What is Multiple Myeloma?
Myeloma is cancer of the plasma cells in the bone marrow. Blood contains both red and white blood cells. The white blood cells generate the antibodies that fight infection. There is one type of white blood cell (plasma cell) that is located in the soft centers of human bones.
Because there are frequently multiple areas in the bones where tumors or lesions can develop, this form of myeloma is called "multiple." Plasma cell tumors can form, appearing in the hip bones, spine, ribs and skull.
In myeloma, one of the plasma cells becomes cancerous and multiplies. Because of this multiplication, certain antibodies are made in too great an amount. Patients become anemic because the growth of plasma cells interferes with the making of platelets and red and white blood cells. They can also suffer from infections and may have a tendency to bleed. Abnormal antibodies are dangerous because if they accumulate in the kidneys, kidney failure can result.
Multiple Myeloma has an estimated frequency of 5 to 6 new cases per 100,000 persons each year. There are currently more than 50,000 people living with Multiple Myeloma in the United States.
What are the Common Symptoms?
Because Myeloma destroys bone, pain is caused or bones can collapse. Symptoms may include:
What are the Risk Factors?
Research is still being performed, as the cause of myeloma is not yet known. Men tend to be affected slightly more than women, and people 40 or older are more at risk.
Research has suggested possible associations between Multiple Myeloma and certain occupations. Those in agricultural occupations, workers in the petroleum and leather industries, and cosmetologists all seem to have a higher than average incidence of developing Multiple Myeloma.
Diagnosis and Treatment
A diagnosis can be based on the symptoms and the results of the following tests:
Because multiple myeloma worsens over time, managing the condition can extend the quality of life. Treatment options may include:
A spine specialist can help deal with the pain caused by this disease.
If you are diagnosed with Multiple Myeloma, who are the people who will care for you?
Individualized therapeutic goals are the basis of treatment regimens. These goals may include:
Management Options for Myeloma
Myeloma therapy is customized for each patient. There is no standard therapy for active Myeloma. There are, however, therapies that have been traditionally used for the treatment of Myeloma and these have a track record that have been documented in scientific journals.
Many factors must be taken into account in the treatment of Myeloma, such as the patient's general state of health, other medical diseases or issues, how effectively the disease is being controlled, as well as the patient's response to therapy in the past. Many variables must be considered in the diagnosis of Myeloma and in determining its prognosis. There is no single test for Myeloma.
It is recommended that eligible patients participate in clinical trials so that therapies for Multiple Myeloma may be further advanced. Clinical trials are designed to be at least as effective as traditional therapies, especially Phase II and Phase III trials.
The patient's disease classification and disease status determine the scope of management options.
There are two disease classifications for patients with Multiple Myeloma, active and inactive.
Asymptomatic in nature, inactive disease does not require immediate treatment nor do patients present with any myeloma-related organ or tissue impairment. Inactive disease includes the following classification subtypes:
Symptomatic or active disease requires treatment. Patients with Myeloma in Stage II or Stage III disease fall into this category.
Treatment options for those who have already received therapy are different than for those who have not. A patient's disease status is fully taken into account.
Those patients with newly diagnosed disease have myeloma that has not yet been treated.
Patients who have received therapy fall into the following categories:
Approaches to Treatment
Interventions will vary depending on whether the patient has active or inactive disease.
Initial therapy is administered to patients with newly-diagnosed, active and symptomatic myeloma. These patients also receive bisphosphonates and the supportive care needed to treat bone disease and other complications. After prior treatment and outcomes have been reviewed, subsequent treatment options are decided. Patients have the opportunity to participate in a clinical trial at every step of this intervention.
Unless their disease begins to progress, patients with inactive and asymptomatic disease are observed and not treated unless their disease progresses. Where there is evidence of active disease with end organ damage, a clinical trial may be recommended without therapy. For some patients with smoldering or indolent Myeloma or Stage 1 disease, bisphosphonates and other forms of supportive care may be recommended. For patients with inactive disease, Thalidomide and other agents are being tested.
During your treatment for Multiple Myeloma, patient safety is a priority at TCCC.
It is the responsibility of all healthcare workers to ensure that all patients are treated in a safe, effective, appropriate and efficient manner. Your caregivers follow a strict set of guidelines to protect your safety, including:
You should always feel that you have the opportunity to ask questions and that you are given ample time by the caregiver to respond to your questions.
If something is bothering you, tell your team. Don't be shy about asking for help with controlling pain, depression or any other concern. Keep a diary so you can keep a record of issues and concerns, and then follow up with a phone call or visit to your doctor.