Multiple Myeloma

MULTIPLE MYELOMA backpain

Last Updated February 20th, 2019

Overview

Cancer is any condition involving the uncontrolled growth of cells to such an extent that this disturbs the normal physiological processes of the body. Blood cancer can be of several types since blood is composed of many different kinds of cells and these can be affected in various ways. Leukemia and lymphoma are well known cancers of the blood. Another less well known but related type of blood cancer is multiple myeloma. This malignancy arises in the blood plasma cells which are usually present in the bone marrow. This disease is hereditary in a small number of cases.

 

What Is Multiple Myeloma?

MULTIPLE MYELOMA bone marrowA multiple myeloma is a form of blood cancer that arises when the plasma cells multiply uncontrollably and form tumors. The function of plasma cells is to produce antibodies that help the body fight pathogens. When plasma cells turn malignant, they fail to perform this function and even prevent the production of others kinds of healthy blood cells. Unlike normal plasma cells, they do not die out when they have worn out or become damaged.

As a result, they accumulate progressively until the bone marrow becomes saturated with defective and malignant plasma cells known as myeloma cells. These malignant cells may be scattered throughout the bone marrow or they may clump together into a plasmacytoma. Multiple myeloma is the condition wherein several such growths arise in the body.

 

What Are Its Causes?

The marrow is the spongy core of the bones and this is where blood cells develop. The three main types of blood corpuscles are white blood cells, red blood cells, and platelets. Each has a distinct set of functions. White blood cells fight infection and foreign bodies. When there is an infection in the body, a certain type of white blood cell known as a B-lymphocyte transforms into a plasma cell. It is these cells that are affected when a person has multiple myeloma.

The function of a plasma cell is to produce antibodies that enable the body to disable pathogens. Plasma cells are capable of producing a variety of antibodies. Certain genetic changes or mutations within plasma cells can trigger the transformations that turn them into malignant cells. Unlike normal cells, these malignant ones do not die when they wear out or get damaged. As a result of this, there is an abnormally high accumulation of defective plasma cells (myeloma cells) and not enough healthy ones. These malignant myeloma cells clump together to form masses known as a plasmacytoma.

The reasons behind the initial genetic mutation are not well understood. In fact, abnormalities in bone marrow cells may also have a bearing on plasma cells turning malignant.

 

Risk Factors

MULTIPLE MYELOMA appetite lossResearch has uncovered certain factors associated with an elevated risk of developing multiple myeloma:

  • Having a close relative with this disease roughly quadruples one’s own chances of developing it.
  • Being overweight or obese.
  • Exposure to radiation.
  • Having other diseases associated with plasma cell abnormalities. This includes solitary plasmacytoma and monoclonal gammopathy of undetermined significance (MGUS).
  • The risk increases with advancing age. The incidence of this disease is particularly high in those over 65 years of age.
  • Certain racial groups are more susceptible than others. For instance, African Americans are more likely to develop multiple myeloma than white Americans.
  • Men are more likely to be affected than women.

 

What Are The Effects of Multiple Myeloma?

A myeloma cell is programmed to multiply indefinitely. Thus, it produces millions of copies or clones of itself, all of which contain the same genetic defect. Although these are different from plasma cells, they do make antibodies. Where healthy plasma cells will produce different types of antibodies in specified quantities in response to infection, myeloma cells, on the other hand, are like machines that cannot be switched off. Even when there is no infection in the body, myeloma cells continue to manufacture antibodies.

Since myeloma cells are all clones of each other, they produce vast quantities of the same kind of antibody, earning these antibodies the name ‘monoclonal proteins’ or ‘M-proteins’ for short. Just like other antibodies, M-proteins are a combination of molecular chains. They include two pairs of one light protein chain and a heavy protein chain each. Typically, myeloma cells tend to produce more light than heavy chains, leading to an excessive buildup of free light chains.

The following are typical features of this disease:

  • Higher susceptibility to infection: A healthy body will have small quantities of normal antibodies produced by healthy plasma cells. In a person who has multiple myeloma, M-proteins are often present in excessive quantities. This condition is known as monoclonal gammopathy. As a result, the person’s immune system becomes weak, increasing susceptibility to infection.
  • Bone problems: Myeloma cells produce chemicals that accelerate the process of breakdown of bone, weakening bone tissue. This leads to the elevation of the quantity of calcium in the bloodstream (hypercalcemia).
  • Anemia and thrombocytopenia: The overgrowth of myeloma cells inhibits the production of other kinds of normal blood corpuscles. When numbers of red blood cells drop steeply this leads to anemia and the organs and tissues become starved of oxygen. Lack of platelets is known as thrombocytopenia and this results in a lower ability of the blood to clot in the event of injury.
  • Light chain amyloidosis: Excess light chains (amyloids) form deposits in the tissues and organs disturbing their normal functioning. A load of abnormal deposits builds up faster than it can be cleared out. Hence, this is a progressive condition in the absence of effective treatment. Organs such as the kidney and heart may eventually fail as a result of an excessive light chain amyloid load.

 

Specific Symptoms

  • MULTIPLE MYELOMA backpainFatigue.
  • Shortness of breath.
  • Dizziness.
  • Drowsiness.
  • Bone pain that may arise in any area such as the hips, ribs or back.
  • Frequent and recurrent infection and fever.
  • Reduced ability of the blood to clot. There may be excessive bleeding from minor cuts or injuries.
  • Darkened purple lumps below the skin.
  • Swelling of the legs.
  • Loss of appetite.
  • Abdominal pain.
  • Kidney problems.
  • Increased susceptibility to fractures.
  • Thickening of blood because of excessive M-proteins.
  • Dehydration.
  • Excessive thirst.
  • Frequent urination.
  • Constipation.
  • Neurological symptoms such as numbness and mental confusion on account of nerve damage.
  • Irregular heart rhythm.

 

What Are The Different Types of Multiple Myeloma?

There are several possible variants of multiple myeloma. These are:

  • Indolent Multiple Myeloma: In this case, the condition is largely asymptomatic although there is a high likelihood of progression into symptomatic disease eventually.
  • Active Multiple Myeloma: This form of the disease is symptomatic. Features such as anemia, bone lesions, plasmacytomas and kidney problems may all be present. M-proteins will be present in the blood and urine.
  • Solitary Plasmacytoma of the bone: This presents with a single tumor composed of myeloma cells and located within the bone. Apart from pain at the affected site, there may be none of the other typical features of multiple myeloma. Eventually, the patient is likely to develop more such growths.
  • Extramedullary Plasmacytoma: Clumps of myeloma cells arise in other parts of the body apart from the bone marrow. Usually, they appear in the soft tissues, in the respiratory tract, gastrointestinal tract, brain or breasts. The patient may have purplish lumps just below the skin if the growths are present in those areas.
  • Light Chain Myeloma or Bence Jones Myeloma: In this form of the disease, the myeloma cells produce only light protein chains. They do not produce heavy chains. This often leads to kidney damage. It accounts for about 15-20% of cases of multiple myeloma.
  • oligosecretory or Non-Secretory Myeloma: Typically, the myeloma cells produce vast quantities of M-proteins. However, in this case, it is not so. There may be only small or negligible output of M-proteins. However, the bone will exhibit lytic lesions.
  • ImmunoglobulinD Myeloma: Patients with this type tend to be somewhat younger than in other cases. This form of cancer is rather rare.
  • Immunoglobulin E Myeloma: This is the least common type. It follows an aggressive course and rapidly progresses beyond the bone marrow.

 

What Complications Can It Give Rise To?

There can be a range of severe and critical outcomes in instances of multiple myeloma:

  • The body becomes unable to mount a robust immune response in case of infection, leaving the patient susceptible to all kinds of infectious disease. In fact, complications are likely to arise as a result of these infections that are unrelated to actual cancer itself.
  • Abnormal thickening of the blood means that blood supply to vital organs such as the brain may reduce and this can lead to severe complications. Patients may need to remain on a course of blood thinners in order to keep such problems at bay.
  • Fractures as a result of the weakening of bone tissue.
  • Organ failure as a result of amyloid builds up. Usually, the kidneys tend to suffer.
  • Extreme hypercalcemia can render the patient comatose.
  • Spinal cord compression can develop when the bones of the vertebrae sustain damage or fractures. This leads to numbness, pain, and weakness of muscles and warrants urgent medical attention.

 

What Is The Procedure For Diagnosing Multiple Myeloma?

Generally, symptoms do not manifest until the disease has reached an advanced stage. The following tests provide indications that help in making a diagnosis of multiple myeloma:

  • Blood tests: Complete blood count tests help diagnose anemia and thrombocytopenia. Free light chains may be present in the blood. A viscosity of the blood may also be abnormal. Blood chemistry tests measure the levels of substances such as blood urea nitrogen, creatinine, and albumin besides electrolytes like calcium. This helps assess kidney function.
  • Urine tests to look for free light protein chains.
  • Electrophoresis tests measure quantities of antibodies and detect the presence of M-proteins. This involves testing both blood and urine samples.
  • Imaging tests to check for tumors in other parts of the body.
  • Tissue biopsy. This involves examining samples of bone tissue under a microscope to look for signs of damage.

 

Treatment & Prevention

Conditions such as multiple myeloma require treatments done in two phases. One is a local treatment which involves treating the cancerous tumor without affecting the rest of the body. The second is a systemic treatment which includes therapies that are aimed at cancer cells that have traveled to other parts of the body.

  • Local treatment involves surgery and radiation therapy. These are employed if the myeloma is in its early stages.
  • Systemic treatment is done with the help of chemotherapy, stem cell transplant, biphosphonate, or plasmapheresis. The method employed here depends on which stage cancer has progressed to.

It is important to discuss all possible treatment methods to treat myeloma along with the side-effects of each. Also, make sure that you get a second opinion as well for diagnosis and treatment of myeloma. There are no specific ways that will guarantee a complete prevention from multiple myeloma. However, controlling the associated risk factors can reduce your chances of developing this condition.

These precautionary methods include:

  • Consuming a low-fat, balanced diet with healthy amounts of antioxidants.
  • Refraining from smoking (both active and passive).
  • Avoiding exposure to hazardous chemicals such as asbestos, pesticides etc.
  • Getting complete vaccination for viral diseases such as hepatitis.
  • Practicing safe sex that hinders the spread of HIV.
  • Protecting yourself from harmful radiations that can cause myeloma.

Facts

  • Multiple myeloma can occur in those regions where the bone marrow is active. In adults, these regions include the skull, spine, pelvis, ribs, and the shoulders.
  • The exact cause for multiple myeloma still eludes the medical community. The associated risk factors include genetic abnormalities and environmental toxin exposure.

Facts

  • The median survival associated with multiple myeloma is about 3 years, though there are patients who have lived for almost 10 years.
  • 96% of the diagnosed cases of myeloma are done in patients above 45 years and older. Only 1% of cases are detected people less than 32 years of age.

Facts

  • Toxic substances such as asbestos, benzene, and pesticides increase the risk factor. Thus people involved in leather, petroleum, agriculture, cosmetology industries are at high risk.

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Dos and Don'ts

Dos
  • Discuss with your doctor and cancer team regarding the side-effects of the treatment prescribed (chemo or radiation therapy).
  • Ask for help from people around you for day-today tasks as myeloma makes you more vulnerable to pains, fractures, and infections.
  • Go for each and every follow-up appointment and discuss the progress of treatment and side-effects experienced by you clearly with the doctor.
  • Get prompt treatment for any systemic condition that might occur as a part of the therapy such as hypercalcemia.
Don'ts
  • Completely rely on alternative treatment methods such as herbal supplements or special diets. None of these have received any form of approval from major government bodies.
  • Practice unhealthy dietary and lifestyle habits. Indulge in healthy physical exercises and consume a nutritious diet.
  • Expose yourself to harmful environmental toxins and infections. Practice proper hygiene and sanitation.

 

 

 

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Hepatitis B Envelope Antigen (HBeAg) The HBeAg or hepatitis B envelope antigen test is a screening test used to diagnose the onset of…
beta 2 glycoprotein 1 IgG
Beta 2 Glycoprotein 1 IgG Beta 2 glycoprotein 1 antibody test involves detecting and measuring the presence of the IgG class of beta…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
macadamia nuts in food
Proven health benefits and nutrition of macadamia nuts Know all about scientific, amazing health benefits of macadamia nuts, its nutrition, recipes, how to consume, price and…
macadamia nuts in food
Proven health benefits and nutrition of macadamia nuts Know all about scientific, amazing health benefits of macadamia nuts, its nutrition, recipes, how to consume, price and…
about mediterranean diet
Why you should be adopting a Mediterranean style of diet today Ever wondered why the Mediterranean diet is so healthy? One simple solution to lowering risk of several deadliest…
kefir bottle
Kefir: Top reasons why this probiotic drink should be consumed by you Yet another remarkable fermented food, kefir is a much healthier version of yogurt. These chewy white grains can…
Agave nectar: The bitter truth about this sweetener revealed Agave nectar is considered to be sweeter than the normal table sugar and even contains higher amounts of…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
Sputum test Sputum test is a commonly used diagnostic tool that is used to examine the presence of pathogens in…
colposcopy
Colposcopy Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and…
Hysteroscopy_procedure
Hysteroscopy Hysteroscopy is a minimally invasive tool to help specialists view the uterus to diagnose and even treat several…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Beware of these common foods that cause high bodily inflammation! Maybe its the long list of inflammatory foods in your diet that is making you frequently sick. Find…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
quinoa salad
Quinoa : A prodigious superfood you need to include in your diet today! Quinoa - what is so special about this native South American grain that has taken the world by…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…