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Multiple Myeloma

Multiple Myeloma (Plasma Cell Neoplasm)

Plasma Cell Neoplasm is a disease in which the body produces too many plasma cells. These cells can either be benign (non-cancerous) or malignant (cancerous). There are various types of plasma cell neoplasm. Some examples include Multiple Myeloma, Plasmacytoma, Macroglobulinemia, MGUS, etc.

Causes

Like other cancers Myeloma begins in cells. When cancer is present, the body tends to produce extra plasma cells that are not needed. In addition, old cells which would otherwise die, would not do so and combine together with the created cells to form a mass of tissue that is called a tumor.

The actual cause of Multiple Myeloma is not known. There are some factors though, that show that an individual may be at risk of contracting the disease.

  • Age over 65
  • History of MGUS
  • Family history of Multiple Myeloma

Other factors like obesity, exposure to certain chemicals or viruses can put an individual at risk of developing the disease.

Symptoms

When a person is affected with Myeloma, the plasma cells become abnormal and tend to divide and create clones of itself. The new cells continue to then divide and make copies of itself, producing more abnormal cells. Over a period of time, myeloma cells collect in the bone marrow and can damage the solid part of the bone. When the myeloma collects in many bones, the condition is known as Multiple Myeloma. The disease can also affect other organs and tissues. Myeloma cells produce antibodies called M proteins along with other proteins. These proteins can accumulate in the blood, urine and other organs.

Most patients experience the following symptoms:

  • Pain in the back and ribs
  • Broken bones
  • Feeling exhausted and weak very often
  • Feeling very thirsty
  • Frequent infections and fever
  • Weight loss
  • Nausea or Constipation
  • Frequent urination

Most of the above symptoms can be due to other medical conditions as well. If a doctor suspects cancer, tests like a blood test, urine test, xrays and a biopsy may be done.

The choice of treatment would depend on the stage of the disease. For patients who have not yet developed symptoms of Multiple Myeloma, watchful waiting is undertaken and treatment is started once the symptoms are more evident.

If there are indications of symptoms in the patient, induction therapy combined with stem cell transplant may be advised.

Induction Therapy includes Chemotherapy, Targeted therapy and Steroids. Chemotherapy destroys the fast growing myeloma cells, but can also damage other healthy cells. Targeted therapy includes usage of drugs that help to block the growth of myeloma cells. The main aim of targeted therapy is to block the action of the abnormal protein which stimulates the growth of myeloma cells. Steroids when used, help to trigger the death of myeloma cells. It may be used alone or in combination with other drugs.

The drugs will be administered to the patient on an out-patient basis and will be given orally through the mouth or sometimes, through a vein (IV). A patient may require hospitalization in order to get the treatment.

Stem Cell Transplant can be done from self or from another family member. If stem cells are taken from the patient itself, they are frozen and stored. The stem cells are then returned to the patient once he is done with Chemotherapy, enabling the good cells to multiply. Stem cells taken from a donor will have to be checked for compatibility before it is given to the patient. New blood cells develop from the transplanted stem cells. The new blood cells replace the ones that were destroyed by treatment.

Associated Risks

It has to be noted that cancer treatment includes destruction of healthy cells as well. So the patient will experience side-effects, details of which the doctor would provide before starting off any treatment.

The side-effects mainly depend on the kind of drugs and the dosage that is administered to the patient. Some of the side-effects are listed below:

  • Blood cells: When a drug for myeloma is administered, it tends to lower the levels of the healthy blood cells. This puts the patient at risk of developing frequent infections and bleeding . The patient also tends to feel very weak and tired
  • Hair Loss: Chemotherapy can cause hair loss. Hair may grow back again, but it may be of a different color or texture
  • Appetite: If myeloma cells are present on the inner lining of the digestive tract, Chemotherapy and targeted therapy can cause loss of Appetite, nausea, vomiting diarrhea, constipation or painful sores on the lip and in the mouth
  • Drugs that are used to treat myeloma can also cause dizziness, drowsiness, tingling in hands/feet and low blood pressure.

These symptoms usually go away once the therapy ends.

Recovery

Following treatment for Multiple Myeloma, the patient would be advised to go for frequent check ups. This is done to ensure that the cancer has not returned and to treat any side-effects that may have resulted due to the cancer treatment.

Even though, the cancer may appear to be completely destroyed, there could be traces of undetected malignant cells somewhere in the body. This can trigger the diseased cells to multiply again. Checkups with your doctor may include a physical examination, blood tests, xrays and a bone marrow biopsy.

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