myeloma

Myeloma
Myeloma is a type of cancer that affects white blood cells. Specifically, it affects the plasma cells. Plasma cells create antibodies. These antibodies help a patient’s body find germs and fight off infection.
Myeloma occurs when unhealthy or cancer cells gather in bone marrow. These cancer cells overcrowd the normal blood cells. The cancer cells cannot make normal antibodies, instead they make irregular proteins. These irregular proteins can cause problems in the body.


In 2018, the estimated number of new myeloma cases of 30,770 in the US. In the US, 50.7% of patients survive after 5 Years or more of being diagnosed with myeloma. This means out of 100 patients with myeloma, about 50 patients have survived the disease for 5 years or more.


Risk Factors  
Factors that can increase your chances of having myeloma include:

• Older age.  Most patients diagnosed with this disease are in their sixties.
• Male gender.  Men have a higher risk of having myeloma compared to women.
• Race.  A black patient’s chances of having myeloma are doubled when compared white patients.
• Family history.  Patients with a family history have a higher chance of getting the disease.
  
  
  

Signs & Symptoms  
The signs and symptoms myeloma can be different for every person. There may not be signs early on for patients with myeloma.  When and if there are symptoms, a patient might experience bone aches, nausea, constipation, a loss of appetite/hunger, foggy thoughts or confusion, fatigue, repeated infections, patients may feel more thirsty than usual, patients may lose weight, legs may feel weak or numb.  


Diagnosis
There are several tests that can help diagnosis myeloma. Some of these tests may be conducted by your provider if they suspect Myeloma. Your doctor may find myeloma by coincidence with some routine tests.  These tests include:

• Blood tests and urine tests, which look for abnormal proteins made by myeloma.
• Inspection of your bone marrow. Your doctor may take a small amount of bone marrow and look at the myeloma cells to find specific genetic irregularities.
• Imaging like X-ray, MRI, CT or positron emission tomography (PET). Imaging can show bone abnormalities that can happen with myeloma.

Treatment Options

• Targeted therapy.   This is a type of drug therapy with injections or pills.  Targeted therapy focuses on a particular characteristic unique to a patient’s cancer cells that allow them to persist and thrive in the body.  This therapy obstructs essential substance/proteins in the cancer cells. This makes the myeloma cells die. Examples of targeted drugs are: Bortezomib (Velcade), carfilzomib (Kyprolis) and ixazomib (Ninlaro)
• Biologic therapy.   This is a type of drug therapy with pills. It improves your own immune cells ability to combat myeloma. Examples of these drugs are drugs thalidomide (Thalomid), lenalidomide (Revlimid) and pomalidomide (Pomalyst)
• Chemotherapy. This is a type of treatment with drugs that come as pills or in an injection.  This type of treatment targets and eliminates cells, like myeloma cells, that grow quickly and haphazardly.  
• Corticosteroids/steroids. This treatment can come as a pill or as an injection. They help control inflammation in the body and works against myeloma cells.
• Bone marrow transplant/ stem cell transplant.  This is when abnormal or unhealthy bone marrow is substituted by hardy and healthy cells.

Before a transplant there are a few steps that are taken.  Progenitor or Stem blood cells are collected. Chemotherapy is then used to kill off the sickly bone marrow cells. The healthy stem cells are then injected back into the body and help to recreate healthy bone marrow cells.      

• Radiation therapy. This is a release of energy in the form of waves or particles. This energy injures myeloma cells and prevents them from growing. This therapy is used to rapidly damage myeloma cells and can be used to target particular parts of the body. Examples of this therapy this include X-rays and protons

​References:
“Cancer Stat Facts: Myeloma.” National Institutes of Health National Cancer Institute, 2019, https://seer.cancer.gov/statfacts/html/mulmy.html
“Multiple-Myeloma.” Mayo Foundation for Medical Education and Research, 2019, www.mayoclinic.org/diseases-conditions/multiple-myeloma/symptoms-causes/syc-20353378 .
 
Web links about Myleloma:
Patient education: Multiple myeloma symptoms, diagnosis, and staging (Beyond the Basics)
https://www.uptodate.com/contents/multiple-myeloma-symptoms-diagnosis-and-staging-beyond-the-basics
 
Plasma Cell Neoplasms (Including Multiple Myeloma)—Patient Version
https://www.cancer.gov/types/myeloma
 
Multiple Myeloma
https://www.merckmanuals.com/home/blood-disorders/plasma-cell-disorders/multiple-myeloma
 
Multiple Myeloma
https://medlineplus.gov/multiplemyeloma.html
 
What Is Multiple Myeloma?
https://www.cancer.org/cancer/multiple-myeloma/about/what-is-multiple-myeloma.html