Category: Multiple Myeloma

Multiple myeloma is a type of blood cancer where abnormal plasma cells are produced at a rapid rate in the bone marrow. The disease can also be referred to as plasma cell myeloma or Kahler’s disease. In multiple myeloma, a large number of plasma cells form masses, or tumors, within the affected person’s bones — particularly in the bone marrow. Bone lesions then occur in the bone marrow as a result. Additionally, the production of normal blood cells may lower significantly in someone who has multiple myeloma. Let’s look at the average life expectancy of multiple myeloma patients.

The Prognosis of Multiple Myeloma

A prognosis is an opinion given by a medical professional regarding the patient’s chances of surviving an illness as well as the chances of the illness recurring — should it recur. During the prognosis, the patient can also learn more about the specifics of what they might go through as the disease progresses.

A prognosis is typically given after considering the factors listed below:

• How much the cancer has spread or progressed. In the case of multiple myeloma, as well as other types of cancers, the medical professional will consider what stage of the disease the patient is in. Specifically, the medical professional will look at the multiple myeloma grade.
• How old the patient is.
• How healthy the patient is, in general.
• How well the patient is responding to treatment.

These factors will vary depending on the patient. As such, each patient’s prognosis will be different.

Life Expectancy of People with Multiple Myeloma

Life expectancy is typically dependent on the factors in which the patient’s prognosis is based on. It also depends on whether or not a certain immunoglobulin is in the patient’s blood, whether or not the patient is experiencing kidney dysfunction, and how the patient responded to initial treatment.

On average, however, life expectancy is around 5.1 years if the patient has been diagnosed with stage I multiple myeloma. If the patient is diagnosed with stage II multiple myeloma, the average life expectancy is about 3 to 4 years. At stage III, the average life expectancy is about 2 years. These numbers are assuming one has received treatment for multiple myeloma. Without treatment, the survival rate of those with multiple myeloma decreases significantly. Around 15% of those diagnosed with the disease who did not receive treatment died within 6 months.

Different Types of Multiple Myeloma

There are two types of multiple myeloma: inactive or active. Those diagnosed with the active type of multiple myeloma will need to be treated immediately. It should be noted that there is an exception: even though no outwards symptoms are shown in either stage I or stage II multiple myeloma, they are still considered to be the active type of multiple myeloma.

The inactive type of multiple myeloma is asymptomatic, meaning that no symptoms of the disease are shown in those who have this type of multiple myeloma. There are multiple subtypes within the inactive type of multiple myeloma, which is listed below.

 

• Monoclonal Gammopathy of Undetermined Significance (MGUS)

This health condition is characterized by an abnormal amount of monoclonal protein in the blood. The condition is largely harmless to the person who has it and so there are typically no health complications that can result in MGUS. However, there is about a 1% chance of the MGUS progressing into active multiple myeloma.

 

• Smoldering Myeloma

This type of myeloma grows slowly. Smoldering myeloma is a cancer that is asymptomatic that could result in an active type of multiple myeloma after a period of time. In this condition, only a few white blood cells are affected and produce an excessive amount of monoclonal protein. The progression of this disease into active multiple myeloma is dependent on plasma cell levels in the bone marrow and the amount of M protein in serum.

Those with smoldering myeloma who has less than 10% of plasma cells in the bone marrow and more than 30 g/dL of M protein in serum has an average of 19 years before the condition reaches active myeloma. Those with more than 10% of plasma cells in the bone marrow and more than 30 g/dL of M protein in serum has an average of 2 years before the condition reaches active myeloma.

There is also the possibility that the smoldering myeloma never reach active multiple myeloma.

 

• Indolent Myeloma

This is a more stable and less severe form of myeloma where the average life expectancy is about 10 years with treatment. Without treatment, however, average life expectancy decreases significantly to 6 months. During stage I of this type of myeloma, average life expectancy is around 62 months. Those with stage II of indolent myeloma have an average life expectancy of around 44 months and those with stage III has an average life expectancy of around 29 months.

Conclusion

Thanks to the continued advancement of medicine and technology, a life expectancy of all kinds of cancers are improving. Additionally, good palliative care, as well as a holistic treatment approach, can help significantly in improving the patient’s day-to-day life.

It is important to note that life expectancy varies greatly from one patient to another. The numbers used in this article is just an average and not anyone’s exact life expectancy.

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Having stages of a disease is a common concept within cancer research. This is because it helps the doctor better evaluate how severe the disease is and how much the disease has progressed. These stages are usually within something called a staging system. For multiple myeloma, a specific type of blood cancer, there are typically two staging systems used to follow the development and severity of the disease. These two systems are the Durie-Salmon Staging System and the International Staging System. Although the systems are structured in a similar way, the two systems have completely different criteria for each of the stages within the system.

A brief description of the Durie-Salmon Staging System, as well as the International Staging System, are available below.

The Durie-Salmon Staging System

This staging system is the more traditional system when it comes to classifying the different stages of multiple myeloma. The Durie-Salmon Staging System consists of three stages that are differentiated by the number of cancerous cells in the body.

During Stage I, there are not a lot of cancer cells in the body. It is unlikely for those with multiple myeloma to experience any physical symptoms at this point. Red blood cell count will likely be normal or just slightly below average. There will also be a normal amount of calcium in the blood.

There is, oddly enough, no specific criteria when it comes to Stage II of the Durie-Salmon Staging System. Multiple myeloma is typically classified as Stage II if the patient does not fall under either Stage I or Stage III.

In Stage III of the Durie-Salmon Staging System, there is a high number of cancerous cells in the body. Red blood cell count will most likely be incredibly low. There may also be a significant increase in the levels of calcium in the blood. As well, those with multiple myeloma must have at least three lesions in the bone to be classified as having Stage III multiple myeloma according to the Durie-Salmon Staging System.

Each of the three stages within the Durie-Salmon Staging System are further classified as having either an A or B designation. The designations are given according to the patient’s kidney function. If the patient still has pretty good kidney function, they are categorized in the A designation. If the patient is experiencing trouble with kidney function, they are categorized in the B designation. The designations are given regardless of stage. It should be noted that multiple myeloma tends to always be worse if there is some form of dysfunction in the kidney, no matter what stage of the disease.

The International Staging System (ISS)

Although the Durie-Salmon Staging System has been used more traditionally when it comes to treating and diagnosing multiple myeloma, many medical professionals now prefer the newer staging system called the International Staging System (ISS). The ISS was developed using data extracted from thousands of multiple myeloma cases around the world. Like the Durie-Salmon Staging System, the ISS also consists of three stages. However, the three stages in the ISS are differentiated using two kinds of chemicals in the body’s blood: serum albumin and beta-2 microglobulin. Many researchers believe that these two chemicals provide a more accurate measure of the severity and progress of multiple myeloma when compared to the cancerous cell count method used in the Durie-Salmon Staging System.

The more the albumin level has decreased in the blood and the beta-2 microglobulin level have increased, the later in stage a patient is in regarding their illness. It should be noted that, unlike the Durie-Salmon Staging System, there are no subcategories to classify whether or not the patient is suffering from any form of kidney damage or dysfunction in the ISS.

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Many health conditions and illnesses can’t be detected without having a physical exam. Multiple myeloma, a type of blood cancer, is one of these illnesses. The multiple myeloma symptoms may not always be readily apparent. As such, many people may not know they have the disease until the severity of the effects — like intense bone pain — begin to show. By that time, however, multiple myeloma will have entered its later stages, where the disease turns life-threatening and treatment is needed immediately.

Multiple myeloma can also be referred to as Kahler’s disease. The disease affects the production of white blood cells and antibodies. Abnormal cells reproduce uncontrollably and eventually turn into a mass– or multiple masses — within the bone marrow. Multiple myeloma occurs when there are multiple masses within the bone marrow. This abnormal cell growth can also cause lesions in the bone as well as abnormalities.

There is no known cure or exact cause of multiple myeloma. However, there are some factors like age, race, and sex that can increase the risk of someone developing the disease. The average age of those diagnosed with multiple myeloma is around 60 to 70 years old. Men are more likely to develop the disease, and those of African American descent are more likely to get multiple myeloma when compared to other races.

Symptoms of Multiple Myeloma

Common symptoms of multiple myeloma typically include intense bone pain around the back and ribs, broken bones in the spine, weakness, tiredness, increased thirst, as well as an increased risk of infection that could cause fever, constipation, increased frequency of urination, nausea, and weight loss. It should be noted that there are typically no physical symptoms of multiple myeloma until in later stages of the disease.

Doctors typically only diagnose patients in the early stage after a blood test and/or urine test. If the blood or urine shows an increased level of an abnormal protein called the M protein.

Diagnosing Multiple Myeloma

Because the physical symptoms of multiple myeloma can be hard to detect, the disease is typically diagnosed after a series of tests conducted by doctors. These tests include blood tests, creatinine tests, urine tests, x-rays, CT scans, and/or MRI scans. A bone marrow aspiration and/or biopsy is usually requested as well after initial diagnosis to check the progress of the disease. Once diagnosed, people with multiple myeloma typically undergo treatment as soon as possible. This is done by consulting a specialist as they will talk to the patient and recommend the most effective treatment.

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Although there are currently a number of researchers working to learn more about multiple myeloma, the cause of the disease remains largely unknown to scientists. While this particular type of cancer can be attributed to some abnormalities in a person’s DNA, many are still unsure if these abnormalities have been present since birth — suggesting that the cause of the disease may mainly be genetic — or if the abnormalities develop some time after birth — suggesting that the cause of the disease may mainly be environmental factors. So are you at risk of developing multiple myeloma?

Despite not knowing the definite cause of multiple myeloma, data and extensive research have allowed researchers and scientists to identify some factors that may increase the risk of multiple myeloma in a person. Below are some of these common factors.

Age

The older you are, the higher the risk of getting multiple myeloma. The average age of those diagnosed with multiple myeloma is typically around 60 to 70. Given how old the average age is for those with multiple myeloma, this gives some weight to the hypothesis that the disease is caused by environmental factors instead of genetics.

Only about 1% of multiple myeloma cases are patients younger than 35 years old.

Race

People of all races can get multiple myeloma, however, the disease is diagnosed more frequently in those of African American descent. In fact, people of African American descent are perhaps two times as likely to get multiple myeloma when compared to people of other races.

Sex

Although the difference is not as large as races, it seems as if men are more likely to get multiple myeloma than women.

Family History

If someone has a relative who has multiple myeloma, they are two to three times more likely to develop the disease. As well, the risk of getting multiple myeloma also increase in someone who has a family member who has monoclonal gammopathy of unknown significance (MGUS). MGUS is not usually dangerous by itself, however many suspect that this condition is a precursor of multiple myeloma and that there is a direct link between MGUS and multiple myeloma.

Chemical Exposure

Risk of getting multiple myeloma can increase after being exposed to harmful chemicals — like asbestos or benzene — for a period of time.

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Multiple myeloma is a type of blood cancer where abnormal plasma cells reproduce uncontrollably and decrease the production of normal and healthy blood cells. There are typically no clear physical symptoms when someone has multiple myeloma. As such, doctors and physicians usually need to conduct a number of laboratory tests to diagnose the illness. Below are some common tests used to diagnose multiple myeloma.

Blood Tests

Those with multiple myeloma will usually produce an uncommon form of protein called M protein. The presence of the M protein is often what doctors and/or physicians look for first when diagnosing multiple myeloma. To check whether or not the M protein is present in the body, doctors and/or physicians will draw blood from the patient and test it. The procedure for this particular blood test is called the serum protein electrophoresis (SPE). It not only help diagnose the disease, the level of M protein in the body also helps to track the progress of the disease.

Urine Tests

Besides blood, M protein can also be found in urine. As a result, doctors and/or physicians will typically also request a urine sample from the patient after or before blood is drawn. The urine is then tested in a procedure known as urine protein electrophoresis (UPE).

Urine tests are especially important because sometimes M protein cannot be detected with SPE or the UPE. In these cases, doctors will use a serum free light chain assay to test the M protein levels in the patient’s urine.

X-Rays

In later stages of multiple myeloma, doctors may be able to diagnose the disease using X-rays. Because multiple myeloma affects the bone marrow, lesions or abnormality in the bone may be present. These things can typically be spotted easily with X-ray imaging.

Besides X-rays, MRIs, CT scans, and other types of body imaging may be used to help detect any damages to the bone. These other types of body imaging can be extremely helpful in the case that the lesions or abnormality are happening within the bone instead of the surface of the bone.

Bone Marrow Tests

This test is typically done after the doctor or physician has diagnosed the patient with multiple myeloma. The test, typically a bone marrow biopsy and aspiration, is usually done to determine the extent of the disease. It involves extracting a sample of the bone marrow with a needle — the biopsy removes a solid sample and the aspiration removes a liquid-only sample.

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Being diagnosed with multiple myeloma can be scary as there is no cure for this type of blood cancer. However, there are many treatments available to help combat the disease and help you continue to live life the way you want to. Below are some things you can do to help you work around some of the effects of the disease to ensure a smoother recovery and help you live your life.

Try to keep yourself from getting ill

Having multiple myeloma can cause your immune system to turn very weak. Recovering from small injuries or the common cold may be much more difficult and complicated than usual — especially with the high risk of infection. As such, taking steps to help prevent yourself from getting ill or injured is pretty important.

One way you can help prevent illness is to carry hand sanitizer around so that you can limit exposure to germs and/or other contaminants. As well, always wash your hands thoroughly before and after eating, after you use the washroom, and after being in public areas where you have a higher chance of contracting germs. It is also highly recommended for those suffering from the disease to limit going outside during peak flu season, which usually begins around November and lasts for a month or so. Additionally, avoid sharing items like glasses, towels, toothbrushes, and food or drinks. This is especially true if someone who may have a contagious illness wants to share these items.

Make sure you are receiving the right nutritions

A common side effect with all cancers is weight loss. To keep your energy up, it is important to ensure that you are getting all daily nutrients you need. The types and amounts of foods that should be consumed by those with multiple myeloma vary from person to person. As such, it is highly recommended that you talk to a dietitian who have experience in creating diets for people with multiple myeloma before you commit to a specific type of diet. The dietitian may also have advice on how to deal with loss of appetite that many people with multiple myeloma and other types of cancer could experience as a result of treatments like chemotherapy.

Typically, a diet your diet should consist of increasing calorie intake to counter weight loss.

Make sure you are keeping up with your emotional health

While physical health is important, it is also important during this time to make sure you are emotionally healthy. Having multiple myeloma and going through the treatments for the disease can be emotionally taxing. As such, having a support system in the form of family and friends can be invaluable during this time. You may also want to look into support groups if you wish to talk to others who are going through the same things as you.

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Multiple myeloma is a type of blood cancer. It occurs when abnormal plasma cells reproduce at an uncontrollable rate. As the abnormal plasma continue to reproduce at a rapid rate, they will begin to build up and turn into a mass, or tumor, and take up space in your bone marrow. This tumor is often referred to as myeloma. Multiple tumors are referred to as multiple myeloma. Because these tumors take up space within the bone marrow, it cripples the bone marrow’s capability to make healthy blood cells. This causes bone weakness, fractures, and a health condition known as anemia. While there is currently no known cure for this disease, there are multiple treatments that one can receive to help combat multiple myeloma and help patients go into remission. So let’s take a look at some of the treatments for multiple myeloma.

Depending on the stage of the disease, symptoms, and treatment can vary. However, it should be noted that treatment for multiple myeloma usually involves a two-fold approach — the first fold of treatments is meant to directly treat the disease, and the second fold of treatments is meant to treat the complications that could have been caused by the disease. During the early stage of multiple myeloma, there are typically no treatments available. If you are diagnosed with early-stage multiple myeloma, you may only need to be monitored on your conditions regularly by your doctor or physician. This is to ensure that the condition does not worsen and cancer does not develop in an aggressive way. If the condition does worsen, however, treatment will be required and needed.

Below are some treatments of multiple myeloma — both treating the cancer directly and treating the complications that are caused by cancer.

Chemotherapy

Chemotherapy is typically the first treatment people with multiple myeloma undergo, according to the University of Texas MD Anderson Cancer Center. Chemotherapy is used to destroy the harmful plasma cells or the cancer cells. This treatment often leaves the patients with intense side effects like nausea, vomiting, and pain. Sometimes, systemic corticosteroids will be given to the patient to help combat these side effects along with swelling and inflammation. However, it is important to note that long-term use of systemic corticosteroids may cause the bones to weaken and impair the immune system.

Additional Drug Therapies/ Immunotherapy

This treatment modifies and/or strengthens the body’s immune system. It typically works by cutting out the nourishment needed by the harmful cancer cells. As a result, the growth of the cancer cell will be hindered. There are also medications that can help the body produce new and healthy blood cells. These new and healthy blood cells will strengthen the immune system and help lower the chances of infection.

Antibiotics may be prescribed, along with a daily dose of penicillin. Additionally, annual vaccinations are strongly advised to help protect the patient against pneumonia and/or influenza.

Clinical trials are also available for patients who wish to participate. These trials are typically done through multiple myeloma research centers. Specialized experts and/or researchers who are trying to find a cure may also have clinical trials that people could participate in.

Radiation Therapy

This is typically the treatment given if the multiple myeloma has grown in a more concentrated area and the patient needs treatment more immediately. It typically has fewer side effects than chemotherapy and has faster results since it treats very specific areas of the affected parts of the bone marrow. Radiation therapy helps to treat serious bone pain and stop the source of the disease responsible for bone tissue destruction.

Stem Cell Transplants

Those with multiple myeloma may receive stem cell or bone marrow transplants. Often, these transplants occur at the same time chemotherapy is being received as a form of treatment. Most people receive autologous transplants. During the autologous transplant, bone marrow is extracted from the body. In a stem cell transplant, the bone marrow is removed from the body and chemotherapy is given to destroy the cancer cells. Then the bone marrow is reinserted back into the body.

Treatment for Bone Loss, Pain, and Fractures

Multiple myeloma can cause bone pain and fractures as the bone breaks down due to the disease. While chemotherapy and radiation will help kill the cancer cells that are causing the bones to break down, it won’t necessarily help with the severe pain one may experience. As such, analgesics, or pain medications, may be prescribed to you for pain control. Additionally, as the bone breaks down, one may experience hypercalcemia, which is an overabundance of calcium in the blood. Those who experience hypercalcemia as a result of multiple myeloma may receive dialysis as a treatment. IV fluids may be received as a treatment as well. Doctors and physicians also often suggest patients with hypercalcemia avoid diuretics and to stay hydrated.

Other alternative treatments for bone pain include acupuncture, meditation, and other relaxation techniques. These treatments are typically not proven as legitimate by doctors or physicians, but instead are usually recommended by patients who have suffered or are suffering from multiple myeloma. It is important to consult your doctor or physician before trying any of these alternative treatments.

Treatment for Anemia

Anemia is a common complication caused by multiple myeloma. As the cancerous cells take up space in the bone marrow, less healthy blood cells are produced. This results in a significant decrease in the amount of blood in the body, which is known as anemia. Blood transfusions are typically used to treat anemia. Oxygen therapy may also be given to help increase oxygen in the blood and aid in shortness of breath. Erythroprotein injections may be given as well to help with the production of healthy blood cells.

Treatment for Kidney Dysfunction and Failure

According to the University of Texas MD Anderson Cancer Center, almost 50% of those with multiple myeloma experience some form of kidney failure. Kidney dysfunction — and eventually kidney failure — often occurs due to the build-up of M protein, which is what the body produces to help fight the cancer cells that cause the disease. The treatment for kidney dysfunction is typically plasma exchange therapy. This helps the kidney filter the blood by lowering the thickness of it that caused by the M protein.

Another treatment is dialysis, where the plasma is filtered externally via a machine or IV fluid. Diuretics and anti-steroidal anti-inflammatory (NSAIDS) medication should be avoided by those with multiple myeloma as it could affect renal function.

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According to the Multiple Myeloma Research Foundation (MMRF), multiple myeloma is the second most prevalent form of hematological — or blood-related — cancer. Hematological cancer occurs when abnormal cells in the blood grow uncontrollably. However, there are multiple stages of multiple myeloma.

About 15,000 causes of multiple myeloma are diagnosed annually and around more than 50,000 Americans are living with multiple myeloma, according to data from the University of Arkansas for Medical Sciences Myeloma Institute for Research and Therapy. Multiple myeloma mostly affects middle-aged and elderly black men. The effects of the disease vary, but some common symptoms, as well as at which stage of the disease the symptoms occur, are explained below.

Early Stage Multiple Myeloma

In the early stages of multiple myeloma, those with the disease do not usually experience any outward symptoms. The level of abnormal antibodies called M protein is elevated during this stage. This is caused by an abnormal cell that gets into the bone marrow, which is responsible for producing blood cells. When this happens, instead of producing plasma cells — a type of white blood cell — the abnormal M protein cell is produced to help the body fight the disease.

No treatment is usually needed during this early stage of multiple myeloma. However, doctors or physicians will typically keep an eye on the patient in case the disease begins to progress and get into more aggressive stages.

Asymptomatic Stage Multiple Myeloma

At the asymptomatic stage, the level of M protein in the body will be higher than in the early stage. As well, at this stage, the harmful cells will have built up within the bone marrow. A bulk of cells will then develop, and this is often referred to as a myeloma. When there are multiples of this mass of cells, then it is referred to as multiple myeloma.

As the harmful cells continue to reproduce uncontrollably, it will gradually take up more and more space in the bone marrow and cripple the production of regular blood cells. As a result, bones may have lesions or weak spots. Symptoms may be bone pain and anemia, which is a decrease of red blood cells.

Symptomatic Stage Multiple Myeloma

At the symptomatic stage, the level of M protein in the body could negatively affect how the kidney functions and can cause kidney failure. As such, treatment is needed immediately and the disease can turn life-threatening at this stage.

Because multiple myeloma lowers the production of regular blood cells, those with the disease can suffer from anemia as well as the symptoms of anemia, as a result. Anemia symptoms can include fatigue, pain, confusion, dizziness/lightheadedness, and an increased risk of contracting pneumonia, the flu, and urinary tract infections. Many of those with multiple myeloma also report symptoms like shortness of breath. This is largely due to a decrease in blood that is oxygenated. As well, one can experience uncontrollable bleeding or could bleed or bruise more easily. This is due to a shortage of platelets — which is responsible for clotting up blood — from a decrease production in normal blood cells.

At this stage, the loss of older bone marrow tissue may occur at a much quicker rate. This could result in a dangerous condition called hypercalcemia. Hypercalcemia occurs when a large amount of calcium is found in the affected person’s blood and can result in a coma or cardiac arrest if left untreated. The quicker destruction of bone marrow tissue can also lead to more frequent bone fractures and cause severe pain in the long bones, skull, the pelvis, as well as bones around the lower back.

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