The plasma cells in your bone marrow produce antibodies and help your immune system to fight against outside aggression. Myeloma is a type of cancer that affects these plasma cells. They begin to behave abnormally and form tumors outside the solid bone. This gradually weakens the bones. It also does not allow the bone marrow to produce healthy blood cells. The cause of the disease is not clearly known. Common treatment options for myeloma include chemotherapy and radiation therapy. Several new treatment options have come up so that the survival rate for myeloma has improved significantly.
The blood cells in the human body are formed in the soft spongy tissue of the bone marrow. One of the cells which are produced here is the B lymphocytes or the plasma cells. These cells help to produce antibodies in the blood. The antibodies are the chief soldiers of the immune system of the body. When myeloma occurs, these plasma cells begin to behave abnormally. They multiply rapidly and eventually they form tumors on the surface of the solid bones. This attacks the bones so that it can no longer function properly. Moreover, the abnormal plasma cells interfere with the ability of the bone marrow to produce healthy blood cells. The abnormal plasma cells often produce an antibody called paraprotein which affects the kidney function negatively. The bone function is also hampered resulting in abnormally high calcium levels or hypercalcemia. Myeloma is also known as plasma cell myeloma or Kahler's disease.
Causes of myeloma
The exact cause of myeloma is unknown. There are some research suggesting and longtime exposures to certain harmful chemicals or radiation can cause myeloma. However, many cases are reported where no such exposure is recorded. In such cases, it has not been possible to determine the causative factors. The following table will help you to get a clear idea about the prevalence of the disease:
Incidence of myeloma (2005 – 2009):
|Male||7.4 per 100000|
|Female||4.7 per 100000|
|Blacks||11.7 per 10000|
|Whites||5.3 per 100000|
|Highest incidence found among Black males aged 85 years and above||93.1 per 100000|
|Number of people living with myeloma||81089|
|Number of new cases expected to be diagnosed with myeloma in 2012||Male – 12190
Female – 9510
Death and survival rates for myeloma
|Five year relative survival rate in 2008||42.6%|
|Three year survival rate in 2009||57.1%|
|Number of anticipated deaths from myeloma in 2012||10710|
|Mortality rates for myeloma||White males – 4.1 per 10000
Black male - 8.0 per 10000
White female – 2.5 per 10000
Black female – 5.4 per 10000
Research with data from 2005 to 2009 showed that myeloma is seventh most common type of cancer among black females and ninth most common type of cancer for black males.
Signs and symptoms of myeloma
Since myeloma is manifested in the form of tumors on the bones, the most prevalent symptoms of myeloma is the pain in joints and bones. The symptoms of the disease are as follows:
- The disease interferes with the ability of the bone marrow to produce healthy blood cells. So, anemia is a common symptom. This is a condition where red blood cells fall dangerously below the required quantity. Paleness, fatigue and shortness of breath are common signs of anemia.
- Low platelet count is common because platelets are no longer being produced normally. This may lead to abnormal and easy bleeding and bruising.
- Lesions may develop on the bones.
- More than 70% cases report high level of bone pain. Prolonged localized pain can even lead to bone fracture.
- Increase in the bone resorption lead to abnormally high levels of calcium. This coupled with the abnormal functioning of the blood cause renal failure which is another symptom of myeloma. Renal failure is also hastened by the production of an antibody called paraprotein by the abnormal plasma cells.
- If the cancerous tumor presses on the nerves, it can affect the nervous system of the body. Hence, weakness, confusion and fatigue are caused. Later, pain and numbness may spread to the arms and legs. Neuropathies may also result.
- In the later stages, lessening control of bowel and bladder and paraplegia may result due to spinal cord compression.
Diagnosis of myeloma
A number of tests are run to confirm the diagnosis of myeloma. These are as follows:
- A number of blood tests are performed to determine complete blood count, level of albumin, calcium and total protein.
- Blood and urine are tested to check for antibodies and proteins.
- Tests are made for hypercalcemia, anemia, renal failure and bone lesions to confirm the diagnosis.
- Bone marrow biopsy and bone x rays are performed to detect the disease.
- Bone density testing is done to monitor the bone loss.
Treatment options for myeloma
The treatment of myeloma depends on whether it is smoldering or aggressive. No treatment is prescribed for smoldering myeloma but it is closely monitored. The conventional treatment options for aggressive myeloma include chemotherapy and radiation.
- Chemotherapy includes the administration of several drugs, especially biophosphonates to help to maintain the health of the bones.
- Steroids are sometimes administered.
- Radiotherapy is used to treat localized bone pain caused by concentrated tumors.
- Surgery is not a common option. But it is sometimes used to repair bone damage.
- Bone marrow transplantation is used in certain cases. it may be of two types:
- Autologous bone marrow or stem cell transplantation is the process that uses the patient's own stem cells.
- Allogenic bone marrow transplant is that where stem cells from a donor is used. This treatment option has serious risks, but it offers long term possibilities of cure.
Natural cures like herbal treatments can be used as support therapy. Astragalus which restores the while blood cell count and Bupleurum are used to ease the side effects of chemotherapy.