Multiple Myeloma: Causes, Symptoms and treatment

Multiple Myeloma is a form of cancer in which plasma’s white blood cells become cancerous. These cells usually produce antibodies to protect the body from infections. However, in multiple myeloma, they create abnormal proteins or antibodies that gather in the bone marrow, leading to complications.

Why Called Multiple Myeloma?

It is called multiple myeloma because it affects multiple parts/Systems of the body e.g. spine, pelvic skull, ribs, kidneys, and other systems of the body.

Symptoms of Multiple Myeloma?

In the initial stages, myeloma doesn’t show symptoms but symptoms worsen in later stages. Sometimes myeloma is detected in routine checkups. Like high levels of antibodies in blood and urine tests. However, the following are the signs and symptoms of multiple myeloma.

• Bone pain: A low level of calcium in bones may lead to bone pains. If cancer appears in the bone marrow over production of cancer cells in the bone may weaken the bone which leads to pain. Bone pain is the first sign of multiple myeloma.
• Lethargy: High energy consumption used by cancer cells may lead to lethargy and is also due to low levels of red blood cells or decreased hemoglobin levels.
• Forgetfulness: High levels of calcium level in the blood affects brain function which causes forgetfulness.
• Numbness in arms and legs: If cancer starts or affects the spine it causes numbness in the arms and legs
• Weight loss: As cancer cells consume more energy for their multiplication and body also starts to fight against cancer which leads to weight loss
• Bone fracture: Due to the release of calcium from bones, bones become weak and fragile, leading to complicated fractures. In severe cases, bone fractures occur even when resting or while walking.
• Frequent infections: Patients’ immunity is compromised due to damage to normal infection-fighting cells, leading to many opportunistic infections Patients may catch infections very easily.
• Hyper-calcemic: High level of calcium in the blood, which may lead to symptoms like constipation, nausea, confusion, increased thrust, and frequent urination due to kidneys over-functioning.

 What Are The Risk Factors?

The exact cause of multiple myeloma is still unknown, but there are certain risk factors that may contribute to its development.

• Genetics/Family History: Myeloma may be a change in genes from the parent or any other in the blood relation.
• Radiation Exposure: Unnecessary radiation exposure may cause the chemistry of cells involved in myeloma.
• Exposure to Strong Chemicals: People with strong exposure to chemicals like benzenes, chemotherapy drugs, benzene, or pesticides are at high risk of developing myeloma. People working in plastic manufacturing or re-cycling factories are at  higher risk of developing multiple myeloma
• Age Factor: Myeloma usually affects people of age above 60.
• Gender: Men are more at risk than females.

When to See a Doctor? Consult a doctor when you have, continuous body pains without any cause, feeling lethargic, increased urination, numbness in hands and arms or legs, confusion or forgetfulness, and feeling of fever all the time.

Diagnostic Tests for Multiple Myeloma:

Complete History and Assessment: Your physician will take a complete history before advising further tests.

Complete Blood Count/Urine tests: Low levels of platelets, white blood cells, and hemoglobin in the CBC test and high creatine levels give some indications of multiple myeloma.

X-rays: These help in identifying fractures in the body.

Serum Calcium Levels: High levels of calcium in blood indicate the sign of degeneration of bone.

Free Chains in Blood. The level of free light chains in blood before the kidneys filter the blood, and if the proteins are also present in urine this may indicate the symptoms of myeloma.

MRI/CT Scan: MRI and CT scan show the presence of plasma tumor in the bone marrow known as plasmacytoma.

Bone Marrow Aspiration and Biopsy: Bone marrow biopsy is done to study the genetic changes in myeloma cells by a test called FISH (Fluorescence in situ Hybridization).

LHD Levels in Blood (lactase dehydrogenase): LDH is an enzyme that indicates tissue injury in the body if there is a high level of LDH in the blood this can indicate a sign of myeloma.

Monoclonal Immunoglobulin Level in Blood: This Test measures the number of antibodies in the blood. the antibodies are immunoglobin A( IgA) immunoglobin G(IgG) and immunoglobin M(IgM).The levels of these antibodies will be low when the myeloma proteins OR antibodies are high. This indicates the presence of myeloma.

Treatment and Management:

Chemotherapy: High doses of chemotherapy are administered to the patient to destroy the myeloma cells. This may result in many side effects of chemotherapy.

High Steroid Therapy: High doses of steroids are given to enhance the effect of chemotherapy to combat myeloma. Also, reduce the intensity of nausea and vomiting caused by chemotherapy.

Immunotherapy: Immunotherapy is the drug that regulates a patient’s immunity to fight cancer cells.

Stem Cell Transplant: After the patient’s disease is in remission patient’s healthy marrow is collected. After the collection of healthy marrow, high doses of chemotherapy are given to kill all cancer cells in the body. As a result bone marrow is damaged. To recover the bone marrow the pre-chemo collected bone marrow is re-infused into the patient. This is called a stem cell transplant which may result in the long remission of the disease.

Home Care of Patients with Multiple Myeloma: Care of patients at home is very important. Following are the tips for managing patients at home, especially after chemotherapy.

• Maintain patient’s personal hygiene.
• Help patient maintain hydration
• Avoid energy-consuming exercises
• Take small frequent meals and avoid fatty foods.
• Avoid visiting large crowded places to avoid contagious infections.
• Avoid using sharp objects to prevent cuts.

Multiple myeloma is a type of cancer that affects plasma cells. These cells produce antibodies that help fight off infections in the body. When these cells don’t function properly, it can cause damage to different systems in the body. Detecting the disease early can lead to better chances of a cure.