World Cancer Day 2020: Lack of awareness on Multiple Myeloma a hindrance to diagnosis

  • By Dr. Rahul Bhargava

World Cancer Day 2020: Wondering what causes multiple myeloma and what is the general survival and life expectancy rate? Multiple Myeloma is a type of blood cancer of plasma cells found in the bone marrow, which is also known as Kahler's disease. Plasma cells help in fighting the infections by making antibodies attack germs.

Multiple myeloma causes

Abnormal plasma cells gather and contain the growth of other cells in the bone marrow that produce red blood cells, platelets and white blood cells. They also reduce the development of normal plasma cells, which leads to a decrease in a person's immunity.

This suppression may result in:

  •  Anemia unexplained renal failure
  • Back pain and destruction of spine
  • Excessive bleeding from injuries
  • Decreased ability to fight infection

Is Multiple Myeloma a fatal illness?

Multiple myeloma accounts for 10% of hematological cancers and 1% of all cancers in India. Even though, the condition is non curable  with an average survival of approximately three years with conventional chemotherapy, the treatment has now improved significantly with the integration of autologous stem cell transplant (ASCT) as a frontline therapy to close to 6 to 7 which gives a chance to see the sunrise of 2025 which might offer a cure.

For the overwhelming majority of patients, it is possible to preserve both quality of life and quantity of life by maintaining a longer remission as a result of stem cell transplant. In spite of these life-prolonging benefits.

What is the first sign of Multiple Myeloma?

Some patients with multiple myeloma might not have symptoms at all. Others can have common symptoms which include the following:

  • Bone pain, especially in the back and spine so every back pain with high esr needs to be investigated

  • Unexplained renal failure

  • Nausea

  • Constipation

  • Loss of appetite

  • Mental fogginess or confusion

  • Fatigue

  • Frequent infections

  • Weight loss

  • Weakness or numbness in your legs
    Excessive thirst

A persistent back or bone pain, unexplained kidney failure or low haemoglobin are signs of multiple myeloma that warrant a deeper investigation for conclusive diagnosis.

Multiple myeloma treatment

The treatment for multiple myeloma includes the following:

  • Targeted therapy

  • Biological therapy

  • Chemotherapy

  • Corticosteroids

  • Bone marrow transplant

  • Autologous transplant

  • Radiation therapy

Understanding Autologous transplant

In an autologous stem cell transplant, a patient's own stem cells are removed from his /her bone marrow or peripheral blood before the transplant procedure is started. The cells are stored until required for the transplant. Thereafter, the patient gets treatment such as high-dose chemotherapy, sometimes with radiation, to kill the cancer cells. When this procedure is completed, the stored stem cells are restored back to the patient into their blood through a vein. This procedure increases the quality of life of the patient along with their longevity.

Multiple Myeloma risk factors

Age: Increasing age is one factor. The risk of multiple myeloma increases as you age, people above 60 are more prone to the disease

Gender: As per recent studies, Men are more prone to develop the disease than women.

Family history of multiple myeloma: There are higher chances of people suffering from multiple myeloma if they have a brother, sister or parent has multiple myeloma

MGUS: Personal history of a monoclonal gammopathy of undetermined significance

Currently, only 5-8 % of all multiple myeloma patients undergo ASCT.  This is due to lack of patient awareness, inadequate patient counseling or poor access to treatment.  In this context, there is an urgent need to bridge the gap so that more number of multiple myeloma patients can benefit from this procedure.

Stem cell transplant is not a cure, but it can help the patient feel better and maybe live longer by prolonging event-free survival. New medication available now has given new hope, better treatment and better results. In the year 2001, only 2 medications were available to treat the disease and now in 2020, 18 medicines are available.

(The columnist is Director & HOD, Haematologist, Haemato Oncologist and Bone Marrow Transplant, Fortis Memorial Research Institute, Gurugram. Views expressed are the author's own.)