MULTIPLE MYELOMA

Multiple Myeloma General Information

Multiple Myeloma, also known as cell myeloma or simply, myeloma, is an incurable, but treatable disease and it represents only 0.5-1% of all cancers and more than 3% of cancers causing deaths (is the second most spread blood cancer). It is a cancer of an extremely important part of the immune system that helps fight against any infection or disease. So it affects the production of antibodies, immunoglobulin (the production is lower than usual). A characteristic of this hematological (blood) disease is the overproduction of Bence-Jones protein (free monoclonal κ and λ light chains) or intact immunoglobulin (IgD, IgE, IgA, or IgG,).There is also an increased number of abnormal plasma cells in the bone marrow. This is why many people who suffer of Multiple Myeloma have an excessive predisposition to infections produced by bacteria, present renal damages, anemia and hypercalcemia. It may also appear in the ribs, pelvis, skull and spine as a diffuse osteoporosis. This blood cancer is more frequent among men than women and it is specific for Pacific Islanders, Africans and Americans. 98% of the cases are over the age of 45 and in more than 45% of the cases are people over 69 years old. So, the age represents a very important risk factor. Specialists believe that this disease is a result of an accumulation of antigenic challenges or toxic insults or it occurs once the process of aging is very advanced so that the immune system becomes weaker and it allows cancer to develop. It is considered that Multiple Myeloma does not affect more than one or two members of a family.

Multiple Myeloma Symptoms

This type of cancer has no specific symptoms this is why it is often diagnosed during examination for other completely different problems because usually presents fractures or simply bone pains. Exposing to various dusts, especially asbestos, petroleum products, insecticides, herbicides, plastics and different heavy metals increases the risk of developing this hematological disease. All these are specific for those people who work in leather or petroleum industries, in agriculture or in the industry of cosmetics. A small number of cases get this disease after they have been exposed to radiation (the survivors of atomic bombs). Because Multiple Myeloma affects a big variety of organs, the signs and symptoms may vary and may due to more than one or two causes. One of the main symptoms is bone pain, especially at ribs and spine. If the pain is persistent and localize may show a pathological fracture. This kind of fractures release calcium into the blood leading to hypercalcemia. The immune deficiency increase the risk of infections (the most common are pyelonephiritis and pneumonias) into the bone marrow infiltrates tumor cells that inhibit the production of red blood cells, causing anemia. The process is called hematopoiesis. Some neurological symptoms are: tiredness caused by hypercalcimia, confusion and weakness. The properties of paraprotein influence the hyperciscosity of the blood resulting visual changes and headaches. If the spinal cord is involved, there will appear bladder control loss of bowel and radicular pain. When the amyloid infiltrates the peripheral nerves neuropathies or carpa tunnel syndrome may be observed.

Multiple Myeloma Treatment

Even if Multiple Myeloma has no cure, there are many excellent treatments that have great results in decreasing the risk of any other dangerous complications that could lead to death. First, when Multiple Myeloma is detected at one patient, he or she is put on a list for stem cells transplantation, depending especially on the general health and age. This is considered an initial therapy. Any treatment for this blood cancer is based on your medical status, health and needs. Though urine and blood routine tests the doctor could easily detect Multiple Myeloma long before you present any symptoms. You must go more often to a physical examination even if you apparently feel good because thanks to repeated lab tests the doctor will discover the disease right on time, before any complications develop. The myeloma cells must me controlled or even better, destroyed. The aim for the treatments are to maintain or to achieve remission and to take care that the patient won’t develop any complications.

This disease is hard to discover because it has no specific symptoms and signs. The standard treatments for this type of cancer are: stem cells transplantation, therapy with radiations, corticosteroids and with drugs such as thalomid (thalidomide), velcade (bortezomib) and revlimid (lenalidomide). But the main treatment is the intravenous or oral chemotherapy, but it depends on the stage of Multiple Myeloma and patient’s kidney state and age. Radiation may have an important role in resolving Multiple Myeloma being very often used. Some aggressive therapies that include dexamethasone, cyclophosphamide or thaliomide are not tolerated by a kind of patients so that health care specialists combine prednisone with a small dose of melphalan. A symptomatic protein proliferation, called hyper viscosity syndrome can be treated with plasmapheresis. When this disease develops in younger patients, consecutive autologous stem cell transplants are performed. In their case, the therapy consists in high-dose melphalan and chemotherapy. Anemia can be treated in order to avoid fractures if doses of bisphosphonates (zoledronic acid or pamidronate) are administrated. As the cancer advances, renal failure can occur. It can have a chronic form, when it is believed to be irreversible. The type of chronic renal failure may give an idea of what the treatment should contain. It usually involves dialysis. To cure acute renal failures the doctor will try to bring the paraprotein and calcium levels at a normal and controlled stage. If this disease is not discovered on time and if the right treatment is not applied, patients may develop complications and the most dangerous are bone loss and infections (requiring strong antibiotics). For preventing the bone loss, the most indicated drugs, called bisphophonates are zometa (zoledronic acid) and aredia) (pamidronate). But these medications could produce adverse effects like harming the jawbone. You are strongly advised to consult your doctor before doing dental procedures.