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Multiple Myeloma – Symptoms, Causes, Diagnosis and Treatment

Multiple myeloma is a type of cancer. It is also referred to as MM, myeloma, plasma cell myeloma, or as Kahler’s disease. Multiple myeloma (MM) is basically a cancer of the plasma cells in bone marrow.

Plasmas cell are a type of White Blood Cells (WBCs) which are a part of the immune system that are responsible for protecting the body from germs and other harmful agents. Multiple myeloma is the most common type of plasma cell cancer.

Symptoms

  • Bone or back pain (It’s the first sign)
  • Broken Bones or Unexplained fractures (usually occurs in the spine)
  • Bleeding gums or nosebleeds
  • Increased susceptibility to infection
  • Renal failure
  • Anemia symptoms such as weakness, shortness of breath, and fatigue
  • Feeling thirsty often
  • Frequent Urination
  • Unusual Weight Loss
  • Getting Headache often
  • Nausea or Constipation

The first six are the main symptoms of this Multiple myeloma disease. To be more specific, problems related to bones are the most important symptoms. Other symptoms are common to many other disease. But it’s better to consult a doctor if you have any of these symptoms.

Causes and Risk Factors

Till now the actual real causes of Multiple myeloma is unknown but let’s see how the disease progresses and risk factors associated with it.

Multiple myeloma starts when the genetic material (DNA) structure is damaged or altered during the development of a stem cell into a B-cell in the bone marrow. DNA consists of all the cell related information such as when to divide, grow, die, etc. When these instructions get altered, uncontrolled reproduction of cells may occur. Such uncontrolled mutation leads to multiple production of plasma cells in the Bone marrow. Interleukin-6 is a key growth and survival factor for myeloma cells that promotes uncontrolled reproduction of myeloma cells and forms tumors in the bone marrow. Generally in normal persons there is less than 5% plasma cells in bone marrow but in patients suffering from Multiple myeloma there is 10% plasma cells in Bone marrow.

When plasma cells grows excessively the body starts losing its ability to to produce red blood cells, white blood cells, and platelets. This in turn leads to anemia and makes the person more prone to infection and causes frequent bleeding.

Pain and destruction of bones occur as the cancer cells starts growing more and more. When the spine bone gets affected more pressure is put on nerves, resulting in numbness or paralysis.

Multiple myeloma is more common among older adults (Above 65). People who have history of radiation therapy have more risk for this type of cancer. Many patients suffering from Multiple myeloma are overweight and doctors say that obese persons have more risk for this type of cancer.

Diagnosis and Tests

Blood tests are taken to diagnose this disease. The tests include:

  • Blood chemistry (CHEM 20) shows increased calcium levels, total protein value, and any abnormal functioning of the kidney.
  • Complete blood count (CBC) gives the count of RBC, WBC and platelets. It is done to find whether the count is low or not
  • Serum protein electropheresis (SPEP)
  • Urine protein electrophoresis (UPEP) or Bence-Jones protein analysis
  • Quantitative immunoglobulins (nephelometry)
  • Bone x-rays are taken to find fractures or any hollow areas in bone. Bone marrow biopsy may also be performed

Treatments

  • People who have been affected by Multiple myeloma have various treatment options that includes watchful waiting, Induction therapy, Chemotherapy, Radiation therapy and stem cell transplant.
  • Radiation therapy and Chemotherapy are performed to relieve bone pain or to treat a bone tumor.
  • Bone marrow transplantation has higher success rate in younger adults as it completely cures the disease but it involves significant risks.
  • Multiple myeloma medications include decadron, thalidomide, melophalan, bortezomib (Velcade) and lenalidomide (Revlimid). Fractures are prevented by using Bisphosphonates.
  • People suffering from multiple myeloma are advised to take plenty of fluids to prevent their body from getting dehydrated and to regulate kidney function. They should be cautious when having x-ray tests that use contrast dye.
  • In some rare cases Chemotherapy and transplants have permanently cured the disease. Let’s hope for the best.

Prevention

Since the causes for Multiple myeloma and clear risk factors associated with it are unknown, at present this disease is considered to occur due to a combination of factors. Hence it is not possible to prevent Multiple myeloma. I hope something will turn up in future.

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