Posted inLymphoma Blood / Hematology Cancer / Oncology

Multiple myeloma: What are the causes?

July 14, 2021
Multiple myeloma: What are the causes?

Multiple myeloma is a type of malignancy that affects the plasma cells. Plasma is a sort of white blood cell that is involved in the fight against infection. Multiple myeloma is a cancer that affects the bone marrow, which produces plasma cells.

Multiple myeloma is a form of plasma cell tumour that affects the immune system, kidneys, and red blood cell count among other organs and systems.

According to the American Cancer Society (ACS), approximately 1 in every 132 people will be diagnosed with multiple myeloma at some point in their lives.

Multiple myeloma is a cancer that primarily affects older persons. Doctors detect fewer than 1% of instances in patients under the age of 35, according to the American Medical Association. Males are slightly more likely than females to suffer from this condition, which affects people over the age of 65.

Definition

Depressed African lady
Multiple myeloma is a kind of cancer that spreads through the bloodstream, according to the latest research.

Multiple myeloma is a kind of cancer that affects the immune system. Cancer begins when the DNA structure in a cell undergoes a transformation. A genetic mutation is what is referred to as this.

A mutation can cause rapid cell proliferation while simultaneously inhibiting the death of undesirable cells in the body. Because the altered cells do not die, they accumulate and eventually form tumours.

Plasma cells are a type of white blood cell that can be found in the body. The antibodies they make assist to protect the body against illness.

Bone marrow is a soft, spongy substance found in the centre of most bones that is responsible for the production of white blood cells.

When multiple myeloma develops, the body overproduces plasma cells in the bone marrow, resulting in the disease. Tumors can form as a result of the proliferation of these cells. The cells also create a protein known as monoclonal protein, or M protein, which is produced by the immune system.

Typically, a doctor will diagnose multiple myeloma if plasma cells constitute 10% or more of the bone marrow or if a person has several lesions on their lymph nodes.

In the beginning, the cells reproduce in the bone marrow of the spine’s vertebrae. They then enter the bloodstream and move to other regions of the body where they can be found in bone marrow. They tend to congregate in the bone marrow as well as the hard, outer portion of the bone.

As this evolution occurs, the plasma cells have the potential to cause a number of cancers. Multiple myeloma is the term used to describe this progression.

Multiple myeloma, in contrast to many other malignancies, appears to spread through the bloodstream. It has the ability to spread swiftly throughout the body, making it difficult to treat.

Multiple myeloma is a form of plasma cell neoplasm that affects the immune system. Plasmacytoma and monoclonal gammopathy of unknown significance (MGUS) are two further instances of rare cancers.

Plasma cell neoplasms are a type of cancer that can be either benign or malignant. Despite the fact that some benign forms can develop into cancer later in life, benign forms are noncancerous. In each year, around 1% of those who have MGUS are at risk of developing multiple myeloma, according to statistics.

Symptoms

In the case of multiple myeloma, the symptoms vary depending on the stage of cancer and the overall health of the individual suffering from the disease. In the early stages, there may be no signs or symptoms.

If symptoms do manifest, they may include the following:

Difficulties

As myeloma progresses, it may cause a number of issues. There are several of these that are potentially fatal.

A side effect of this is that calcium from the bones is released into the bloodstream. High calcium levels in the blood can result in the following complications:

  • excessive thirst and frequent urination
  • confusion
  • constipation
  • loss of appetite
  • nausea and vomiting
  • restlessness

As plasma cells overproduce, they have the potential to crowd out normal cells. Changes in the numbers of red and white blood cells, as well as platelets, can result in:

  • fatigue
  • breathlessness
  • repeated infections
  • easily bruised skin
  • nosebleeds, bleeding gums, or other unusual bleeding
  • a higher risk of infection, such as pneumonia

It is also possible to suffer kidney damage and spinal cord compression. These are some of the consequences:

  • numbness
  • weakness
  • tingling in the legs

Acute myeloid leukaemia (AML) is a kind of leukaemia that grows rapidly.

Causes and risk factors

Scientists are unsure of the specific cause of multiple myeloma, although the following factors may raise the likelihood of the disease:

Age: The majority of diagnoses are made in adults over the age of 65.

Race or ethnicity: It is more likely to affect African Americans

Sex: It is slightly more common in males.

Factors related to genetics: Some persons who have multiple myeloma have a family who has the disease.

Obesity: This appears to increase the risk.

Other plasma cell conditions: Having MGUS can increase the likelihood of developing this disorder.

According to the findings of a study released in 2012, exposure to chemicals that individuals use in farming, printing, and cleaning may raise the risk of developing cancer.

Diagnosis

A biopsy
A biopsy can aid in the diagnosis of multiple myeloma.

Doctors will do a thorough examination of the patient’s personal and family history in order to identify multiple myeloma.

They may also employ a variety of tests, such as the ones listed below:

  • a physical examination
  • blood tests, urine tests, and X-rays
  • imaging tests
  • a bone marrow biopsy

A regular blood or urine test may occasionally reveal aberrant proteins, such as M proteins, that are not expected. Multiple myeloma is characterised by the presence of these symptoms.

Staging

A staging approach known as the Revised International Staging System is used by myeloma doctors in order to determine the stage of the disease.

This system takes into account four factors:

  • levels of albumin in the blood
  • levels of blood beta-2-microglobulin
  • levels of LDH in the blood
  • genetic features of the cancer

Depending on the results, a person will be assigned to one of three stages: stage 1, stage 2, or stage 3. An individual receiving a diagnosis at the earliest possible stage will have a greater probability of living at least 5 additional years.

However, only around 4.8 percent of persons acquire a diagnosis at this point, owing to the fact that symptoms frequently do not manifest themselves until later.

Treatment

Currently, there is no cure for myeloma, however treatment can help to slow or even stop the disease’s course.

Various treatments are discussed in greater detail below. The following are the objectives of these interventions:

  • The removal of cancerous cells from the bone marrow is used to manage cancer
  • For as long as possible, keep the cells from returning to their original location
  • reduce the severity of symptoms such discomfort, anaemia, and renal damage

Chemotherapy

Chemotherapy has the potential to eliminate myeloma cells. A doctor recommends chemotherapy, which is a combination of potent chemicals that can either help kill cancer cells or prevent them from dividing.

Chemotherapy can be classified as follows:

  • systemic, which indicates that it has an effect on the entire body, or
  • regional, with a focus on a certain area

These medications can be taken orally or administered intravenously (IV) over a period of several months.

In addition to killing cancer cells, chemotherapy has the potential to destroy healthy cells as well. This implies that it has the potential to cause serious side effects. These adverse effects, on the other hand, usually subside once the treatment is completed.

Learn more about chemotherapy and its side effects here.

Transplantation of stem cells

Stem cells are immature blood cells that have not yet matured. Following high-dose chemotherapy, the individual may benefit from a stem cell transfusion that is derived either from their own cells or from those of a donor, depending on their circumstances.

Because the new stem cells aid in the body’s recovery, a person who receives stem cell treatment may be able to take a higher dose of chemotherapy as a result of the treatment.

The usage of this alternative is dependent on the course of the disease, the age of the patient, and the overall health of the person who has myeloma.

Various other medications

Corticosteroids: Corticosteroids are medications that can be prescribed by a doctor. However, the exact mechanism by which they work is unknown. They may stimulate the immune system to stop the growth of new cancerous cells.

Biologic therapy: These can either delay or prevent tumour growth by interfering with the immune system’s ability to function. Thalidomide and interferon are examples of such medications.

Targeted therapy : Some cancer drugs are capable of identifying and attacking cancer-promoting cells or processes. They are less toxic than chemotherapy since they exclusively attack specific cells, which means they should have less side effects. One example is the use of monoclonal antibodies in medical treatment.

According to the Food and Drug Administration, there are presently two immunotherapy alternatives for multiple myeloma that have been approved:

  • Daratumumab (Darzalex)
  • Elotuzumab (Empliciti)

Monoclonal antibodies are what these are referred to as. They work by targeting specific routes, and they may be effective in treating certain persons with advanced multiple myeloma.

Surgery and radiation therapy

Occasionally, to remove a tumour completely, a doctor will propose a combination of surgery and radiation therapy.

There are additional clinical trials available for patients with multiple myeloma. Anyone who may be interested should chat with their doctor about the possibility of participating in one of these studies. Participating in clinical trials can provide individuals with access to novel treatment choices that are not yet available to the general public.

Managing the signs and symptoms

Other symptoms and consequences may need the prescription of different medications by your doctor, including:

  • pain relief medication for back or bone pain
  • dialysis for kidney problems
  • an annual influenza jab to prevent infections
  • therapy and possible transfusion for anemia

In addition, the doctor may urge that you stay hydrated and avoid taking certain medications that can exacerbate renal problems.

Sometimes a person will not receive any therapy, but will instead attend routine doctor’s appointments to allow the doctor to watch for any changes in their condition. This method is referred to as “watchful waiting.”

Self-management

Multiple myeloma cannot be cured by changing one’s way of life. They may, on the other hand, improve overall health and lessen the impact of myeloma on people’s overall quality of life.

Dietary recommendations

Dietary suggestions that may be beneficial in strengthening the body while undergoing treatment include:

  • maintaining a healthy weight
  • avoiding crash diets
  • eating 5–6 small meals a day or a small meal every 3 hours
  • consuming bland foods, such as crackers, yogurt, and potatoes, so reducing the risk of nausea
  • including protein-rich foods, such as eggs, fish, or nuts, which play a role in cell repair
  • eating whole-grain foods, such as whole wheat bread and rice
  • following food hygiene rules, as the person may have a higher risk of infection
  • staying hydrated, especially by drinking water
  • limiting or avoiding sweets, sugars, and alcohol
  • monitor bowel habits for changes
  • consuming plenty of fresh fruits and vegetables

These options can assist in reducing the burden of myeloma on one’s daily activities.

Is there a link between a person’s diet and their risk of cancer? More information can be found here.

Other suggestions for a healthy lifestyle

Physical exercise
Physical activity may be beneficial for those who have multiple myeloma in terms of improving their overall quality of life.

Other aspects of one’s lifestyle that may be beneficial include:

  • making sure you receive adequate physical activity and sleep
  • locating a local support group that can provide emotional and other assistance
  • If it is appropriate, you should consider stopping smoking

Some cancer experts advise taking vitamins and other preventative actions to manage the disease.

When considering alternative or complementary therapies, cancer patients should consult with their doctor first, because certain remedies can combine with existing treatments or make symptoms worse.

Outlook

Multiple myeloma is a cancer that cannot be cured, although it can be managed. On average, a person who receives a cancer diagnosis has the following chances of living at least another 5 years after being diagnosed:

  • Early stage: 73.9%
  • Later stage: 51.1%

In the early stages of the disease, around 4.8 percent of persons acquire a diagnosis.

The percentages are calculated by the health authorities based on historical statistics. Individual factors, on the other hand, will influence how long a person will live with any type of cancer.

These considerations are as follows:

  • the type of cancer
  • the person’s age
  • their overall health, especially their kidneys function

Furthermore, as a result of scientific and medical advancements, the chances of surviving most cancers have improved significantly in recent years and are expected to continue to improve in the future.

Sources

Last updated on July 14, 2021