Multiple Myeloma: Symptoms And Treatment Options

Multiple Myeloma

What Is Multiple Myeloma?

Multiple myeloma or Kahler’s Disease is a cancer of the plasma cells. It is a rare but deadly form of blood cancer. Plasma cells are a category of white blood cells (WBCs) present in the bone marrow. These cells are the body’s first line of defense against infections. They produce the antibodies required to fight infections.

In multiple myeloma, the white blood cells produce weak antibodies. The abnormal antibodies exceed the healthy ones, which makes it difficult for the body to fight infections. In later stages, the white blood cells start to attack and kill the healthy cells. This reduces the patient’s immunity.

Multiple myeloma begins in the plasma cells present in the bone marrow. It is a sponge-like tissue present in some bones, viz. the spine, hip, and thigh bones. Bone marrow houses stem cells. Stem cells can develop into specialized cells, such as platelets or red blood cells. 

Symptoms

Patients of multiple myeloma may or may not exhibit any symptoms. If symptoms surface, they are usually non-specific.

Although common symptoms observed in patients may include: 

  • Too much thirst
  • Pain in bones of the chest and spine
  • Nausea
  • Reduced immunity which leads to recurring infections
  • Fatigue

Treatment Options

There is no definite cure for multiple myeloma. However, treatments can vastly slow down the spread of cancer. Sometimes, they also help in curing major symptoms caused due to the disease. Since the symptoms of multiple myeloma vary from one patient to another, treatments also differ. 

Many patients who do not exhibit symptoms may not even need immediate treatment. Rather, their condition is closely monitored with periodic tests for blood and urine. Treatment is generally dependent upon the stage and intensity of cancer. Some common forms of therapy may include medications, chemotherapy, and even surgery. Let us read about them in detail.

1. Solitary Plasmacytomas

It is the first stage of multiple myeloma. The treatments in this stage are fairly local. This means that treatments do not affect other parts of the body. The treatments prescribed in this stage include surgery and radiotherapy. In the early stages of Kahler’s disease, these solutions eliminate the risk of paralysis.

1.1. Surgery

A patient has to undergo surgery if the cancerous cells have grown into a tumor. The precondition for surgery is that the tumor must not be in a bone. The cancerous tumor is removed from the body by excision surgery.

1.2. Radiotherapy

In this method of treatment, ionizing radiations are used. These radiations shrink the cancer tumors, killing any existing cancer cells. Radiation therapy can also be used in the event cancer is detected inside the bones. 

2. Smoldering Multiple Myeloma

Patients diagnosed at the second stage are at a high risk of active myeloma. Patients do not usually require treatment at this stage. On the contrary, starting an early treatment has no considerable effect on the lifespan of the diseased. Such patients are usually kept under close observation by their doctors. Their plasma cells are continually examined. Along with blood and urine tests at regular intervals. 

2.1. Corticosteroids

Drugs like dexamethasone are steroidal anti-inflammatory drugs. These drugs regulate the immune system to fight and destroy cancer cells. Corticosteroids can be administered either as pills or by an intravenous syringe.

3. Active Myeloma

Active myeloma is the final stage of Kahler’s Disease. Patients at this stage are treated to allay their symptoms and help them live longer. Many treatments are available for active myeloma. However, one must bear in mind that myeloma cannot be cured. The treatments aim at making life easier for the patient by limiting the spread of cancer. 

Multiple myeloma can spew out of the bones and start to attack healthy cells and organ tissue. Hence, it becomes necessary to curb its growth. Following are some treatments prescribed to patients at this stage:

3.1. Chemotherapy

Chemotherapy can be performed either by a single drug or multiple drugs. Is deployed as a measure to destroy cancer cells. Drugs used for this purpose can be administered via an intravenous syringe or taken in the form of pills. A combination of the two may likewise be prescribed.

Chemotherapy is sometimes used as a supplementary measure for bone marrow or stem cell transplants. Oncovin, Cytoxan, and Doxil are some of the common drugs used for chemotherapy.

3.2. Immune Therapy

Biological therapy or immune therapy is used to strengthen the patient’s immune system. Drugs known as immunomodulating agents are used in the process. These drugs identify specific cells in the immune system and enhance them. These enhanced cells can then attack the cancer cells, restraining their growth. There are three drugs used for immune therapy, viz. Thalomid, Pomalyst, and Revlimid. 

3.3. Targeted Therapy

Much like its name, targeted therapy is directed at certain abnormalities of a cancer cell. Myeloma cells create a lot of something called M-Protein. Drugs used for targeted therapy will attack and break down this protein. This causes the cancer cells to starve and die. 

A class of drugs called protease inhibitors is normally used for such therapy. Drugs like Bortezomib, Ixazomib, and Carfilzomib are some prominent protease inhibitors used for treating active myeloma. Monoclonal antibodies are sometimes also used for the purpose. These comprise of drugs like abciximab, alefacept, and belimumab.

3.4. Bisphosphonates

The bones take a lot of damage because of cancerous plasma cells. These bones weaken; resulting disc collapses in the spinal column. Such weak bones also increase the risk of fractures. Bisphosphonates like zoledronic acid and denosumab help in controlling this bone damage.

Conclusion

Multiple myeloma is a terminal disease with no cure in its advanced stages. Although there are treatments that help patients lead a relatively healthy life. If your cancer is diagnosed at a fairly early stage. You can get suitable treatments. These could include surgery or radiotherapy. 

Cancer survivors have a high risk of recurrence. Hence, you should maintain a healthy lifestyle after treatment and rehabilitation. As far as a cure is concerned, biologists and scientists are rigorously working to develop one. CAR-T Cell Therapy has shown promising results. But there is still a lot of research and investigation needed.