Spotting the Signs of Myeloma Before It’s Too Late

Explain Multiple Myeloma.

Multiple myeloma is a type of blood cancer that begins in plasma cells found in the bone marrow. These cells generally fight infections with antibodies. Plasma cell abnormalities and uncontrolled proliferation crowd out healthy cells and produce defective proteins in myeloma.

Key Myeloma Features

• Origin: Bone marrow plasma cells.
• Natural: Cancerous plasma cells accumulate and disrupt blood cell formation.
• The spine, skull, ribs, pelvis, and shoulders have bone marrow.

Body effects of myeloma

Multiple myeloma interrupts blood cell synthesis and produces aberrant proteins that damage organs and tissues, causing extensive and often subtle effects. A breakdown of its systemic impact:

Bone System

• Pain and fractures: Myeloma cells break down bone, causing osteoporosis and lytic lesions.
• Nerve compression and mobility difficulties might result from vertebral collapse.
• Hypercalcemia: Bone destruction Excess calcium can induce disorientation, constipation, and kidney difficulties.

Immune and Blood Systems

• Depleted red blood cells cause weariness, weakness, and breathlessness.
• Leukopenia and thrombocytopenia: Low white blood cells and platelets increase infection and bleeding risk.
• Low immunity occurs when abnormal antibodies crowd out functional ones, which decreases the body's defence against infections.

Nervous system

• Nerve injury or side effects from treatment can cause tingling, numbness, or pain in the hands and feet.
• Fatigue and metabolic abnormalities can impair concentration and memory.

Renal Function

• Bence Jones proteins block kidney filters, causing renal failure in myeloma.
• Electrolyte imbalance occurs when kidney failure alters the levels of sodium, potassium, and calcium.

Heart, Lungs

• Anemia and excessive calcium might strain the heart.
• Rarely, the buildup of plasma cells might damage lung tissue or cause fluid accumulation.

What are myeloma symptoms?

Bone marrow disturbance, aberrant protein production, and organ damage are the causes of all multiple myeloma symptoms. The overview is structured as follows:

Common Myeloma Symptoms

• Back, hip, and rib bone pain
• Anemia causes fatigue and weakness.
• Immune dysfunction causes frequent infections.

Unexpected weight reduction

• High calcium levels cause nausea or constipation.
• Increasing thirst or urination—kidney damage symptoms
• Nerve compression or peripheral neuropathy—numbness or tingling
• Low platelet levels cause rapid bruising and bleeding.
• Confusion—often caused by hypercalcemia—mind fog

What causes myeloma?

Plasma cell genetic alterations induce multiple myeloma; however, the specific causes are unknown. Researchers' knowledge breakdown:

Root Causes and Mechanisms

• Myeloma begins when plasma cells in the bone marrow acquire abnormalities that lead them to proliferate uncontrollably and create aberrant proteins.
• Monoclonal gammopathy of unknown significance (MGUS), a benign disorder characterized by abnormal plasma cells, frequently progresses. Annually, 1% of MGUS cases develop myeloma. Bone marrow disruption occurs when cancerous plasma cells crowd out healthy blood cells, impairing immunity.

Possible Risks

• Over 60s are the most common.
• Men are slightly more common.
• African-Americans have higher rates.
• Family history: Myeloma or MGUS in close relatives increases risk.
• Exposure: Radiation, benzene, and agricultural pesticides may contribute.

When should I see a doctor?

If you have persistent, unexplained symptoms that may be associated with multiple myeloma, especially if you are over 60, have a family history of plasma cell abnormalities, or have MGUS, visit a doctor. Advice to help you choose

Consult a doctor immediately if:

• Chronic back, rib, or hip bone discomfort
• Fatigue or weakness that fails to improve with rest
• Recurrent infections or sluggish healing
• Unexpected weight reduction
• Hand/foot numbness/tingling
• Increased thirst or urination may indicate renal problems.
• Easily bruising or bleeding
• High calcium levels may cause confusion or concentration issues.

Also see a Doctor 

• If you have abnormal blood or urine test results (e.g., excessive protein levels, anemia, renal disease),
• You have MGUS/smoldering myeloma and new symptoms.
• While being monitored for another ailment, your symptoms intensify.
• Early diagnosis of multiple myeloma is difficult since its symptoms mimic other illnesses. If something feels “off” and lingers, get tested, even if symptoms are mild.

Furthermore, read https://www.singhealth.com.sg/symptoms-treatments/multiple-myeloma.

How is myeloma diagnosed?

Multiple myeloma is diagnosed through blood tests, urine tests, bone marrow analysis, and imaging studies. The overview is structured as follows:

Myeloma Diagnostic Tests Key

1. Blood Tests

• M-protein detection: Myeloma-produced abnormal monoclonal proteins.
• Beta-2 microglobulin: Disease severity.
• Complete blood count: Possibly anemia or insufficient platelets.
• Tests for calcium and renal function are also conducted. CalcElevated calcium levels and impaired renal markers are common findings. Urine Checks

• The The presence of Bence Jones proteins, which are urine M proteins, is a hallmark of multiple myeloma. Bone Marrow Biopsy

• AspiA bone marrow aspiration and biopsy confirm the presence and proportion of aberrant plasma cells. Imaging

• CT, MRI, PET, or X-rays: Examine for bone lesions, fractures, and marrow.

5. Genetic/Cytogenetic Testing 

• FISH and other molecular tests identify chromosomal abnormalities affecting prognosis and treatment planning.

Criteria for diagnosis

• Doctors often analyse organ damage using the CRAB criteria:
• High Calcium
• Renal dysfunction
• Anemia
• Lesions in bones

Treatment for myeloma?

Treatment for multiple myeloma is tailored to manage the disease, alleviate symptoms, and prolong survival. An organized summary of the key approaches:

1. Drug Induction Therapy

• Combination treatments typically involve using 3 to 4 medications, including proteasome inhibitors such as bortezomib and carfilzomib.
• Immunomodulators (lenalidomide, thalidomide)
• Dexamethasone, steroids
• This treatment reduces tumor burden either before a stem cell transplant or as the primary therapy.

2. Targeted Treatment

• Monoclonal antibodies like daratumumab target proteins on myeloma cells.
• SpecT-cell engagers and CAR-T cell treatments show promise for patients with relapsed or refractory multiple myeloma. Stem Cell Transplant

• Autologous stem cell transplantation is a common result of drug therapy.
• It sustains remission but does not provide a cure. Radiotherapy

• Radiochemotherapy is used to treat spinal cord compression or localised bone pain. Support Bone Health

• Bisphosphonates, such as zoledronic acid, strengthen bones and reduce the risk of fractures.
• Consider taking calcium and vitamin D supplements. Maintenance Therapy

• Low-Drugs like lenalidomide are used to maintain remission. Assistance

• It treats conditions such as anemia, infections, kidney problems, and neuropathy.
• Treatment options include physical therapy, psychological support, and pain management.

Treatment plans are tailored according to a patient's age and overall health.

• Disease stage/aggression
• Organ involvement and genetic markers
• Newly diagnosed or relapsing disease

One of the main complications of multiple myeloma is anemia.

• Reduced bone marrow production of red blood cells occurs due to hypercalcemia.
• Anaemia Multiple myeloma can lead to fatigue, weakness, and dyspnea. Bone Injury

• Myeloma cells disrupt bone remodeling, leading to pain and fractures, especially in the spine, ribs, and hips.
• Osteoporosis
• High Elevated calcium levels can lead to confusion or concentration issues. Renal Dysfunction

• Kidney filters may become clogged with abnormal proteins, such as Bence Jones proteins.
• Renal failure and electrolyte abnormalities may also occur.

4. Immune suppression

• Regular plasma cells are replaced by myeloma cells, which limits antibody production.
• Infections and vaccination failures increase.

5. Neurological Issues

• Lesions or spinal fractures can compress nerves.
• Peripheral neuropathy can be either diseased or treated.

6Side effects connected with the treatment.

• Fatigue, nausea, and neuropathy are potential side effects of both chemotherapy and immunotherapy.
• It increases the risk of infection.

Could myeloma be prevented?

• The cause of myeloma is unknown; hence, it cannot be prevented.
• Multiple myeloma cannot be prevented because its cause is not well understood. However, research suggests techniques to either minimize risk or detect precursor symptoms early.

Why Prevention Isn't Possible

• The condition is commonly caused by mutations in plasma cells.
• Unchangeable risk factors include age, race, gender, and family history.

A benign illness called MGUS (monoclonal gammopathy of uncertain significance) can proceed to myeloma, but identifying who will progress is difficult.

Strategy to Reduce Risk

• These steps may prevent myeloma, but are not guaranteed:
• Maintain weight health.
• Avoid exposure to hazardous compounds such as benzene and insecticides.
• Observe radiation limits
• If diagnosed, examine MGUS or smoldering myeloma often.

Research is ongoing on genetic predisposition, viral triggers, and environmental exposures. Iceland's Stop MM program aims to detect myeloma before any symptoms appear.

Conclusion

• Plasma cell cancer, multiple myeloma, interrupts blood production, weakens bones, inhibits immunity, and damages organs, especially the kidneys. Early detection and intensive care can help manage major complications.
• WWhile prevention isn't possible, monitoring high-risk patients, such as those with MGUS, and reducing environmental exposures may help.
• EEarly diagnosis, individualized care, and ongoing monitoring are essential for effective disease management and maintaining quality of life.