What Is Multiple Myeloma And How Is It Treated?

Multiple myeloma, more commonly referred to as myeloma, is a type of blood cancer that develops in plasma cells found in bone marrow. A plasma cell is a type of white blood cell. These cells are part of the healthy functioning of the immune system intended to produce antibodies that fight infections under normal conditions. When they turn into cancer, abnormal antibodies are created called M proteins. These proteins are not helpful for the immune system and as the cancer progresses, the M proteins overtake the healthy antibodies and other symptoms of myeloma begin to develop.

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Three Types Of Multiple Myeloma

The three kinds of multiple myeloma are monoclonal gammopathy of undetermined significance (MGUS), asymptomatic myeloma and symptomatic myeloma. When a patient has a high number of M proteins, but no other tumors or symptoms, this is usually a sign of MGUS, which starts out as benign but can turn into multiple myeloma. Approximately 16% of MGUS patients develop multiple myeloma. 

Most commonly, MGUS affects people over the age of 70. When a patient has an increasingly high level of both plasma cells in the bone marrow and M proteins, this is a sign of asymptomatic multiple myeloma. Some of the symptoms are anemia and lesions on their bones. Finally, when a patient is quite visibly ill with symptoms of anemia, vomiting, infections and renal failure, this is often a sign of symptomatic myeloma.

Common Symptoms Of Multiple Myeloma

For patients with symptomatic myeloma, the most common symptoms include; bone pain and fractures, increase or decrease in urination, impaired kidney function, increased thirst, loss of appetite and weight loss, nausea and vomiting, fatigue, weakness, confusion, and restlessness.

Cancer in the bone marrow eats away at the bones and results in osteolytic lesions, which weakens bones and increases the risk of fractures. Hypercalcemia causes the breakdown of bones as a result of too much calcium in the blood. The excess calcium causes many of the symptoms related to symptomatic multiple myeloma such as an increase in thirst, changes in urination, confusion, restlessness, and loss of appetite, resulting in weight loss.

Progression Of Myeloma

As this cancer progresses, the high levels of calcium and proteins overwork the kidneys, which eventually start to fail. The body then begins to fail as it can no longer rid itself of waste or excess fluids and salts. This often causes the legs to swell and feel itchy. Multiple myeloma also has a negative effect on healthy blood cells. As the cancerous cells multiply crowding out the healthy cells, the damaged bone marrow will also lose the ability to create healthy blood cells. 

This will result in the patient developing anemia (dangerously low supply of red blood cells), leukopenia (very low white blood cell count) and thrombocytopenia (abnormally low count of platelets). Anemia can cause dizziness, shortness of breath and weakness, while the other two conditions weaken the immune system.

Diagnosis Of Multiple Myeloma

Since an abnormally high number of M-proteins in the blood is one of the key indications of multiple myeloma, a doctor will begin performing blood and urine tests when they first suspect a patient has the disease. However, myeloma is difficult to diagnose on the basis of a single test, so a variety of diagnostic tests are usually performed. In addition to blood and urine tests, a physical evaluation, review of patient history, as well as a bone marrow biopsy may be performed to see if abnormalities are found. Additional tests used to diagnose myeloma are X-rays MRIs, CT scans, and PET scans. A thorough examination and tests are important in helping doctors make accurate diagnoses as well as treatment plans for each individual patient.

Managing Side Effects Of Myeloma

Myeloma can cause the breakdown of bones resulting in holes or thinning of the bones, also known as osteoporosis. Due to these side effects of myeloma, patients are more at risk of breaking bones. Light exercise such as walking or swimming can be physically and mentally beneficial. It is important to seek the guidance of a physical therapist when exercising to avoid injuries. With anemia being a common side effect of myeloma, taking iron, vitamin B12 or folic acid supplements can help with fatigue and weakness. 

Additionally, there are prescription medications or blood transfusions that your doctor may suggest to manage side effects. M-proteins produced by myeloma are cleared by your kidneys, so it is important to drink 6-8 cups of water to help flush out toxins and medications from the body.

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