Multiple Myeloma: Symptoms, Causes, and Treatment

Multiple myeloma is a cancerous condition that affects the plasma cells, a type of white blood cells. Normally, healthy plasma cells make proteins called antibodies. In the case of a patient having multiple myeloma, the plasma cells are not healthy. They multiply and form unhealthy or abnormal antibodies. Resultantly, a host of medical conditions are triggered, which affect the bones, the kidneys, and the body’s ability to produce red and white blood cells and platelets. While multiple myeloma cannot be cured, its symptoms can be managed, and its progress can be slowed down.

The soft substance inside bones that helps produce blood cells is called bone marrow. When a patient is struck by multiple myeloma, cancerous plasma cells grow in the bone marrow. They soon outnumber the healthy blood cells. Instead of making antibodies that are healthy, the cancerous plasma cells make a different kind of protein that doesn’t do what healthy antibodies are supposed to do. This leads to the patient developing complications on account of the multiple myeloma condition.

Symptoms of Multiple Myeloma

Symptoms are not always evident at the early onset of multiple myeloma. Only when the disease has progressed, do some or many of these symptoms show up:

• Bone pain in the hips, chest, and spine.
• Constipation.
• Nausea.
• A sense of confusion or mental fogginess.
• A sense of loss of appetite.
• Fatigue and overall weakness.
• Infections that cause fever.
• Feeling thirsty.
• Feeling the urge/requiring to urinate frequently.
• More bleeding in situations caused by bruises: This is a sign of unhealthy plasma cells preventing the production of platelets which normally help the blood to clot.

Causes of Multiple Myeloma

Medical science has not been able to determine what causes multiple myeloma. However, researchers are examining and considering a few possible causes:

• Genetic Mutations: It is believed that multiple myeloma patients don’t have all the pieces of a specific chromosome. This has led researchers to study the connection between mutating oncogenes, also known as the cells that further growth, and the disease.
• Inflammatory Disease or Condition: Heart disease, type 2 diabetes, and rheumatoid arthritis are conditions that are inflammatory in nature. Their connection to multiple myeloma is being studied.
• Obesity: The presence of high-fat content in the body is considered a possible cause of multiple myeloma.
• Environmental Factors: Some studies have established a connection between multiple myeloma and exposure to radiation or to the chemicals in fertilizers and pesticides.

The onset of multiple myeloma is always with one plasma cell in the bone marrow. This plasma cell turns cancerous for some reason. It then multiplies quickly. Soon, the cancerous plasma cells outnumber the healthy plasma cells. Normally, healthy cells are born and die in a set pattern with a fixed tenure. But cancerous cells don’t follow this pattern or schedule. Therefore, over time, there are more cancerous cells than healthy cells in the bone marrow. This means the body is no longer able to fight infections as well as it should be doing. The patient also begins to experience fatigue. Even as the other symptoms begin to show, the disease begins to damage the patient’s kidneys.

Diagnosis and Treatment

Doctors begin diagnosing multiple myeloma with a thorough physical examination and a complete understanding of the patient’s family history.

These are some of the tests that may be ordered:

• Complete Blood Count (CBC): This test is used to measure the number of white and red blood cells in the body, the concentration level of red blood cells, and the amount of hemoglobin in the red blood cells.
• Quantitative Immunoglobin Test: This is done to measure the level of some antibodies in the blood.
• Blood Chemistry Test: This is required to measure lactic dehydrogenase levels (LDH). LDH is a tumor marker. Additionally, this test tells how the kidneys are working (through creatine levels). It also gives details of albumin (a protein) levels and calcium levels.
• Electrophoresis: This test determines the presence of M proteins in the blood. Monoclonal or M proteins are antibodies that cancerous cells make that cause all the complications associated with multiple myeloma.
• X-ray: To study the impact of the disease on the bones.
• CT Scan: To study bone damage in greater detail.
• MRI: This imaging test is required to look for plasmacytomas, single groups of abnormal plasma cells.
• PET Scan: This is another test that can help identify plasmacytomas.
• Bone Marrow Biopsy: More than one biopsy may be ordered to understand and analyze the percentage of normal and abnormal plasma cells in the body. This test will also be useful to test the DNA of the patient to assess the potential for the cancer to grow in the future.

Multiple myeloma cannot be cured. However, a combination of treatment options will be attempted by the doctor once multiple myeloma has been diagnosed. This is mainly to manage the symptoms and slow down the progress of the disease. These options include:

• Medication to manage pain.
• Antibiotics to fight and kill infections.
• Steroids to fight inflammation and kill the cancerous cells.
• Chemotherapy to bring down the number of abnormal plasma cells.
• Radiation therapy reduces bone tumors and kills cancerous cells.
• Stem cell transplants to replace unhealthy stem cells with healthy stem cells from the patient’s body. In rare cases, a donor’s healthy plasma stem cells may be used.
• Immunotherapy helps the immune system fight the disease by producing more cancer-fighting cells.

Living with Multiple Myeloma

As it is with all cancers, early detection is important in the case of multiple myeloma too. Patients are known to have lived for 10 years or more with multiple myeloma.

Patients can consider taking the following steps to cope with the condition and live with it:

• Eat healthy foods. Eat smaller meals, frequently. This is because multiple myeloma results in loss of appetite. This is a way to work around that situation.
• Rest well.
• Quit smoking if you do have the habit.
• Prevent infections as much as possible.
• Collaborate with your doctor and work on starting a simple exercise routine.
• Preserve yourself emotionally. Talk to family, friends, and a therapist, if required.

Conclusion

Multiple myeloma is a blood cancer. It affects the plasma cells. It is rare and cannot be cured. Early detection always helps. The doctor will start a treatment plan that works on managing the symptoms and slowing the progress of the disease. People have lived for years with the condition. Others have the condition in remission. But it is never easy living with cancer. So understanding the condition, developing an outlook to manage it, and slowing down its progress is important.

Frequently Asked Questions