Oncology

Multiple Myeloma: Symptoms and Treatment Options

admin Aug 30, 2024

Plasma cells are a type of white blood cells found mainly in the bone marrow, which is integral in the body’s adaptive immune system. Multiple myeloma, also known as Kahler’s disease, is a type of blood cancer that originates in the plasma cells, where these cells become abnormal and uncontrollably multiply, leading to serious host health issues. Apart from generating antibodies that combat infections, this type of cancer also starts generating non-normal antibodies known as monoclonal protein, or m-protein. These proteins do not fight against infections, making one more immunocompromised. It is a rare form of cancer and is the second most common blood cancer after non-Hodgkin’s lymphoma. Although not curable, advances in treatment have significantly improved the patient’s quality of life. Early recognition of symptoms such as persistent bone pain, frequent infections, and easy fatiguability is essential for timely diagnosis and management.

Symptoms of Multiple Myeloma

The symptoms of Multiple Myeloma are variable by nature and slowly develop over time. The symptoms are unnoticeable at the early stages, making its detection challenging. As the disease progresses, several common symptoms are seen. Some of them are as follows:

Bone Pain and Bone Weakness: Cancerous cells produce substances that can cause osteoclasts to break down old bones more rapidly than new bones are formed. This abnormality can lead to increased susceptibility to weakened bones and fractures. The most commonly affected bones are the bones in the back, ribs, and hips.
Fatigue and Weakness: Rapid overgrowth of abnormal plasma cells can displace healthy red cells, causing anemia. This, in turn, can result in persistent fatigue and weakness.
Recurrent Infections: Impairment in the body’s immune system makes it difficult to fight off infections. Patients may encounter frequent infections, such as pneumonia, urinary tract infections, and sinusitis.
Kidney Diseases: Accumulation of the m-protein produced by cancerous myeloma cells can lead to impairment of kidney function, further resulting in kidney damage or failure. Symptoms include changes in urine output, swelling in the legs, and high blood pressure.
Hypercalcemia: Weakened and broken-down bones release calcium into the bloodstream, leading to hypercalcemia. It often presents as nausea, vomiting, constipation, excessive thirst, and confusion.
Nerve Damage: Multiple myeloma can cause nerve damage, causing numbness, tingling, or weakness in arms and legs.
Weight Loss: Poor ability to absorb nutrients can lead to unintended weight loss and have a significant impact on overall health.

Diagnosis of Multiple Myeloma

Diagnosis of multiple myeloma involves multiple tests, including blood tests, urine tests, imaging studies, and bone marrow biopsy.

Blood Tests: Presence of abnormal proteins, renal function tests, blood calcium levels etc.
Urine Tests: Presence of markers, such as m-protein or Bence Jones protein
Imaging Studies: To identify bone damage or tumors associated with multiple myeloma
Bone Marrow Biopsy: To confirm multiple myeloma by detecting the presence of myeloma cells.

Treatment Options:

Treatment options for multiple myeloma are personalized based on the stage of the disease, the patient’s overall health, and the presence of symptoms. Initial treatment strategies include:

Chemotherapy and Targeted Therapy: Traditional chemotherapeutic drugs are used to kill rapidly growing myeloma cells. They are administered orally or intravenously and are given in cycles. Targeted therapies are designed such that the drug attacks a specific protein or pathway essential for the growth and survival of myeloma cells. These can be used in combination with other treatments. Bortezomib, carfilzomib, and ixazomib are examples of targeted therapies used in multiple myeloma.
Immunotherapy: This treatment modality harnesses the body’s immune system to fight cancerous cells. These include monoclonal antibodies that target specific markers on myeloma cells and destroy them.
Stem Cell Transplantation: With an autologous stem cell transplant, the patient’s healthy stem cells are extracted, high-dose chemotherapy is given to eradicate the myeloma cells, and the stem cells are subsequently reinfused to aid with bone marrow restoration. Although it is not a cure, this technique can assist in achieving a deeper remission.
Radiation Therapy: When a tumor or lesion in the bone is localized and is causing discomfort or compression of the spinal cord, radiation treatment may be utilized to treat it. Using high-energy radiation, cancer cells are targeted and destroyed during this treatment.

Supportive Care in Multiple Myeloma

Supportive care, in addition to direct cancer treatments, is essential for controlling symptoms and enhancing quality of life. Blood transfusions for anemia, medications to treat bone pain, and supplements to maintain bone density are frequently utilized.

Treatment might also be necessary for side effects, such as infections, renal failure, or hypercalcemia, in patients. To address the multiple elements of the disease, a multidisciplinary strategy combining nephrologists, oncologists, hematologists, and other specialists is necessary.

Conclusion

The critical and complicated nature of multiple myeloma necessitates interdisciplinary care and extensive treatment. Longer survival and a higher quality of life are possible despite the disease’s continued incurability, thanks to continuous research and treatment advancements. The key to successfully managing the illness is early detection and a tailored treatment regimen. Being aware of the disease and actively involved in one’s care can greatly impact the quality of life for those who are dealing with multiple myeloma.