What is Multiple Myeloma?

What is Multiple Myeloma?

    Multiple myeloma, also known as plasma cell myeloma or Kahler's disease, is a type of cancer that affects plasma cells. Plasma cells are part of the immune system and produce antibodies to protect the body against infections.

    In multiple myeloma, there is an abnormal growth and proliferation of plasma cells, leading to cancer in the bone marrow and bones. The disease is characterized by the excessive production of cancerous cells in the bone marrow. These cancerous plasma cells replace normal plasma cells and can suppress the production of normal blood cells by affecting the function of the bone marrow.

    Symptoms of multiple myeloma may include bone pain, easy occurrence of fractures, fatigue, recurrent infections, anemia due to bone marrow failure, and kidney problems. Diagnosis of the disease involves using methods such as blood tests, bone marrow biopsy, and imaging tests.

    Causes of Multiple Myeloma

    The exact causes of multiple myeloma are not fully understood yet. However, it is known that cancer development is generally a complex process involving the interaction of multiple factors. Some factors that may potentially play a role in the formation of myeloma include:

    • • Age: Multiple myeloma is typically observed in middle-aged and older individuals (aged 60 and above). Advancing age may increase the likelihood of accumulated damage and mutations in the cells' DNA over time.
    • • Genetic Predisposition: Individuals with a family history of multiple myeloma may have an increased risk. However, a specific genetic cause has not been identified yet.
    • • Radiation and Chemical Exposure: High levels of radiation exposure or prolonged exposure to certain chemicals may raise the risk of the disease.
    • • Monoclonal Gammopathy Conditions: Refers to a condition where abnormal proteins accumulate in the body. In some individuals, this condition may progress to myeloma.
    • • Obesity: Some studies suggest that obesity may increase the risk.
    • • Chronic Inflammatory Conditions: Certain chronic inflammatory diseases are thought to potentially elevate the risk of multiple myeloma.

    Further research is needed to determine precisely what causes multiple myeloma. Therefore, reducing risk factors and undergoing regular health check-ups for early detection are essential.

    Who Gets Multiple Myeloma?

    Multiple myeloma is a type of cancer that is typically observed in middle-aged and older individuals. According to statistics, it is more commonly seen in people aged 60 and above. However, it can rarely be diagnosed in younger individuals and lower age groups as well.

    While the exact risk factors and causes are not fully understood, the factors mentioned above are believed to increase the likelihood of its development.

    Moreover, symptoms may not be the same for everyone, and they can be mild in the early stages of the disease. Therefore, in older individuals and those with risk factors, especially if there are symptoms such as bone pain, fatigue, weight loss, or recurrent infections, it is important to consult a healthcare professional and initiate the diagnosis and treatment process through appropriate tests.

    What are the Symptoms of Multiple Myeloma?

    The symptoms of multiple myeloma can vary and may depend on the progression of the disease, the areas in the body where cancerous plasma cells are present, and the overall health of the patient. Below are some common symptoms:

    • • Bone Pain: Since the disease most commonly affects the bones, pain and tenderness can be experienced in the back, chest, hips, and shoulders. The presence of cancerous cells in the bones can lead to bone damage and pain.
    • • Easy Fractures: Myeloma can weaken and thin the bone tissue, making bones susceptible to easy fractures.
    • • Fatigue: Proteins produced by cancerous cells can interfere with the production of normal blood cells, leading to anemia. Anemia can result in feelings of fatigue and weakness.
    • • Recurring Infections: The disease can weaken the immune system, making the patient more vulnerable to infections. Recurring respiratory and urinary tract infections are common.
    • • Anemia due to Bone Marrow Suppression: Multiple myeloma can suppress the production of normal blood cells in the bone marrow, leading to anemia.
    • • Kidney Problems: The disease can cause certain proteins to accumulate in the kidneys, leading to impaired kidney function.
    • • Weight Gain or Loss: The progression of the disease and changes in protein levels in the body can lead to weight fluctuations.

    Remember that these symptoms can overlap with those of other diseases. Therefore, if you or someone you know is experiencing any of the above symptoms or a combination of them, it is important to seek medical attention and undergo a thorough evaluation by a healthcare professional.

    What are the Stage Symptoms of Multiple Myeloma?

    The stages of multiple myeloma are a classification system used to determine the extent of the disease and how it has spread throughout the body. Staging plays a crucial role in determining the treatment plan and predicting the prognosis of the disease. The commonly used staging system for multiple myeloma is the International Staging System (ISS).

    The ISS categorizes the disease into three different stages based on laboratory test results:

    • • Stage I: Characterized by low levels of M-protein (monoclonal protein) and low beta-2 microglobulin levels in the blood. Typically, there is only one bone lesion present at this stage.
    • • Stage II: Falls between Stage I and Stage III values or represents a different set of criteria that does not meet either of these stages.
    • • Stage III: Characterized by high levels of M-protein and high beta-2 microglobulin levels in the blood. This stage often involves multiple bone lesions and indicates more widespread disease.

    Staging also assesses whether the disease has spread to other organs (such as the kidneys or bones).

    How is the Diagnosis of Multiple Myeloma Established?

    The diagnosis of multiple myeloma is established through various tests and imaging methods. The diagnostic process generally follows the steps below:

    • • Hospital Visit and Medical History: The individual who presents with suspected multiple myeloma provides detailed information about the symptoms to a healthcare professional and answers questions about their medical history, including family history.
    • • Blood Tests: Blood tests used in the diagnosis include a complete blood count (CBC) and biochemical blood tests. These tests are conducted to assess anemia, evaluate kidney function, and determine the levels of M-protein (monoclonal protein).
    • • Serum and Urine Protein Electrophoresis: Tests called serum and urine protein electrophoresis are performed to detect the levels of M-protein. These tests help identify the presence of abnormal proteins produced by cancerous plasma cells.
    • • Bone Marrow Biopsy: One of the most crucial tests for diagnosis is a bone marrow biopsy. During this procedure, a sample is taken from the bone marrow, typically from the pelvic bone or the back of the chest, using a special needle. This sample is then examined in the laboratory to assess the presence and quantity of cancerous plasma cells.

    • Imaging Methods: Imaging methods like X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) are used to evaluate whether multiple myeloma has spread to the bones or other organs.

    Treatment Options for Multiple Myeloma

    The treatment of multiple myeloma involves the use of various methods, taking into account factors such as the stage of the disease, overall health status, and the patient's preferences. The primary goal of treatment is to control cancerous plasma cells, slow down the progression of the disease, and alleviate symptoms. The treatment options include:

    • • Chemotherapy: Chemotherapy is a drug therapy used to destroy cancer cells or inhibit their growth. Various chemotherapy drugs can be used in the treatment. Chemotherapy may be used alone or in combination with other treatment methods.
    • • Targeted Therapies: Targeted therapies work by attacking specific target proteins of cancer cells. These treatments tend to be more selective in targeting cancer cells and causing less damage to healthy cells.
    • • Immunotherapy: Immunotherapy works by encouraging the immune system to fight against cancer cells. This treatment uses special proteins like monoclonal antibodies to enhance the immune system.
    • • Steroids: Steroids are commonly used drugs in the treatment of multiple myeloma. They can help control cancerous plasma cells and reduce disease symptoms.
    • • Radiation Therapy: Radiation therapy targets and destroys or shrinks cancer cells using high-energy rays. It can be used, especially if there is bone pain or focused lesions in the bones.
    • • Bone Marrow Transplant: Bone marrow transplant is used to replenish healthy bone marrow cells after high-dose chemotherapy. Different methods are available, such as autologous (using the patient's own bone marrow), allogeneic (using donor bone marrow), or mini-transplants.
    • • Supportive Care: During treatment, supportive care such as pain management, blood transfusion, and infection prevention measures can be provided to the patients.

    The choice of treatment depends on the individual situation of the patient. Treatment often involves a combination of multiple methods.

    Does Multiple Myeloma Kill?

    Yes, multiple myeloma is a serious cancer disease and can be fatal if left untreated or not effectively controlled. Myeloma involves the excessive production of cancerous plasma cells in the bone marrow, leading to the formation of lesions in the bones and affecting bone health and other organs.

    Untreated myeloma can lead to severe complications due to the spread of cancerous cells in the body and the disruption of normal blood cell production. Conditions such as bone fractures, kidney failure, infections, and anemia can significantly impact the quality and duration of patients' lives.

    However, significant advancements have been made in the treatment of the disease, and modern treatment approaches can help control the disease and alleviate symptoms. The treatment plan is determined based on the patient's stage, overall health status, and other factors. Early diagnosis and effective treatment can extend the patient's lifespan and improve their quality of life.

    How to Protect Yourself from Multiple Myeloma?

    The exact mechanisms causing multiple myeloma are not fully understood yet, but certain risk factors are known to increase the likelihood of developing the disease. Therefore, to protect yourself, you can follow these important steps:

    • • Healthy Lifestyle: Improve your overall health and increase your resistance to diseases by adopting a balanced and nutritious diet, engaging in regular physical activity, and maintaining healthy habits.
    • • Regular Health Check-ups: Participate in regular health check-ups appropriate for your age and family history. Early diagnosis is crucial, so seek medical attention immediately if you experience any symptoms or suspect any health issues.
    • • Reduce Risk Factors: Take measures to reduce controllable risk factors for multiple myeloma, such as quitting smoking, limiting alcohol consumption, and managing obesity.
    • • Avoid Chemical and Radiation Exposure: Individuals working with chemicals in industrial jobs, those exposed to radiation, and others at risk should take appropriate protective measures.
    • • Participate in Health Screenings: Early detection can improve treatment success. Evaluate your risk status through health screenings, including blood tests, bone density scans, and other appropriate tests.
    • • Regular Exercise: Regular physical activity can strengthen your immune system and increase your resistance to diseases.
    • • Stress Management: Chronic stress is believed to have a negative impact on the immune system. Learn stress-coping techniques and practice methods to reduce stress.

    Keep in mind that the exact causes of myeloma are not fully understood yet, but adopting a healthy lifestyle and reducing risk factors will improve your overall health and increase your resistance to various diseases.

    The content of the page is for informational purposes only, please consult your doctor for diagnosis and treatment.

    Aynur UğurBİLGİN

    Prof. M.D.

    Aynur Uğur BİLGİN

    Koru Ankara Hospital