Future Prospects For Patients With Multiple Myeloma

Multiple myeloma is a type of cancer of a variant of blood cells known as plasma cells. These are predominantly found in the bone marrow. Of the two variants of immune cells, the B and T cells, plasma cells are a type of B lymphocyte cells. 

So in essence multiple myeloma is when these plasma cells increase in numbers beyond their normal requirement within the body, as observed with any other malignancy. These cancerous plasma cells go on to produce proteins that deposit in various parts of the body, called amyloidosis,  which in turn leads to organ damage. 

And like a lot of the cancers that we know of, multiple myeloma does not have a particular underlying cause. Genes, environmental toxins, or occupational exposure have all been linked as possible risk factors that cause multiple myeloma.

While relatively rare, in the United States, a diagnosis of multiple myeloma accounts for about 2% of the overall cancer diagnosis.

Identifying Possible Signs Of Multiple Myeloma

Like most cancers, multiple myeloma also has insidious symptoms. It can take a long time before a diagnosis of multiple myeloma is reached. Since tumor cells are replicating within the bone marrow, one of the first signs patients document is bone pain.

Additionally, patients with multiple myeloma may document recurrent infections. This occurs due to the uncontrollable replication of tumor cells within the marrow and limited functioning immune cells being produced.

Since tumor cells take up most of the space within the bone marrow (which is the powerhouse of cell production) other cells such as red blood cells and platelets are also found to be limited in number. Patients can as a result document anemia and bleeding.

For diagnosis, tests identify an abnormal protein that is produced by the plasma cells of multiple myeloma. Referred to as the Bence Jones protein, this protein can be obtained in a 24-hour urine sample of patients with multiple myeloma. A bone marrow sample might also be taken to observe the increase in the number of plasma cells to confirm a diagnosis.

Frequent Misconceptions About Multiple Myeloma

While multiple myeloma is extensively studied there is very little understanding among the masses about the condition. It is not uncommon to observe misconceptions in relation to multiple myeloma.

One such misconception can be that multiple myeloma has no or limited methods for treatment. In essence, this might be true to an extent, where there isn’t a complete cure for the condition. However, survival rates following early detection can be as high as 75%. These numbers can increase following a successful marrow transplant.

Another common misunderstanding is that multiple myeloma only affects older individuals. While the average age for diagnosis maybe around 60, there are many who are diagnosed in their 20s and 30s. It is true that multiple myeloma can be present for years before it is diagnosed.

There are also concerns that only the closest matching or their own (autologous) stem cells are the only methods of transplantation that are beneficial for patients. However, experts have studied that 5-year survival rates are pretty good even with foreign (allogeneic) stem cell transplants as well.

While deciding on the best management course for multiple myeloma it is easy to encounter several conflicting opinions. With new trials and more treatment regimes available it can be overwhelming. The best step forward is always discussing all your options and finding one that perfectly suits you. 

Standard Treatment Methods for Multiple Myeloma

Management of multiple myeloma depends vastly on the stage of the disease. Initial stages are usually without symptoms and are difficult to detect. Most patients with multiple myeloma present in Stages 2 and 3.

The primary aspect at any stage in multiple myeloma, however, is improving the overall survival rates of the patients. Some things that may affect the survival rate are the age of the patient, underlying health conditions, and kidney function.

One of the first and most important steps towards treatment is analyzing whether a patient can be a potential candidate for a bone marrow transplant. Younger patients who are relatively healthy without any underlying comorbid conditions do well following a stem cell transplant. Diagnosis in later stages of multiple myeloma, or more aggressive conditions are generally not the best candidates for transplants.

Chemotherapy and immunotherapy are one of the first steps in treating all patients with multiple myeloma. This approach is made to reduce the cancer burden in the body. There are several drugs that have been FDA approved for this purpose. Steroids are also often prescribed in combination therapies as they work to increase the efficacy of other drugs that lower the cancerous burden on the body.

Radiation therapy directly kills cancer cells and may have some benefit in managing multiple myeloma.

The best step in managing any patient is looking at their complete medical outcomes following treatment and building the best treatment strategy for them.

Advances In Medical Management of Multiple Myeloma

With increased research, there is a lot of innovation that is taking place for patients with multiple myeloma. This has increased the overall life expectancy for patients with multiple myeloma to about 5.5 years on average.

Dr. Chakra Chaulagain, Director of the Multiple Myeloma Program at Cleveland Clinic Weston, was a part of a clinical trial that brought forth a new FDA-approved immunotherapy for multiple myeloma. This drug binds to the myeloma cells and directly works to reduce its numbers.

Improvements Observed Over The Last 10 Years

With every condition, there are always new studies and insights that help with innovating better for them. Multiple myeloma has observed several such strides in understanding the condition better.

In 2014, the International Myeloma Working Group updated the diagnostic and staging system for multiple myeloma. This is primarily due to the increase in the number of FDA-approved treatment regimes available. 

With more effective management available over the last decade there has been a significant increase in the median survival rate of patients with multiple myeloma. Even new methods for transplantation, known as the Tandem Autologous Stem Cell Transplant, have significantly improved the prognosis for newly diagnosed cases of multiple myeloma. While resistance and relapses have been observed, therapies that target multiple facets of the disease can help to improve the numbers further over time.