Multiple myeloma is a cancer that attacks the plasma cells in the bone marrow. Plasma cells are a type of white blood cell that functions to form antibodies. This cancer is generally characterized by bone pain.
Multiple myeloma is a type of blood cancer. This condition occurs when abnormal (abnormal) plasma cells grow and develop excessively, and interfere with healthy cells around them.
These cancer cells also produce abnormal antibodies. In addition to not being able to function to protect the body, the accumulation of abnormal antibodies can damage certain organs, such as the kidneys.
Causes of Multiple Myeloma
Multiple myeloma occurs when abnormal plasma cells (myeloma) in the bone marrow grow and develop very quickly, and damage healthy cells, such as red blood cells, white blood cells, and platelets, that are in the vicinity.
Under normal circumstances, plasma cells will produce antibodies that function to protect the body (M protein). When plasma cells become myeloma, the antibodies they produce don't work as they should. M protein eventually accumulates and damages several organs, such as the kidneys, bones, and nervous system.
The exact cause of multiple myeloma is not known. However, this condition is often associated with MGUS (monoclonal gammopathy of undetermined significance). About 1 in 100 people with MGUS is estimated to have multiple myeloma.
There are several risk factors that make a person more likely to develop multiple myeloma, including:
- Male gender
- Over 60 years old
- Have a family history of multiple myeloma or MGUS
- Being overweight or obese
- Have a history of radiation exposure, such as radiotherapy
- Having a compromised immune system
- Have a history of exposure to or contact with chemicals, for example in oil workers
Symptoms of Multiple Myeloma
In the early stages, people with multiple myeloma often do not feel any symptoms. However, as the disease progresses, the following symptoms may appear:
- Bone pain, especially the spine, ribs, and pelvis
- It's easier to break bones
- Easier to get infected
- Legs feel weak to numb (numb)
- Easy bruising on the skin, nosebleeds, or bleeding gums
- Nausea and vomiting
- No appetite
- Drastic weight loss
- Anemia
- Stomach pain and constipation
- Often feel tired and weak without knowing why
- Headache
- Blurred vision
- Be dazed and confused
When to go to the doctor
Immediately see a doctor if you experience the symptoms mentioned above. Symptoms of multiple myeloma are often atypical. The initial examination aims to determine the cause of the complaints you feel. If it is caused by multiple myeloma, early treatment can be done to prevent complications.
If you are at risk for multiple myeloma, such as having a family history of MGUS, do medical check-up every 5 years if you are 18-40 years old or every year if you are over 40 years old. It is necessary to monitor your health condition.
If you have been diagnosed with multiple myeloma, follow the therapy and examination schedule given by the doctor, so that your condition can be monitored.
Multiple Myeloma Diagnosis
To diagnose multiple myeloma, the doctor will ask the patient's symptoms, as well as the patient's and family's medical history. After that, the doctor will perform an examination to identify signs of bleeding, such as bruising and signs of infection, such as fever.
To confirm the diagnosis, the doctor will perform the following investigations:
- Blood tests, to detect anemia, hypercalcemia, M protein levels, albumin levels, beta-2 microalbumin (B2M), lactate dehydrogenase (LDH), genetic changes, and to determine kidney function
- Urine test, to detect the presence of M protein in the urine
- Scans with X-rays, MRI, CT scans, or PET scans, to determine bone structure and detect damage caused by multiple myeloma
- Bone marrow aspiration, to check the number and appearance of plasma cells in the bone marrow, as well as the presence of cancer cells in the bone marrow
The supporting examination is also carried out to determine the severity of the patient's condition and the type of treatment that can be given to the patient.
Multiple Myeloma Treatment
Multiple myeloma cannot be cured. Treatment will be carried out if the patient feels symptoms. Treatment aims to control the growth of cancer cells, prevent complications, and relieve complaints and symptoms. This can be done with the following treatment options:
Drugs
The forms of drugs to treat multiple myeloma can vary, from oral medications to injections. Some types of drugs that can be given by doctors are:
- Target drug therapy, namely drugs to inhibit and stop the growth of cancer cells (myeloma). Examples of these drugs are bortezomib and carfilzomib.
- Biological drug therapy, which is a drug to increase the patient's immune system so that it can fight myeloma cells. Examples of these drugs are thalidomide, lenalidomide, or pomalidomide.
- Chemotherapy, which is a drug to kill cells that are growing too fast, including myeloma cells. Chemotherapy is often done before the patient undergoes a transplant stem cells.
- Corticosteroids, which are drugs to regulate the immune system that controls inflammation. Examples of these drugs are prednisone and dexamethasone.
In addition to the drugs mentioned above, the doctor will also provide some supporting drugs, such as:
- Medications to prevent bone breakdown, such as bisphosphonates
- Pain relievers, such as paracetamol
- Blood-boosting drugs and treating anemia, such as erythropoietin
Radiotherapy
Radiotherapy is a therapy using high-energy rays, namely X-rays, to destroy and stop the growth of myeloma cells. This therapy is usually used when you want to destroy myeloma cells in specific areas of the body.
Bone marrow transplant or stem cells
Bone marrow transplant is a procedure of replacing abnormal cells present in the bone marrow with healthy bone marrow cells. Healthy bone marrow cells can come from patient stem cells or donor stem cells.
Multiple Myeloma Complications
If not treated immediately, multiple myeloma can cause various complications, including:
- Bone disorders, bone pain, porous bones, and broken bones
- Easy to get infection or often sick
- Anemia and thrombocytopenia
- Kidney failure
Multiple Myeloma Prevention
There is no specific prevention for multiple myeloma. However, there are several things that can be done to reduce the risk of this condition, namely:
- Check regularly with your doctor, especially if you have been diagnosed with MUGS or have a disorder of the immune system.
- Follow the safety standards that have been set while working, especially if you are often exposed to chemicals.
- Apply a healthy and balanced diet, especially by eating healthy foods and having a balanced nutritional content.
- Keep your weight within the ideal range, by adopting a healthy diet and exercising regularly.