- Anemia may occur when multiple myeloma hinders the bone marrow from creating enough red blood cells
- During cancer treatment, myeloma patients' bones receive the ability to repair the damage caused by myeloma cells
- Patients’ regular visits to their physicians are essential to maintain bone health and avoid complications from multiple myeloma
What is Multiple Myeloma?
Multiple myeloma is a blood cancer that is also known as hematologic cancer. It is characterized by the uncontrollable multiplication of a certain population of plasma cells (also known as malignant plasma cells, or myeloma cells). Plenty of similar antibodies, known as monoclonal proteins, specifically M-protein, is produced by the myeloma cells. As a result of the proliferation of myeloma cells, a multiple myeloma patient's bone marrows becomes overcrowded and reduces the production of other blood cells such as red blood cells, white blood cells, and platelets. Another effect of multiple myeloma is reduced body immunity since the body only produces the M-protein antibodies and cannot fight against disease-causing organisms. Anemia can occur as a complication when multiple myeloma hinders the bone marrow from creating enough red blood cells. Bone and other organs may be invaded and/or destroyed by the greatly multiplied plasma cells. Organs, especially the kidneys, may be affected by the monoclonal protein that is secreted by plasma cells. The acronym "CRAB" describes common multiple myeloma symptoms related to organ destruction. These are hyper-calcemia (High blood calcium level), Renal insufficiency (kidney failure), Anemia (low red blood cell counts), and Bone lesions.
Despite its classification as a cancer of the blood, victims of myeloma my observe bone-related symptoms including bone pain, frequent fractures, and bone damage or low bone density.
It mostly occurs in the bone marrow and is most harmful in that region. Multiple Myeloma can occur in the bone marrow of the ribs, hips, shoulders, spine and pelvic bones.
Effects of Multiple Myeloma on Bone Health
Multiple myeloma can cause soft spots in the bone known as osteolytic lesions, which are seen on x-rays and appear to be holes. These holes, or osteolytic lesions, can be very painful and may also result in fractures and breaks in the bones. Myeloma is also known for causing nerve damage or pain when a tumor is pressed up against a nerve. This nerve pressure may result in the compression of the spinal cord, which can result in back pain and muscle weakness. According to a research study done by the Multiple Myeloma Research foundation, about 85 percent of the patients that have been diagnosed with multiple myeloma report bone loss to some extent, as well as the pain associated with it.
In a healthy body, osteoblasts regularly maintain bones, keeping them in optimal health and condition. Myeloma cells can interfere with this critical function by tampering with the osteoblasts' bone-building ability. The cancerous cells stimulate the processes the of osteoclasts' breakdown, which can eventually lead to the breakdown of the entire bone.
Bone-Related Symptoms and Their Impact on Patients
The effects of multiple myeloma on patients are dependent on the advancement of the disease. If it is diagnosed at earlier stages, patients may experience bone pain, especially in the lower back and pelvic region. In advanced stages, patients' bones are fragile and can break easily, even when performing light tasks such as walking or lifting light loads.
Are the Effects on Bones Permanent?
During the cancer treatment required for multiple myeloma, bones build up the ability to repair themselves as the myeloma cells are eliminated. Nevertheless, medical intervention may be required if the damage to bones is severe or slow to heal properly. This often depends on the individual complications that a patient faces. Always consult your doctor to know more about your specific condition.
Maintaining Healthy Bones in Multiple Myeloma Patients and Survivors
Those who have or had multiple myeloma should be sure to schedule regular visits to their doctor, receive timely and thorough checkups and bone scans, and seek medical intervention when necessary.
For patients with multiple myeloma, the regular visits are important because the condition of their bones often subjects them to a catch-22 scenario. Though heavy exercises normally strengthen bones, they increase the risk of fracture in myeloma patients because their bones are too weak to handle the stress of even light exercise.
Multiple myeloma patients should refrain from consuming vitamin D supplements and calcium on their own, because bone loss caused by myeloma may also increase the levels of blood calcium, and more supplementation can make matters worse. Therefore, supplements and physical activity should always be regulated by a doctor that is familiar with the patient's individual state.
Apart from an organization of a supplement regimen and exercise, physicians may also prescribe bisphosphonate drugs in many myeloma survivors and patients to assist in bone regrowth and strengthening.
Treatments for bone pain and lesions
As we just discussed earlier multiple myeloma can be very painful for the bone of the patient and therefore the first priority of the doctor is to relieve the patient of this unbearable pain. There are a number of methods for relieving the pain, including medical and natural. But before starting a new treatment one should always consult his/her, doctor. The most important thing that is to be noticed here is that the treatment for the bone pain and lesions will only help in bone pain and will have no effect on myeloma. In other words, you could say that it will not stop myeloma from growing on its own. Some of the medical treatments for bone pain are:
- Surgery is one of the most common methods used to treat fractures. Rods and plates are inserted into the fracture to support the delicate and fragile bones.
- Radiation therapy is used to shrink the tumors which in turn helps to relieve pinched nerves and compressed spinal chords.
- Doctors sometimes use anticonvulsants and antidepressants to treat the pain that stems from nerve damage.
Current Research on Bone Health and Multiple Myeloma
According to recent studies, long-term use of bisphosphonate medications may put multiple myeloma patients at risk for other conditions like jaw fractures, bone loss, and fractures of the thigh bone. Researchers are still investigating the highest recommended dose and period to take bisphosphonates, thereby optimizing their effectiveness and reducing the risk of negative effects. There are also many clinical trial investigations on bone growth agents that may be more effective or produce fewer side effects.