Multiple myeloma is a rare form of blood cancer where the bone marrow has cancerous plasma cells. Plasma cells are responsible for generating antibodies, which are important in the immune system, as they are the proteins responsible for fighting specific diseases. Multiple myeloma is a cancer caused when these cells generate uncontrollably and in an unbounded fashion. They cause fractures, tenderness and pain in bones, infections, anemia, organ damage, nerve damage, and other complications.
Though multiple myeloma is a relatively rare form of cancer, it has been found that each year four individuals in every 100,000 people are diagnosed with multiple myeloma in the United States. Men are slightly more affected by this condition than women, and it has also been found out that black people are twice as likely to be affected when compared to white people. The average age of diagnosis for multiple myeloma is 65-70 years.
Currently the treatment options used for treating multiple myeloma cases include stem cell transportation, watchful waiting, immune modulation medications, surgery, radiation, plasmapheresis, and chemotherapy with other drugs. Although these treatment options can ease a patient’s symptoms, bring them relief, and provide some of them with palliative care, extending survival and curing this form of cancer is a rarity.
While it is hard to pinpoint the exact causes of this condition, it has been found that organic chemicals such as benzene, exposure to radiation, insecticides, and herbicides might play a role. Viral infections and genetic factors are also known to be risk factors which make people vulnerable to developing multiple myeloma.
To identify and determine whether the cancer has metastasized, that is, if it has spread to other parts of the body, doctors employ a host of tests in cancer diagnosis. Some of these diagnostic tests are effective in further defining the best treatment options for the disease. A biopsy has so far proved to be the only effective method that has managed to diagnose most cancers. In the case a biopsy cannot be conducted, your health practitioner may advise you to take other tests, such as urine and blood tests, to arrive at a diagnosis of your cancer. To know whether the cancer has spread, imaging tests are also conducted in some cases.
Using test results to diagnose multiple myeloma
Test results are prominently used to diagnose multiple myeloma, although physical examination of the patient and identification of other symptoms is also important in correctly diagnosing the disease. Initial evaluation to diagnose a person as having multiple myeloma includes running blood and urine tests in addition to conducting a biopsy.
The tests often conducted to identify if a patient has multiple myeloma are the following:
- Blood tests. These will reveal the incidence of M proteins that are produced by myeloma cells.
- Urine tests.
- Bone marrow examination.
- Imaging tests.
To diagnose the condition as multiple myeloma, either of the following is required:
1. A plasma cell tumor that is proven by biopsy and a minimum of one of the following:
- High levels of calcium in the blood
- Kidneys that function poorly
- Bones with holes due to growth of tumor, as seen on imaging tests
- Bones or bone marrow with abnormal areas, as seen on an MRI scan
- Blood with one increased type of light chains
2. Incidence of more than 60% plasma cells in the bone marrow
Smoldering myeloma refers to early stage myeloma that is asymptomatic and does not cause complications. Because it is a precursor to myeloma, its symptoms show up before the person depicts any signs of cancer. A person can have smoldering myeloma for several years before they progress to the first stage of multiple myeloma.
Individuals with smoldering myeloma exhibit some signs of multiple myeloma, which could be any of the following:
- Incidence of 10-60% plasma cells in the bone marrow
- High quantity of M protein found in the blood
- Urine with high levels of light chains
However, individuals with smoldering myeloma have normal levels of calcium, their blood count is normal, they have normal kidney function, they exhibit no amyloidosis signs, and they have no organ or bone damage. People who have been diagnosed with smoldering myeloma require no immediate treatment.
What is light chain amyloidosis?
The most common type of amyloidosis, light chain amyloidosis is a condition where a patient is diagnosed as having the following:
- A biopsy indicating amyloid consisting of light chains
- Amyloidosis signs and symptoms
Includes any of the following:
- Blood with elevated free light chains
- Urine with elevated light chains
- Bone marrow filled with abnormal plasma cells
Assigning a stage and a risk category
If through the tests it has been found out that you have cancer, the doctor will then further classify the illness as first stage, second stage, or third stage, based on the information from the tests conducted. Multiple myeloma, as most other cancers, can also be classified into these three stages, each stage more advanced than the stage before.
First stage is classified as the stage where the disease is in a less severe form where there is less prevalence of cancerous cells. For multiple myeloma, first stage patients may only be slightly anemic and have normal levels of calcium in their blood, and have minimum bone damage. Second stage cancer is characterized by higher incidence of cancer cells and worsening anemia. The third stage indicates that a disease is aggressive and may cause damage to multiple organs, such as the kidneys and other organs, and to the bones. Third stage multiple myeloma includes severe anemia, aggressive cancer highlighted by the high incidence of cancerous cells, bone damage, and other equally serious symptoms.
Your illness can also be allocated a ‘risk category,’ which indicates the severity of your multiple myeloma.
A doctor is able to design and provide the best treatment options and have a proper prognosis of your cancer based on the categorization of the stage of your illness and by assigning the proper risk category to it.
In essence, going to the doctor is the best way to proceed if you’re looking to save a lot of dread in the future.