Multiple Myeloma: Causes, Symptoms, Diagnosis and Treatment

Orthopaedics & Joint Replacement | Posted on 03/23/2020 by RBH

Multiple Myeloma or Kahler’s disease is a form of blood cancer, which forms in plasma cells of the body. These plasma cells are a type of white blood cells, which help fight infections in the body by producing antibodies that recognize and then attack the germs.

If a person suffers from multiple myeloma, these plasma cells multiply in the wrong way and let too much protein in the bones and blood, while accumulating in the bone marrow and eventually outnumbering the healthy blood cells. These cells instead of producing healthy antibodies start to produce abnormal proteins which then cause several complications. As multiple myeloma spreads, these plasma cells then start branching out from the bone marrow, causing more organ damage.

Even though this condition is life-threatening in some severe cases, it might not require any treatment at all for people who do not experience any signs or symptoms. That said, for the ones who experience the symptoms, several treatment options are available.

Causes of Multiple Myeloma

There is no exact cause of multiple myeloma. However, certain factors make one more at risk of developing the condition than others. These risk factors include:

• People with age over 65 years
• Males
• African Americans or other black races
• Family history
• Genes
• Overweight or obesity
• Exposure to radiation
• Contact or long-term exposure to chemicals used in rubber manufacturing, woodworking or firefighting, or even in herbicides
• Personal history of monoclonal gammopathy of undetermined significance (MGUS)

Symptoms of Multiple Myeloma

Symptoms and signs of multiple myeloma vary from person to person. Some people might not even experience any symptoms at all, while others might not have initial symptoms but experience severe signs with the passage of time.

That said, when signs and symptoms do occur, they will include:

• Pain in the bones, especially in the spine or the chest
• Nausea
• Severe constipation
• Loss of appetite
• Confusion or lack of concentration
• Mental fogginess
• Recurrent infections
• Sudden weight loss
• Weakness or numbness in the legs or arms
• Upset stomach
• Fatigue
• Severe thirst

Diagnosis of Multiple Myeloma

In cases, with signs and symptoms, the doctors will use those to make the first analysis. However, in cases, where there are no symptoms, the diagnosis is mostly made accidentally when the patient is undergoing a blood test for another reason. In such cases, the patient will have either of the below:

• Excessive levels of calcium in the blood
• Fewer count of red blood cells
• Kidney problem
• High total protein but low levels of albumin specifically

That said, some tests and procedures used to confirm the initial diagnosis of multiple myeloma include:

• Blood test to check for complete blood count (CBC) or Blood urea nitrogen (BUN and creatinine levels
• Urine test
• Bone marrow examination
• Imaging tests including X-ray, MRI, CT scan, or a positron emission tomography (PET) scan

Treatment for Multiple Myeloma

For a person experiencing no symptoms, treatment may not be required. But regular monitoring of the condition to check for its progression will need to be done. This will involve regular blood and urine tests.

That said, for cases where there are significant signs and symptoms or in the above condition, if the disease starts to show growth, the below treatment options can be used:

• Targeted therapy: This involves directed drug treatment to cure specific abnormalities in the cancer cells, which allow them to survive. The type of drugs used depends on the age and the stage of cancer, as well as the general health of the person.
• Biological therapy: This involves using the body’s immune system to fight the myeloma cells. These drugs identify and then attack the cancer cells.
• Chemotherapy: This treatment involves killing the fast-growing myeloma cells. Chemotherapy drugs are administered to the patients through a vein in the arm or given in pill form. High doses of these drugs a given to patients before a bone marrow transplant.
• Corticosteroids: Corticosteroids are given to patients suffering from multiple myeloma to help them regulate the immune system, thereby helping to control the inflammation in the body. These steroids are also active against the myeloma cells and are either given in a pill form or through a vein in the arm.
• Radiation therapy: This form of treatment uses external, high-energy beams of energy such as X-rays and protons to kill the myeloma cells and stop their production. This therapy may be used to speedily shrink myeloma cells in a particular area, such as when a collection of these cells is forming a tumor leading to pain or destruction of a bone. 
• Bone marrow transplant: Also known as a stem cell transplant, a bone marrow transplant procedure is used to replace the diseased bone marrow with a healthy one. Before the procedure, blood-forming stem cells are taken from the blood of the patient, and the person is given high doses of chemotherapy drugs to kill the diseased bone marrow. Once through, the collected stem cells are infused into the body of the patient, from where they travel to the bones and eventually start rebuilding the bone marrow.

Even though life-threatening, multiple myeloma can be effectively treated provided the accurate medical diagnosis is made in time and adequate medical treatment is received.