Myeloma: early signs, risk factors and prognosis

Myeloma is a malignant neoplasm that develops from plasma cells in the bone marrow.

This disease does not manifest itself at first, and its symptoms only become apparent in the advanced stages. That is why it is so important to see a doctor at the first signs.

Modern medicine has effective solutions to combat this pathology. Therefore, patients with this disease can continue to lead an active lifestyle.

We will tell you more about this disease in this article.

What is myeloma?

In simple terms, myeloma is a cancer that occurs when immune cells (plasma cells), which are responsible for producing antibodies, begin to multiply uncontrollably. Instead of protecting the body from infections, they accumulate in the bone marrow, displace healthy cells and produce abnormal proteins. It is these proteins that damage the internal organs.

This disease of the haematopoietic system disrupts the normal formation of leukocytes, erythrocytes and thrombocytes. This subsequently leads to anaemia, reduced immunity and blood clotting problems.

Types of myeloma

Each form of this blood cancer has its own characteristics in terms of progression and treatment.

Multiple myeloma

This is the most common type of the disease. Its main feature is the presence of numerous affected areas in different parts of the bone marrow. If myeloma is multiple, it progresses faster than other conditions and requires immediate medical attention. It is this type that most often causes fractures and bone pain.

Solitary plasmacytoma

In solitary plasmacytoma, there is only one focus of the disease. This type of bone marrow tumour is localised in one bone or soft tissue. It responds better to local treatment with radiation therapy and has a good prognosis. However, after treatment, the patient still needs to be monitored.

Asymptomatic (slow) myeloma

This is an intermediate stage between a benign condition (monoclonal gammopathy) and active-stage blood cancer. In this case, abnormal cells and pathological protein are present in the body, but there are no signs of damage. This form requires only active monitoring without immediate therapy.

Secondary myeloma

It can develop as a complication after fighting other oncological diseases. Especially after prolonged chemotherapy or radiation. Malignant tumours located in other areas can trigger the development of this pathology. Secondary forms often have a more aggressive course.

Causes and risk factors for the development of cancer

Unlike other forms of cancer, the causes of myeloma are not precisely established. However, it is important to highlight the factors that may contribute to its development.

• Age - in elderly people, the susceptibility to developing the disease increases significantly.
• Gender and ethnicity - men are more likely to develop the disease than women. People of African descent have a higher risk of developing the disease compared to the Caucasian population.
• Genetics - the presence of this pathology in close relatives increases the likelihood of cancer in subsequent generations by 2-3 times.
• Monoclonal gammopathy of undetermined significance - a condition in which a pathological protein is present in the blood, but there are no signs of disease.
• Prolonged exposure to radiation or working with radioactive materials increases the risk of haemoblastosis.
• Obesity and metabolic disorders create favourable conditions for the transformation of healthy cells into malignant tumours.

Early signs of multiple myeloma

The symptoms of myeloma are quite non-specific. Therefore, at first, a person perceives them as signs of ageing or other health problems. However, unusual symptoms should alert you and prompt you to see a medical professional.

This oncology usually manifests itself as follows:

• constant fatigue or weakness. These arise due to the development of anaemia, shortness of breath appears, and the skin takes on a pale hue;
• pain in the back and pelvic bones. It intensifies with physical exertion and does not go away after rest;
• frequent infectious diseases. This is a consequence of a compromised immune system, which does not perform its protective function against bacteria and viruses;
• increased thirst, frequent urination.
• This occurs due to hypercalcaemia, a condition in which the level of calcium in the body increases as a result of bone destruction;unexplained weight loss. Cancer is often accompanied by weight loss that is not due to changes in diet or physical activity;
• neurological symptoms, such as numbness and weakness in the legs. These may indicate the growth of a tumour or a pathological fracture of the spine.

When to see a doctor

If you notice any of the above symptoms, we advise you not to delay seeing a doctor. Timely diagnosis and treatment significantly increase the likelihood of recovery.

Consult the doctors at the Oncare Medical Centre in the following cases:

• Constant bone pain that lasts for several weeks and is not related to injury. Also, if the pain does not subside after taking painkillers or worsens at night.
• Weakness, fatigue even after rest.
• Recurrent infections of the respiratory or urinary tract.
• Increased thirst accompanied by nausea, constipation, and confusion.
• Any problems with the nervous system may indicate compression of the spinal cord.

Possible complications of myeloma

Without proper treatment, myeloma leads to complications that affect everyday life. Let's take a closer look at what happens to the human body if this pathology is left untreated.

1. Bone fractures - occur even with the slightest stress due to the leaching of calcium from bone structures. The greatest threat is posed by compression fractures of the vertebrae. As a result, paralysis may develop.
2. Renal failure - pathological protein produced by abnormal plasma cells is toxic to the renal tubules. Hypercalcaemia and dehydration also have a negative effect on kidney function.
3. Severe anaemia causes constant fatigue, shortness of breath, and rapid heartbeat.
4. The presence of pathological protein thickens the blood, making it viscous. This can lead to bleeding, headaches, and visual disturbances.
5. Complications from the nervous system.
6. Impaired functioning of the immune system.

Myeloma diagnosis

To diagnose this condition, an oncologist prescribes a set of procedures. In the case of myeloma, laboratory diagnostics, biopsy, and imaging methods make it possible to reliably confirm or refute the presence of cancer.

Early detection of this disease significantly affects the prognosis and allows you to start fighting before serious complications develop.

A blood test is essential for diagnosing myeloma. It shows anaemia and a decrease in platelet count. Biochemical analysis provides information about calcium, creatinine, albumin and total protein levels.

Electrophoresis of blood and urine proteins shows the presence of monoclonal protein (M-protein), which is characteristic of myeloma.

Biopsy is a necessary and very informative test. During the procedure, the doctor takes a sample of bone marrow, usually from the pelvic bone, with a thin needle. In myeloma, the percentage of plasma cells exceeds 10% of all cells.

The specialist also prescribes imaging diagnostic methods - MRI, CT, X-ray. The results of the examinations allow the degree of bone damage to be assessed.

PET-CT is used to identify active foci of the disease and monitor the tumour's response to treatment.

Myeloma treatment

The choice of treatment strategy is influenced by the stage of myeloma, the patient's age, the presence of concomitant diseases, and the characteristics of the specific malignant tumour.

Let's look at the main areas of modern therapy. With myeloma, the duration of treatment depends on the response to therapy and can range from several months to years of maintenance therapy.

Chemotherapy

Chemotherapy remains the basis for the treatment of cancer. Doctors use drugs that inhibit the rapid growth of malignant cells. Medications are used either separately or in combination.

Targeted therapy

This method affects the survival mechanisms of tumour cells. Targeted medications directly affect plasma cells and do not harm healthy cells.

Immunotherapy

This is a new method in which monoclonal antibodies specifically attack specific proteins on the surface of tumour cells. CAR-T cell therapy is a method in which the patient's own T lymphocytes are genetically modified to recognise and destroy myeloma cells.

Stem cell transplantation

After high-dose chemotherapy, which destroys both tumour and normal bone marrow cells, the patient is given their own stem cells that were collected beforehand. This restores normal blood formation and ensures long-term remission.

Radiation therapy

Radiation therapy is used locally to destroy tumour foci in the bones. This is especially important if they cause pain or threaten pathological fracture. Radiosurgery allows targeted irradiation of individual foci with minimal damage to surrounding tissues.

Supportive therapy

In the case of myeloma, treatment in this way involves the use of drugs to strengthen bones and prevent fractures, to correct anaemia and to prevent infections. Painkillers eliminate pain syndrome.

Treatment for bone marrow cancer is selected individually, depending on the age, stage, and condition of the patient. For young patients with aggressive forms, intensive therapy with transplantation may be effective. At the same time, elderly patients with concomitant pathologies require milder, less toxic regimens. The genetic profile of the tumour also influences the choice of drugs — some chromosomal abnormalities make cells more sensitive to certain types of therapy.

Prognosis for the disease

Thanks to the emergence of new treatments, it is possible to live for years with myeloma. The average five-year survival rate is about 55%, but this figure varies from 30% to 80% depending on the stage, age, and genetic characteristics of the individual.

Patients under the age of 65 without significant comorbidities tolerate intensive therapy better and have a higher chance of long-term remission. Elderly patients with heart, kidney or lung failure require modified treatment regimens.

Response to initial therapy is the most reliable indicator. Patients who achieve complete remission live significantly longer.

Prevention and lifestyle

There is no specific prevention, but general recommendations for preventing this disease are as follows:

• a balanced diet and maintaining a normal body weight
• regular physical activity
• avoiding prolonged contact with harmful substances, toxins, pesticides
• regular check-ups with your doctor

Once diagnosed, follow your doctor's recommendations regarding medication and follow-up examinations.

Conclusion

Blood myeloma is a dangerous oncological disease. However, with proper treatment and timely diagnosis, the prognosis is quite favourable. Pay close attention to your health and remember to visit your doctor. At the Oncare Medical Centre, we do everything we can to help you live a full life.