Multiple myeloma is a blood cell (plasma cell) cancer most often diagnosed in people over the age of 65. In the United States, the risk of multiple myeloma is highest among African-Americans and lowest among Asian-Americans. It is estimated that this cancer affects five to six individuals per 100,000 each year.
Cancer means the uncontrolled growth of cells. In multiple myeloma, the bone marrow produces excessive amounts of abnormal plasma cells. Unlike other cancers where there is always a tumor, these cancer cells are most often in the bone marrow and in the blood throughout the body, although a tumor can form in the bone or in soft tissues.
The diagnosis of multiple myeloma is confirmed by the presence of myeloma cancer cells (abnormal plasma cells) in the bone marrow and the presence of excess protein in the blood or urine.
Classification and staging
Multiple myeloma may be classified into one of three categories:
* Monoclonal gammopathy of undetermined significance (MGUS) – this condition is a sort of “pre-multiple myeloma,” meaning that the excess protein is present but the level of plasma cells is low. MGUS is by itself harmless, but about 16 percent of individuals with it develop multiple myeloma over time.
* Solitary plasmacytoma - myeloma in only one spot or a single tumor
* Asymptomatic or smoldering multiple myeloma – the blood tests and bone marrow biopsy show the presence of multiple myeloma but symptoms are not present.
* Symptomatic multiple myeloma
Staging a cancer means determining its extent. Is the multiple myeloma confined to the bone marrow, or has the cancer spread to other parts of the body like the bones? The stage of the cancer determines what types of treatment will be needed. Because multiple myeloma can be widespread, its staging is often based on a rough measure of how much cancer is in the body.
Treatment
Individuals with MGUS or no symptoms are usually observed through regular physical examinations and blood tests, but are not treated. Individuals who have symptoms may be treated with:
* Chemotherapy drugs – these may include Cytoxan (cyclophosphamide), Alkeran (melphalan), or corticosteroids such as prednisone. The combination of Thalomid (thalidomide) and Decadron (dexamethasone) has also been an effective treatment.
* Radiation therapy
* Stem cell (bone marrow) transplantation – the individual receives healthy bone marrow to replace the diseased bone marrow.
* An anti-cancer drug called Velcade (bortezomib)
In addition, the individual may receive treatment for symptoms, such as receiving a blood transfusion to treat anemia or antibiotics to treat infections.
Blood cancer is a form of cancer which attacks the blood, bone marrow, or lymphatic system. There are three kinds of blood cancer: leukemia, lymphoma, and multiple myeloma. These malignancies have varying prognoses, depending on the patient and the specifics of the condition, but overall survival rates with blood cancer increased radically in the late 20th century with the development of advanced treatments. When caught early, blood cancer can be very manageable in some cases, which is one very good reason to make regular trips to the doctor a priority for people of all ages.
In the case of leukemia, the cancer interferes with the body's ability to make blood. Leukemia attacks the bone marrow and the blood itself, causing fatigue, anemia, weakness, and bone pain. It is diagnosed with a blood test in which specific types of blood cells are counted. Treatment for leukemia usually includes chemotherapy and radiation to kill the cancer, and in some cases measures like bone marrow transplants may be required. There are several different types of leukemia, including chronic myelogenous leukemia, acute lymphoblastic leukemia, and hairy cell leukemia.
Lymphomas are blood cancers which involve the lymphocytes, a type of white blood cell. They are divided into Hodgkin's and non-Hodgkin's types. Lymphoma often involves swollen lymph nodes in addition to the symptoms for leukemia listed above, and it is also treated with chemotherapy and radiation. Multiple myeloma is a type of blood cancer which primarily appears in older people, involving the plasma, another type of white blood cell. Chemotherapy, radiation, and other drug treatments can be used to manage multiple myeloma.
The goal in treating blood cancer is to achieve remission, a situation characterized by the absence of symptoms. Even in remission, a blood cancer can still start up again, so people who have experienced blood cancer may need to attend regular follow-up medical appointments and annual checkups to check for a recurrence of the cancer. Blood cancer does not appear to be preventable, but like other cancers, the risk seems to be reduced among people who eat a healthy diet, exercise, and maintain good mental health.
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People diagnosed with blood cancer can work with an oncologist, a doctor who specializes in cancer, or a hematologist, a doctor who specializes in diseases of the blood. Some patients work with both, attempting to develop a treatment plan which will be as effective as possible. Because individual cases can be quite varied, patients often benefit from second opinions to confirm the diagnosis and treatment plan.