Healthy Living

Can Multiple Myeloma be Asymptomatic?

Can Multiple Myeloma be Asymptomatic?

Key Takeaways

  • Individuals with asymptomatic multiple myeloma are treated only when they start showing symptoms, but should be closely observed and monitored regularly.
  • The doctor will usually determine the stage of multiple myeloma as it assists to start a course of treatment and determine the chances of recovery. 
  • Multiple myeloma is classified as benign (pre-cancerous), asymptomatic and symptomatic and determines the correct time to begin treatment.

Early treatment for persons suffering from multiple myeloma that is asymptomatic may not be beneficial. The initial stages for multiple myeloma do not show symptoms, and this is known as being asymptomatic.

The treatment for persons with asymptomatic multiple myeloma should be deferred up to when the patient starts showing symptoms.

Multiple myeloma is a type of cancer that involves crucial immune cells known as plasma cells. Plasma cells assist your body in battling infection by generating special types of proteins known as antibodies that eliminate cells that are foreign.  

Cancerous cells for patients with multiple myeloma generate too many antibodies that are not normal and ineffective in battling an infection. The development and functionality of other cells that are required for generating blood cells and immune tasks are overwhelmed by cancerous plasma cells that mass in the bone marrow. Tumors develop in the bone, and the bone breaks down due to the accumulation of cancerous cells in the bone marrow.

Persons with multiple myeloma exhibit symptoms like painful bones in the back and ribs, excessive thirst, tiredness, loss of weight, fever, nausea, vomiting, frequent urination and infections.

Diagnosis

Multiple myeloma is diagnosed by detecting proteins that are generated by the cancerous cells known as M-proteins which is normally present in the urine or blood of multiple myeloma patients. An MRI is used to detect the existence of tumors in the bone.

Immediate treatment is required for the majority of multiple myeloma patients who show symptoms even before the condition is diagnosed. Some individuals, however, do not show symptoms and require diagnosis over screen tests particularly high M-proteins in the blood which determines the presence of multiple myeloma. These individuals may have harbored the condition for long without exhibiting symptoms before getting treatment to relieve symptoms and extend their survival. An approximated 15% multiple myeloma patients are asymptomatic. 

Stages of Multiple Myeloma                                                            

Determining the degree of growth or spread of multiple myeloma in a patient is known as staging. The stages of multiple myeloma are useful for the doctors to start a course of treatment and determine the chances of recovery of the person.

The doctors also tend to classify the patients on the basis of whether they are showing symptoms (symptomatic) or not (asymptomatic). Patients without symptoms are only kept on close watch. Treatment is given only to patients who show symptoms. These patients have high blood calcium called hypercalcemia. Their kidney or renal function is also poor. They have bone lesions and also suffer from anemia.

Two staging systems are what doctors specialized in myeloma refer to.

Durie-salmon staging

This is a traditional staging system good for knowing the extent of the disease. 3 stages of myeloma are included in this system: the first stage, the second and the third. Each stage is further classified into A or B depending on the extent to which the kidney is damaged.

The following factors determine the stages:

  • The quantity of myeloma cells in the body
  • Level of damage as a result of the myeloma cells
  • The intensity of M-proteins present in the urine or blood
  • Levels of blood calcium
  • Levels of hemoglobin and albumin

Patients with Stage I myeloma do not have any symptoms. More cancer cells are present in stage II. Stage III has the most cancer cells, anemia and hypercalcemia, advanced bone damage and high amounts of protein in blood or urine.

Depending on the amount of kidney damage, myeloma can also be categorized into Group A and Group B. The normal operation of the kidney is what is indicated by Group A, while its abnormal operation is indicated by Group B. For example, a patient could be categorized into Stage II B.

ISS

Known as international staging system, this system too has three stages and is centered on the levels of the serum albumin and serum B2-microglobulin. This system is now used more commonly. It uses data collected from patients around the world and lists the factors for the survival of the patient.

Types of Multiple Myeloma

Various types of conditions that are related to myeloma exist. Although all of them will need to be examined to know if the condition is progressing, some will need to be to be treated, while others will not. This classification makes it easier to know the correct time to begin treatment.

MGUS (Monoclonal Gammopathy of Undetermined Significance)

Patients with MGUS carry little myeloma cells in the bone marrow, although these cells do not develop a tumor and myeloma symptoms do not exist. It is detected at routine blood assessment that indicates strange quantities of protein in the blood.

The MGUS condition is pre-cancerous so assessments are required after every six months to observe it and ensure that multiple myeloma do not form from it although this occurs in a minority of myeloma patients.

A CT scan, MRI, chromosome analysis and gene array are used to detect MGUS.

Asymptomatic Myeloma or Smoldering Myeloma (SMM)

A person with this condition will have more myeloma cells than a MGUS patient. This illness causes no body harm and no symptoms for myeloma are exhibited.          

This condition can remain stable for a while, although it progresses later and treatment is required. Most patients with SMM will almost always develop myeloma. For this reason, these patients are kept under close watch and treatment is started as soon as there are signs of progression of myeloma.

Symptomatic Myeloma                                                                        

A patient with this condition carries more plasma cells and M protein than asymptomatic myeloma and MGUS patient.

The disease at this level results in bone damage, anemia, high calcium levels in the blood, damaged bones and problems of the kidneys.

Treatment

SMM patients do need treatment. At Stage 1, chemotherapy and/or radiation are given.

A bone marrow transplant is also advised in case of early stages of multiple myeloma. Once the old marrow is removed, the patient is given high dose chemotherapy. After that, the transplantation of healthy bone marrow is done. Treatment in the way of therapy to improve the patient’s quality of life is also given.

There is still plenty of research going on about this disease.