – No symptoms are present in this category, it is also known as indolent myeloma. No huge growth of plasma cells and protein are seen in this, so not very dangerous.
- Symptomatic Myeloma – Symptoms are experienced during this type and it is also known as solitary myeloma and myeloma plasmacytoma. Tumour can be seen in bone.
Causes Of Multiple Myeloma
The actual cause of multiple myeloma isn’t found yet but suddenly plasma cells overproduce in the bone marrow then regular count. Regular mature plasma cells grow and then die when new cells start forming but cancerous cells do not die instead divide and pair with non-cancerous to cause harm.
Symptoms Of Multiple Myeloma
Symptoms changes from case to case, in some, in early phase symptoms remains hidden but gradually one or more symptoms begin, primary symptoms are:
- Anaemia (less healthy red blood cells)
- Excess calcium gets stored
- Renal failure
- Bone injury
- Frequent thirst – It caused due to medicines or illness
- Diarrhoea/stomach ache
- Desire to eat reduces/get less hungry than usual days
Bowel movements become less frequent and can be noticed when calcium rises rapidly. When M protein increases the risk of kidney failure stops working properly. Other secondary symptoms are dizziness (unconsciousness), tiredness, fractures, back pain, and bone damage can also happen when cancerous cells fill the area of bone marrow. Blurry vision, sudden weight loss, loss of muscle strength (weakness), infection, problem while passing out the urine are also some of the undeniable symptoms of multiple myeloma
Ways To Diagnose Multiple Myeloma
Even though symptoms aren’t noticeable, when you visit the doctor he/she can easily detect whether a person has multiple myeloma conditions or not. They particularly take help with various basic tests initially such as urine tests, physical examinations, and blood tests. If the doctor suspects signs further requirement of different tests arises, even if you don’t have any symptoms.
- Blood tests – Usually conducted to analyze the M protein’s interference, it becomes extremely important to know Proteins are due to multiple myeloma or any other serious condition.
- During the test :
- Plasma cells count is checked only in bone marrow
- WBC, RBC and platelets counts are monitored
3. Urine Test – This test is done to prevent kidney damage and to see uric acid’s presence level.
4. Biopsy – A piece of bone marrow is given in the laboratory to detect the cancer by observing it through a microscope.
To clear the doubt of the bone’s degeneration/injury imaging tests are done like MRI scan, Computer tomography and Magnetic resonance imaging.
Treatment Options For Multiple Myeloma
To reduce the multiplication of cancerous cells, some of the treatments are invented but none of them gives 100% guarantee of vanishing multiple myeloma. Treatments are recommended to the people who have one or more symptoms otherwise oral medicines and tests can help to protect the body to some extent.
- Targeted Therapy
This therapy is based on medicines several effective medicines are given to the patient to fight against harmful cells medicines such as Kyprolis and Bortezomib. Both are given through the veins.
- Oral Medicines
Orally given medicines are Revlimid, Pomalist and Thalomid are excellent. Out of all three revlimid is spot on because it has minimum or no side effects while other two have more or less side effects.
- Radiation Therapy
Powerful beams are used to kill cacerous cells and to pause their growth permanently When extreme symptoms like plasmacytoma is present in patient this treatment works for him/her.
The function of corticosteroid is to keep White blood cells separate from cacerous cells also reduces swelling and pain in affected area. Effective ones are prednisone and dexamethasone.
This treatment is very advantageous but has some serious side effects also becuases high dose consisting medicines are given such as Oncovin, Treanda, Melphalan, Doxil, Cytoxan and Adriamycin.
- Stem Cell Transplant
When above mentioned all the treatment fails this becomes necessary, in this entire damaged bone marrow is removed and in its place new, functioning bone marrow is added. This is very successful procedure.
Stages Of Multiple Myeloma
Chiefly, doctors splits multiple myeloma in 4 stages:
- Smoldering Stage
This stage is the initial stage of multiple myeloma, gap between SMM and stage1 can be huge or short some lives many years with SMM and then progresses to stage 1 while in some it can convert into stage 1 in few days or months only. This stage is symptom free stage. Silent myeloma cells are there in the body which remains deactivated. However, some abnormal changes are seen in the spine in some people.
One can notice a small proportion of M protein in urine and blood, also this stage causes imbalance in Haemoglobin as it fluctuates. Small portion of bone may or may not damage.
Cancerous cells number increases in this stage and haemoglobin decreases than normal ( less than 12 in women and less than 15 in men). Multiple areas of bone starts degenerating and gets injured also.
This is the most intense stage and maximum damage caused by myeloma cells is seen in this stage only, haemoglobin becomes half, calcium level rises and bone destruction doesn’t stop.
PROGNOSIS OF MULTIPLE MYELOMA
Generally, a person who undergoes stem cell transplant can live more (about 15-20 years or more) than a person who has done normal treatment, when both have similar kind of multiple myeloma. If the younger person has myeloma and the older person also has the same stage myeloma than chances of younger patient’s of surviving increases by 30%.
On ana average survival rate is more than 50% and rest depends on how early the patient is treated and diagnosed. If checked and treated before the first stage survival rates becomes 70-75% and if diagnosed and treated in the final stage then chances reduce and become 50%.
- What are the risk factors involved with multiple myeloma?
If a person is male and his age is more than 50 then he has more chances of developing multiple myeloma. Especially if he is working in oil refining/extracting/transporting then possibility increases even more. Other factors are overweight, race ( american-african) and history of monoclonal gammopathy.
- What are potential complications of multiple myeloma?
If not treated on time then it can cause:
- Bone loss – cured with drug therapy
- Anemia – can be cured with erythropoietin
- Back pain – back brace can help
- Can past family history cause multiple myeloma?
The main cause is still hidden, but no studies show that it is due to genetic factors.
- What foods to avoid when a person has multiple myeloma?
Avoid eating sugary, oily and extremely salty food such as processed cheese, cakes, ice creams, crisps/chips, etc. all of these can increase the weight and obesity can cause multiple myeloma. To reduce the chances of anemia eat iron-dense food such as spinach, broccoli, sprouts, raisins, etc. Cut down calcium rich food if its levels are higher than normal you can avoid curd, milk, cottage cheese, etc.