What Is Multiple Myeloma and What Are Your Treatment Options?

Multiple myeloma is a complex cancer that forms in a white blood cell called a plasma cell. Healthy plasma cells help fight infections and make antibodies to find and attack germs. When someone has multiple myeloma, cancerous cells build up in the bone marrow, crowding out the plasma cells and leading to health complications. While there is no cure, available treatment options can significantly improve patient outcomes and overall quality of life.

What is multiple myeloma?

Multiple myeloma is a cancer of the blood that develops in the bone marrow. Bone marrow is a soft, spongy tissue that makes up the center of one's bones. When bone marrow is healthy, normal plasma cells make antibodies that protect an individual's body from infection.

In multiple myeloma, healthy plasma cells become cancerous cells that grow out of control. They overcrowd the normal plasma cells that help fight infection. The malignant plasma cells then produce an abnormal antibody called M protein.

Symptoms of multiple myeloma

Symptoms of multiple myeloma vary from person to person but often include the following:

• Bone pain or damage
• Weakened spots on bones (osteolytic lesions)
• Low platelet count (thrombocytopenia)
• Hypercalcemia
• Fatigue
• Infections
• Anemia
• Excessive bleeding
• Loss of appetite or weight loss

There may be no obvious symptoms in the early stages of multiple myeloma. When they are present, they can be subtle or similar to other medical conditions.

Diagnosis and staging

If a healthcare provider suspects that the patient has multiple myeloma due to existing symptoms or while testing for another condition, they may order additional tests. These tests may include blood, urine, imaging tests (e.g., X-rays, CT, or MRI scans), and a bone marrow biopsy. Once diagnosed, the oncologist can conduct further tests to determine the stage and progression of the disease.

Staging multiple myeloma helps guide the treatment process and the patient's prognosis. Oncologists categorize multiple myeloma into three stages based on factors such as kidney function, symptoms, and the burden of the disease.

1. Monoclonal gammopathy of underdetermined significance (MGUS). In this stage, a small amount of M protein is in the blood. However, no other signs are present.
2. Solitary (isolated) plasmacytoma. There is a single myeloma tumor in the body but no signs of anemia, kidney damage, or further disease.
3. Smoldering multiple myeloma. There are low levels of M protein in the blood. However, the patient is experiencing little to no symptoms.

Depending on the patient's classification and stage, the oncologist may recommend methods of multiple myeloma treatment. If the condition is in its early stages, they may implement a "watch and wait" strategy to closely monitor the patient until they begin to experience symptoms or their symptoms get worse.

Treatment options for multiple myeloma

Chemotherapy

Chemotherapy is the use of strong medicines that kill fat-growing cancer cells. Prednisone and melphalan are the most common chemotherapy drugs used to treat multiple myeloma. This treatment may be used alone or in combination with other therapies.

Radiation therapy

In radiation therapy, powerful energy beams kill myeloma cells using various tools, including X-rays, protons, and other high-energy sources. Radiation can quickly shrink growth in myeloma cells and even target cells that form a mass (plasmacytoma). Radiation can help control a plasmacytoma that is causing severe pain or destroying the integrity of a bone.

Targeted therapies

Targeted therapy uses medicine that attacks specific chemicals in the malignant cells. They inhibit specific signaling pathways or target genetic mutations. These therapies aim to expose the molecular vulnerabilities of the cancer cells while minimizing damage to healthy tissues.

Immunotherapy

Immunotherapy is a medicinal treatment that helps the body's immune system to kill cancer cells. Cancer cells survive by hiding from the immune system. Immunotherapy can help the immune system find and kill cancer cells in the bone marrow.

CAR-T cell therapy

Chimeric antigen receptor T cell therapy, also known as CAR-T cell therapy, trains the immune system cells to fight multiple myeloma. This treatment involves removing a small amount of white blood cells (T cells) from the blood. The oncologist then sends these cells to a lab where they are treated to make special receptors. These receptors can help the cells recognize a marker on the surface of the cancer cells. The cells are then injected into the patient's body, allowing them to detect and destroy multiple myeloma cells.

Bone marrow transplant

A bone marrow transplant, or a stem cell transplant, is where the oncologist replaces the patient's diseased bone marrow with healthy bone marrow. Before the transplant, the oncologist removes blood-forming stem cells from the patient's blood. They can then deliver high doses of chemotherapy to destroy the diseased bone marrow before placing the stem cells back into the body. These stem cells travel to the bones and begin building healthy bone marrow.

There are some cases where patients cannot receive a bone transplant from their own blood (autologous bone marrow transplant). In these situations, the oncologist may recommend stem cells from a healthy donor (allogenic bone marrow transplant).

Do not give up on hope

Multiple myeloma is a challenging and complex disease, but there is hope. Effective treatments can help control the prognosis of this disease and improve symptoms. If you or someone you love has recently been diagnosed with multiple myeloma, it is important to work with an experienced oncologist to get a personalized treatment plan tailored to your needs. Call our office to schedule an appointment and get it started.

Request an appointment here: https://lindenbergcancer.com or call Lindenberg Cancer & Hematology Center at (856) 475-0876 for an appointment in our Marlton office.

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