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MULTIPLE MYELOMA

Multiple myelomas is the cancer of the plasma cells of the bone marrow. The plasma cells function by producing antibodies that recognize germs and fight infections in the body.

The uncontrolled growth of plasma cells leads to decreased production of healthy blood cells in the bone marrow. It also decreases the production of antibodies and increases protein production that affects the normal functioning of the kidneys.

The overproduction of protein from the bone marrow, called immunoglobulin, leads to the accumulation of protein in the bloodstream. This leads to the release of certain chemicals that dissolves the bones and in severe cases, they spill out the contents of the bone marrow and cause organ damage.

Multiple myeloma is commonly found in people above 60 years of age. However, the incidence is higher in men when compared to women.

Symptoms

The symptoms of multiple myeloma include:

  • Bone pain
  • Increased risk of infections
  • Bone fractures
  • Weight loss
  • Confusion
  • Decreased cognitive functions
  • Numbness of the hands and feet
  • Loss of appetite
  • Fatigue
  • Constipation
  • Increased thirst
  • Altered blood clotting

Causes

The exact cause of multiple myeloma is not known. However, studies suggest that an inherited gene or a change in the DNA pattern may be the cause of developing multiple myeloma.

Risk factors

The risk of developing multiple myeloma may increase with the following conditions:

  • Age: People between the age group of 50and 60 are at a greater risk of developing the condition
  • Gender: The incidences of reported cases are higher in men when compared to women population
  • Exposure to radiation and chemicals: Frequent exposure to harmful radiations and toxic chemicals may increase the risk of developing multiple myeloma
  • Genetic disorders: A family history of a certain type of defective gene increase the risk of developing multiple myeloma

Complications

Multiple myeloma can cause complications such as:

  • Increased risk of infections: The inability of the plasma cells to fight infections may increase the susceptibility to infections
  • Bone defects: It causes bone thinning, bone pain and fractures as multiple myeloma affects the bones in the body
  • Renal impairment: The increased blood calcium levels cause the bones to erode and also interfere with the normal kidney function. The inability to excrete excess protein from the body leads to kidney damage

Diagnosis

Multiple myeloma can be diagnosed by the following diagnostic procedures:

  • Image scans: Imaging scans such as magnetic resonance imaging (MRI) scan, computed tomography (CT) scan, positron emission tomography (PET) scan and x-rays are used to detect the bone defects associated with multiple myeloma. It also helps in diagnosing any underlying cause of multiple myeloma.
  • Bone marrow aspiration test: The bone marrow cells are monitored by collecting a sample of bone marrow either from the pelvic bone or the sternum of the chest bone. The cells are monitored under the microscope to determine the change in the morphology and shape of the blood cells.
  • Blood and urine test: The blood and urine samples are tested for the presence of M-proteins produced from the myeloma cells. These samples also provide scope for the detection of any underlying cause of infections of inflammation.

Treatment

Multiple myeloma is treated by the following:

  • Chemotherapy: The therapy involves the use of cytotoxic drugs that prevent the growth and spread of cancer cells. These drugs are either administered orally or through the intravenous route of administration. Chemotherapy is used in combination with radiation therapy or surgery for better treatment options.
  • Radiation therapy: High-intensity radiations are used to destroy the cancer cells. They cause shrinkage to the tumor cells, thereby preventing the growth of the spread to myeloma cells. This therapy is used in combination with chemotherapy for better response rate.
  • Bone marrow transplantation: It is also called as stem cell transplantation. The procedure involves replacement of affected cells with the healthier cells. The transplantation helps in regeneration of newer cells in the body. In certain cases, chemotherapy is performed before bone marrow transplantation for better treatment outcomes.
  • Medication therapy: The use of corticosteroids such as prednisone and prednisolone regulates the immune system and prevents inflammation in the body. These drugs are administered orally that helps in the management of multiple myeloma.

Management

Multiple myeloma can be effectively managed by limiting the consumption of alcohol and tobacco. Maintaining a healthy diet with regular exercise helps in reducing the risk of developing the condition. It is also advised to limit the exposure to harmful radiation and toxic chemicals that lower the risk of developing multiple myeloma.

Support from family and friends helps in coping with anxiety and depression caused by the condition. Thus, promoting mental health by meditation, yoga and other therapies eases faster recovery from the condition.

A regular follow-up post multiple myeloma treatment is essential to prevent worsening of the condition.

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