Multiple myeloma

Our body is made up of millions of tiny cells. A group of cells is called a tissue, and tissues form an organ. The normal and continuous life cycle of cell includes cell growth, cell division and cell death. But in some cases the cell undergoes few changes called mutation, as a result the complete life cycle process of cell changes. The mutated cells grow very rapidly, and they do not die as a result forming cell clumps and ultimately resulting in formation of a tumor. If the tumor is non-cancerous it does not spread to other part of the body but in contrary, if the tumor formed invades and infects other parts of the body than it is a cancerous growth.

Multiple myeloma- Cancer of plasma cells

Multiple Myeloma is a cancerous condition that starts in the plasma cells. Plasma cells are a type of white blood cells that protects your body from germs and foreign particles.

Plasma cells are formed in the bone marrow (soft tissue found inside the bone); therefore, this cancerous condition affects your bone marrow.

Multiple myeloma results when one of your plasma cell inside the bone marrow is mutated (changed) and divides uncontrollably forming a tumor. They also affect the surrounding bone cells and stop the formation of other healthy blood cells.

Symptoms of multiple myeloma depends on how advanced the disease is. In the initial stages, a person might not experience many multiple myeloma symptoms. But when they do occur they include

  • Weakness

  • Fatigue

  • Weight-loss

  • Repeated infection

  • Broken bone

  • Or pain in the back bone and bones in the ribs

In advanced cases, symptoms include

  • Nausea

    • Vomiting

    • Difficulty in urinating

    • Constipation

    • Numbness or weakness in the legs

    The exact cause of multiple myeloma is not known. Multiple myeloma starts when the plasma cells of bone marrow undergo mutation and start multiplying uncontrollably.

    Studies show that genetics or family’s medical history also plays a major role in developing multiple myeloma.

    Exposure to certain environmental factors such as agriculture chemicals, certain foods, and petrochemical industries are shown to increase the risk of multiple myeloma.

    Exposure to certain radiations may result in mutation of the cells, and certain viruses also thought to initiate the cancerous process.

    Success rate of treatment

    The success rate of treatment depends on many factors. It mainly depends on the age of the patient and the stage of multiple myeloma. Patients diagnosed in the early stage of the disease has favorable outcome than older patients, patients in advanced stage of the multiple myeloma, and patients with other illness or chronic diseases. Treatment procedures like chemotherapy and stem cell transplantation very rarely results in cure.

    There are several tests done to find out multiple myeloma.

    1. X-ray:X-ray study of the entire body can help the doctor to find out the extent of bone damage, areas of bone loss or if there is any thinning or broken bone.

    2. Blood test:Blood test is done to check the

      • Level of protein as cancer increases the level of protein in blood.

      • Also you will be checked for anemia (less iron content ion blood) and platelet count as they tend to reduce if you have cancer.

      • You will be checked for increased level of calcium as multiple myeloma when spreads to bone results in release of calcium into the blood stream

      • Kidney function is also checked by creatinine testing. About 25 – 50-% of people with multiple myeloma are found to have increased amount of creatinine in their blood indicating kidney failure. Kidney fails due to the production of large amount of monoclonal antibodies by the myeloma cells

    3. MRI scanning:Magnetic resonance imaging is done to check the condition of bone and also whether or not the spine is affected by multiple myeloma cells as filling up of myeloma cells in the bone marrow interferes with the normal production of white blood cells, red blood cells and platelets

    4. Biopsy:One perfect diagnostic test that gives you 100% reliable result is biopsy, where a needle is inserted into your bone to take a very less sample of the bone marrow cells. This is called bone marrow aspiration.

    Treating multiple myeloma is very difficult. But there are many treatment procedures that improve the quality of patient’s life and extend the survival period. Many multiple myeloma patients who do not show any symptoms do not actually require any myeloma treatment because the side effects of treatment may overshadow its benefits. However, they must be watched carefully for appearance of any symptoms.

    Multiple myelomas are usually treated with chemotherapy. Chemotherapy is actually drug therapy where your doctor might prescribe 2 or 3 drugs that work to kill the myeloma cells. These drugs can be given orally or injected into the blood vessels.

    The most common drug is vincristine, adriamycin and dexamethasone (VAD). Melphalan is also another used as chemotherapy drug. Chemotherapy drug kills the cancerous cells but along with it, it also kills few normal cells.

    You may lose hair but it will grow once chemotherapy is stopped. In case if you are bleeding from nose, gums or suffer bruises; have skin rash or cough after chemotherapy, consult your doctor immediately. You must not get pregnant during chemotherapy treatment as it might harm your baby. Radiation therapy is often accompanied with chemotherapy. This treatment procedure uses high energy X-rays that are focused on the tumor and its neighboring area to destroy the cancer cells.

    Radiation therapy is recommended when there is a pain in the bone and chemotherapy doesn’t prove effective. But the decision of going for a radiation therapy should be made with extra care as sometime bone pain may be due to structural damage and subjecting to radiation therapy in such cases could interfere with future treatment procedures.

    The side effects of radiation therapy vary depending on the area treated. It may result in nausea, vomiting, and diarrhea.

    Stem cell transplantation has proved effective in many patients. Stem cells that are obtained from other parts of your body are transplanted in the affected region. Stem cell transplantation is used in conjugation with high dosage of chemotherapy. Although stem cell transplantation has cured many; it is very difficult to find donor availability, and age limitation is another big factor that has to be considered during stem cell transplantation.

    Apart from these medicinal treatments, it is important that you stay active because being active helps you to maintain your calcium level, and keeps your bones strong. Have a balanced diet and drink lots of water.