Until the recent death of Geraldine Ferraro, Multiple Myeloma was a disease most people hadn't heard of. Even in reports of her death, the cause was reported as "blood cancer" which encompasses several types of cancers as opposed to the specific type she had suffered from. Yet now more and more people are attempting to learn about this type of cancer as well as its warning symptoms and treatment options.
Multiple Myeloma -- The Unknown Blood Cancer
Although one of the least common types of cancer in adults, the majority of individuals are familiar with at least some forms of hematological cancer (cancers of the blood, bone marrow and lymph nodes). Yet while most people have heard of Leukemia or Lymphoma few have heard of Multiple Myeloma, the third type of blood cancer. In this country alone, approximately 20,000 learn they have this disease and 10,000 people die from it. However, while the incidence rates are increasing, the deaths resulting from this disease have begun decreasing. This is largely due to increased research, leading to better treatment and numerous clinical trials testing additional experimental treatments.
Causes and Symptoms
Multiple Myloma results from the abnormal growth of plasma cells in the bone marrow hindering the production of normal plasma cells. This causes the immune system to weaken until it is unable to fight off infections or even minor illnesses which can be deadly for individuals in this state. In addition, these abnormal plasma cells begin to form and multiply at a rate too fast for normal antibodies to fight off. As these abnormal cells proliferate and the tumor becomes larger, it destroys the bone around it and leads to such symptoms as kidney damage, bone pain and brittle bones, back pain, fatigue, confusion, nausea, loss of appetite, weakness, a compromised immune system, anemia, infections, headaches, bruising, hazy vision, and nose bleeds.
Risk Factors for Developing Multiple Myeloma
The most significant risk factor for developing Multiple Myeloma is age. Individuals under the age of 45 rarely develop this disease while rates increase dramatically for those age 65 and older. In addition, gender and ethnicity are associated with the development of this disorder. Men are more likely than women to develop this disorder and African Americans are twice as likely to develop the disease as are Caucasians. While nothing can be done to target these risk factors other factors which can be focused on to decrease risk of developing this disease as well as numerous others include obesity, working in petroleum related industries, and exposure to radiation. However, no specific recommendations regarding such risk factors to reduce chances of developing the disease have been issued.
Diagnosis
A number of tests are used to determine whether the disease is present and if so, how far it has spread as well as if certain organs, such as the kidneys, have suffered damage. Blood and urine tests are used to discover whether there is protein build-up in either body fluid while bone marrow aspirations determine the percentage of plasma cell in the marrow (more than 10% is indicative of the presence of multiple myeloma). Several other tests are also used to obtain a diagnosis and determine the stage of the disease if present.
Treatment Options
While there is currently no cure for Multiple Myeloma, a number of treatments are available that can help a patient achieve remission both at initial diagnosis and after relapse, slow the progression of the disease, control symptoms and prolong survival. Standard treatment includes:
- Corticosteroids alone or in combination with other medications in particular thalidomide or lenolidamide, a newer version of thalidomide that results in better outcomes with less serious side effects. (Thalidomide is a medication previously used in the 1950s for nausea and sleeplessness in pregnant women, which resulted in severe birth defects such as babies being born with short, flipper-like limbs. It is now being used to treat a number of diseases including Multiple Myeloma although mandatory safety measures have been put into place for those using it in an effort to prevent a new wave of thalidomide babies .
- Chemotherapy, which involves administering toxic drugs aimed at killing off malignant cells.
- Radiation Therapy which can damage the malignant cells causing them to die and can be targeted at a specific area where, for example the tumor has grown large and is causing pain or bone fractures.
- Stem Cell Transplantation which involves first destroying the patients own stem cells with high doses of chemotherapy then replacing these cells with healthy cells which can be taken from the patient themselves after remission is established or from a donor.
- Bortezomib -- the first approved drug in a new class of medications called proteasome inhibitors, which prevents the normal action of proteasomes (large proteins that break down damaged or unnecessary proteins). This class of medications have been shown to cause the malignant cells in Multiple Myeloma to die by blocking the functions of proteasomes.
Clinical Trials
Clinical trials are research studies evaluating the outcomes of standard treatments, combinations of existing treatments or newly developed experimental treatments. They can also be the best way for patients with a disease to gain access to the newest and potentially life saving treatments available. There are currently over 300 clinical trials being conducted on treatments for Multiple Myeloma. More information on this can be obtained from the Multiple Myeloma Research Foundation.
Sources
- CDC. Blood Cancers: Leukemia, Lymphoma, and Myeloma. Retrieved April 30, 2011
- CDC. What You Need to Know About Multiple Myeloma. Retrieved April 30, 2011.
- Cure Talk. (2010, November). List of Multiple Myeloma Clinical Trials and Treatments . Retrieved April 30, 2011
- Lifescript Healthy Living for Women (2009, November). EBSCO Publishing. Retrieved April 8, 2011.
- Mayo Clinic. Multiple Myeloma. Retrieved April 30, 2011.
- Mayo Clinic. Multiple Myeloma - Treatment and Drugs. Retrieved April 30, 2011.
- Medicinenet.com. Definition of a Thalidomide Baby. Retrieved April 30, 2011.
- Memorial Sloan Kettering Cancer Center. Multiple Myeloma -- Diagnosis. Retrieved April 30, 2011.
- Nandi D et al.(2006). "The ubiquitin-proteasome system". Journal of Bioscience, 31, 137--55. doi:10.1007/BF02705243. PMID 16595883.
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