What Causes Myeloma?

Multiple myeloma generally occurs when plasma cells begin to multiply out of control, which, in turn, leads to too much immunoglobulin in both the bones and blood. Like other forms of cancer, it is not immediately clear what precipitates this chain of events or what causes the disease in the first place. Nonetheless, this buildup of immunoglobulin is not limited to bone and blood only; it can build up throughout the body to the point where it can cause organ damage. It is also not uncommon for immunoglobulin to start crowding healthy blood cells in the bones, which can weaken and ultimately dissolve the bone tissue. As myeloma progresses, one’s health can quickly begin to deteriorate. Studies show that the excess plasma that collects in the bone marrow will ultimately leak out and begin to spread throughout the body, which can potentially damage vital organs.

Common risk factors for developing multiple myeloma include:

• Over the age of 65
• Being overweight or obese
• A family history of the disease

It is also important to note that African-Americans are at a greater risk of developing multiple myeloma when compared to their Caucasian counterparts. Additionally, those who have been diagnosed with other plasma cell diseases like systemic light-chain AL amyloidosis and monoclonal immunoglobulin deposition disease, for example, are likely to develop multiple myeloma as well.

What Are the Symptoms of Multiple Myeloma?

In its earliest stages, multiple myeloma is generally asymptomatic; however, as the disease advances, most people will experience the following:

• Sudden weight loss
• Bone pain
• Fatigue

Additional symptoms associated with multiple myeloma may include

• Kidney problems
• Low albumin levels
• High blood protein levels
• Too much calcium in the blood

How Is Multiple Myeloma Diagnosed?

If an individual is experiencing any of these symptoms, they should be seen by a physician who can order a blood test to confirm the presence of the disease.

The most commonly ordered blood tests include:

• CBC (complete blood count) – This type of blood test is generally used to measure the types of cells in the blood.
• BUN (blood urea nitrogen) – This type of blood test can provide invaluable insights regarding the health of a patient’s kidneys.

In addition to blood tests, a urine test and a bone marrow biopsy may be needed to confirm that a patient has developed multiple myeloma. These blood and urine tests will enable physicians to determine the type of abnormal proteins the patient’s body is producing and whether or not they are linked to the disease.

The bone marrow biopsy, which often entails inserting a needle into the patient’s hip to collect a sample of bone tissue marrow, is used to reveal how many plasma cells are inside of the patient’s bone tissue. Of course, the testing does not stop here. To definitively diagnose a patient with multiple myeloma, CT scans, MRIs, PET scans, and X-rays may also be required as well.

What Treatments are Available for Multiple Myeloma?

In treating multiple myeloma, most physicians will take into consideration the symptoms that a patient is experiencing before deciding on a specific course of treatment.

For example, if a patient has multiple myeloma but is otherwise asymptomatic, most physicians will choose to monitor the patient as opposed to starting them on a particular treatment right away. However, if a patient is experiencing symptoms, most physicians will work with the patient to create a treatment plan that not only addresses their symptoms but also helps improve their overall health.

In some cases, physicians may encourage their patients to work with a nutritionist to develop healthier eating habits. Depending on the severity of their symptoms and how far the disease has progressed, some physicians may advise patients to take part in clinical trials. In doing so, patients can take advantage of new medications and combinations that can help them better manage their multiple myeloma symptoms. That aside, some of the more commonly prescribed medications used to treat multiple myeloma include

Chemotherapy

• Cyclophosphamide
• Doxorubicin
• Etoposide
• Bendamustine
• Melphalan
• Vincristine
• Liposomal doxorubicin

It is important to note that chemotherapy drugs are often combined to yield the best possible results when it comes to treating multiple myeloma.

Targeted Therapies

Targeted therapies involve the use of specific medications that work to target genes, proteins, and tissues in the body to help prevent or minimize the growth of cancer cells. Some of the most common targeted therapies include:

Immunomodulatory drugs – These medications are designed to boost the immune system and also prevent new blood vessels from forming in the bone marrow, which deprives multiple myeloma cells of the nourishment that they need to survive. Some of the most commonly prescribed Immunomodulatory drugs include:

• Thalomid
• Pomalyst
• Revlimid

Monoclonal antibody therapy – These cancer treatment drugs are designed to boost the immune system, increasing its ability to spot myeloma cells and destroy them. Some of the most commonly prescribed monoclonal antibody drugs include:

• Darzalex
• Empliciti

Monoclonal antibody drugs are generally prescribed to patients who are asymptomatic as a means of preventing myeloma from progressing to the point where additional treatments might be needed.

Proteasome inhibitors – These types of medications help destroy unnecessary proteins that are created by myeloma cells and also kills the cells in the process. Commonly prescribed Proteasome inhibitors include Velcade (bortezomib), Kyprolis (carfilzomib), and Ninlaro (ixazomib).

Interferon – This targeted drug is designed to slow the growth of myeloma cells in the body and can also be used as a maintenance drug once multiple myeloma is in remission.

Stem Cell Transplantation

In addition to chemotherapy and targeted drug therapies, stem cell transplants have also been shown to be effective amongst those struggling with multiple myeloma. Of course, it is important to note that this approach may not work for every patient. Physicians will have to take into consideration the overall health of the patient and the probability of a favorable outcome before stem cell transplantation can be considered a viable treatment option.

Stem cell transplantation involves removing some of the patient’s stem cells and freezing them. From there, the patient will have to undergo chemotherapy and radiation, which will destroy the multiple myeloma cells in the bone marrow. It is important to note that this process can destroy healthy cells as well, which explains why stem cells are collected beforehand. Lastly, the stem cells are put back into the bloodstream to rebuild the damaged bone marrow and promote healthy cell growth. On a side note, donor stem cells can be used in stem cell transplantation as well.

How Self-Care Can Improve Multiple Myeloma Symptoms

While often overlooked, self-care can help ease multiple myeloma symptoms and should be part of a comprehensive treatment plan. Practicing self-care doesn’t mean completely overhauling your life. In fact, small changes can significantly improve how you feel. Here are a few tips to help get you started:

• Consuming a healthy, balanced diet
• Exercising to improve blood circulation and to strengthen bones
• Staying hydrated
• Getting plenty of rest

Although self-care alone doesn’t necessarily drive multiple myeloma into remission, it can help ease symptoms and can improve your overall quality of life.

Indeed, multiple myeloma is a life-altering disease, but it doesn’t have to signify the end of your life. There are a variety of treatments that are effective in not only easing symptoms but also driving the disease into remission. Of course, the sooner you seek treatment, the better off you will be in the long run.

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