What is Multiple Myeloma & How Do You Treat It

by Calyn Ehid

Multiple myeloma is a type of blood cancer, sometimes referred to as Kahler’s disease. As of writing, there is no cure for multiple myeloma, but there are multiple treatment options available. Some of the treatments slow the progression, while others focus on eliminating the symptoms. Multiple myeloma affects the plasma cells in your body. You need plasma cells to create antibodies, which normally fight infections in your body. With multiple myeloma, your plasma cells start incorrectly multiplying. These cells let too much immunoglobulin into your blood and bones. This causes a protein buildup, which causes damage to your organs. It also causes lytic lesions within your bones.

Other Symptoms of Multiple Myeloma

In addition to organ damage, there are other possible symptoms associated with multiple myeloma. Because your body is producing so many plasma cells, it may stop producing other blood cells. If your body stops producing enough red blood cells, you may become anemic, which leads to feeling weakened or fatigued.

The platelets in your blood may also decrease as a result of multiple myeloma. When your body stops producing platelets, you are at risk of developing thrombocytopenia, which makes your body more likely to bruise and takes longer for bleeding to stop. If your body stops producing white blood cells, you are at risk of developing leukopenia, which makes it harder for your immune system to fight off infections.

You also have a greater chance of developing bone or calcium related issues. Normally, your bones are constantly being remade to stay strong. Your body produces two cells to accomplish this. Osteoclasts break down your old bones. Osteoblasts lay down foundation to grow new, stronger bones. When you have myeloma, your body starts to increase the production of osteoclasts, which increases the rate your bones are broken down. Your body is still producing osteoblasts, but not quick enough to replace how often your bones break down, leading to an increase in possible breaks or fractures.

How Multiple Myeloma Develops

Multiple myeloma begins in the bone marrow, which is the spongy tissue inside most of your bones. Your bone marrow produces fresh blood cells. Multiple myeloma changes the way your body produces blood cells, forcing your body to produce a single type of plasma cell, known as M protein. Your body continues to produce these cells, which leaves less space to create red and white blood cells.

As of writing, researchers are unsure what causes multiple myeloma to initially develop. Like other cancers, it is classified as a heterogeneous virus, meaning each case is unique. While the exact cause remains unknown, researchers have found some groups are at an increased risk of developing multiple myeloma. It is more common in males, as well as seniors over the age of 65. African Americans are also at higher risk to develop multiple myeloma. Some researchers also believe you have a chance to develop multiple myeloma if a family member was diagnosed with it. Finally, being overweight also increases your chances of suffering from multiple myeloma.

Diagnosing Multiple Myeloma

There are several ways to diagnose multiple myeloma. The most common option is to perform a blood test. A blood test allows doctors to look for the telltale M proteins associated with multiple myeloma. Another protein doctors look for in a blood test is beta 2 microglobulin, which is an indicator of how aggressive your myeloma is. A blood test also reveals important details about your kidney function, overall blood count and calcium levels. This is a good indicator of how the myeloma has progressed and indicates what sort of treatment you need.

Another way to search for M proteins is through a urine test. A urine test does not provide as much information as a blood test, so it is not the primary means of testing. However, if you have a urine test as part of a physical or another procedure, your doctor may be able to detect myeloma before it has a chance to fully develop.

Once you have been diagnosed, your doctor may want to perform a bone marrow examination. During this process, your doctor extracts a portion of your bone marrow. The sample is taken to a lab and carefully examined, going through a series of specialized tests. These tests serve several purposes. In terms of research, it gives scientists the opportunity to collect data and try to figure out why you developed myeloma. The tests also show the severity of your myeloma, including the rate at which your body is producing the harmful cells.

Stages and Risk Categories

There are three possible stages, 1-3, representing the severity of your multiple myeloma. Stage 1 is the least severe, while stage 3 indicates your bone, kidneys or other organs are actively in danger. Some doctors also assign a risk category as well. The risk category effectively acts as a subcategory to the myeloma stages. With a lower risk category, your myeloma is less likely to progress to the next stage.

Treating Multiple Myeloma

Once you are diagnosed, the next step is to determine a treatment plan. For stage 1 myeloma, you may not need immediate treatment. However, you are strongly encouraged to frequently visit your doctor to monitor your blood levels to track whether the myeloma is progressing.

If you do need treatment, there are several possible options. The first is targeted therapy using a number of drugs. The three most common ones are Velcade, Kyprolis and Ninlara, which are used to target the myeloma cells, causing them to break down. You may also be given biological therapy drugs, such as Pomalyst, Thalomid or Revlimid. These drugs strengthen your immune system and help your body target the cancer cells.

In more severe cases, treatment involves chemotherapy. Chemotherapy targets cancerous cells using concentrated doses of medication. It is sometimes used alongside radiation treatments. If the myeloma continues to progress, the next step is a bone marrow transplant. You must go through chemotherapy before undergoing a bone marrow transplant. During the transplant, your bone marrow is destroyed and regrown using blood-forming stem cells, which are injected into your body.