Understanding Multiple Myeloma

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Multiple myeloma is a cancer that forms in a type of white blood cell called as plasma cell. Multiple myeloma is one of many conditions that can cause problems with your plasma cells, collectively known as plasma cell dyscrasias.

Its aetiology remains unknown, but it has been established that some groups of people are more susceptible to it.

Those older than 65 years, male, African American, family history of the disease, overweight or obese, exposed to radiation, contact with chemicals used in rubber manufacturing, woodworking, or firefighting or in herbicides are more likely to contract it.

How does it present

Early on, those afflicted with multiple myeloma may not encounter any symptoms. But over time, there may be the following signs and symptoms: bone pain, weakness and fatigue, weight loss and loss of appetite, upset stomach, constipation, confusion, frequent infections, severe thirst, and weakness or numbness in your arms and legs.

Doctor may suspect multiple myeloma if there are any clinical symptoms, or a blood test conducted shows: anemia, hypercalcemia, kidney problems, decreased albumin, or A:G ratio reversal.

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Investigations To confirm a diagnosis, you might have blood tests including: complete blood count with Peripheral smear examination, Kidney function test, Serum protein electrophoresis, Free light chain assay, bone marrow evaluation, etc.
  • Blood urea nitrogen (BUN) and creatinine. These check how well your kidneys are working.
  • Other blood and urine tests check whether your body is making unusual proteins and, if so, what kinds and how much.
  • After your test results come in, your doctor may want to do a bone marrow biopsy. They’ll put a needle into a bone, usually in your hip, and take a sample of marrow to check the number of plasma cells in it.
  • You might get imaging tests. X-rays can show spots of bone damaged by multiple myeloma. You may also need a CT scan, MRI, or PET scan.

If tests indicate you have multiple myeloma, doctor will use the information gathered from the diagnostic tests to classify the disease as stage I, stage II, or stage III. Stage I indicates a less aggressive disease, and stage III indicates the most aggressive disease.

Multiple myeloma may also be assigned a risk category, which indicates the aggressiveness of the disease.

The multiple myeloma stage and risk category help your doctor understand the prognosis and treatment options.

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Treatment

If you’re experiencing the aforementioned symptoms, treatment can help relieve pain, control complications of the disease, stabilize your condition, and slow the progress of multiple myeloma.

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Treatments for myeloma Standard treatment options include:
  • Targeted therapy,Immunotherapy, Chemotherapy, Corticosteroids, Bone marrow transplant, and Radiation therapy.
  • The combination of treatments in a particular patient will depend on whether the patient is a good candidate for bone marrow transplant. This depends on the risk of the disease progression, age, and overall health.

Treating complications

Because multiple myeloma can cause a number of complications, you may also need treatment for those specific conditions. For example:

Pain medication, radiation therapy and surgery may help control bone pain.

People with severe kidney damage may need dialysis.

Your doctor may recommend certain vaccines to prevent infections, such as the flu and pneumonia.
Your doctor may recommend bone-building drugs to help prevent bone density loss.
If you have persistent anemia, your doctor may recommend medications to increase your red blood cell count.
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