Multiple Myeloma

Multiple myeloma is a cancer that begins in plasma cells, a type of white blood cell. These cells are part of your immune system, which helps protect the body from germs and other harmful substances. In time, myeloma cells collect in the bone marrow and in the solid parts of bones.

Common symptoms

No one knows the exact causes of multiple myeloma, but it is more common in older people. It can run in families. Symptoms may include:

• Bone pain, often in the back or ribs
• Broken bones
• Weakness or fatigue
• Weight loss
• Frequent infections and fevers
• Feeling very thirsty
• Frequent urination

Diagnosis

Doctors diagnose multiple myeloma using lab tests, imaging tests, and a bone marrow biopsy.

If the multiple myeloma is in a later stage, you may need more tests. Your doctor might want you to have a magnetic resonance imaging scan of your bones (also called an MRIscan). This scan can show if the multiple myeloma is in your spine.

Treatment

Your treatment depends on how advanced the disease is and whether you have symptoms.

If you have no symptoms, you may not need treatment right away.

If you have symptoms, you may have chemotherapy, stem cell transplantation, radiation, or targeted therapy. Targeted therapy uses substances that attack cancer cells without harming normal cells.

Even with treatment, sometimes your symptoms will be better and sometimes they’ll be worse.

However, if you have a fever, bleeding (such as nosebleeds, bleeding gums or severe bruising), a skin rash or a cough that doesn’t go away, call your doctor right away. These are some of the more serious side effects of chemotherapy.

Multiple Myeloma Complications

How Multiple Myeloma Affects the Body

As the myeloma cells grow in excess, they disrupt normal cell production, which can result in numerous health complications. The exact complications of multiple myeloma will vary by individual; however, multiple myeloma primarily affects the bones, the blood and the kidneys.

Bone problems

Bone loss is the most common complication of multiple myeloma, and 85% of patients diagnosed with multiple myeloma typically have some degree of bone loss. The most commonly affected bones are the spine, pelvis, and rib cage. Bone loss in myeloma patients may be best treated with cementoplasty, vertebroplasty, kyphoplasty, bisphosphonates or radiation therapy. Infact Treatment of bone pain or bone loss, coming from spine must be treated with Percutaneous, awake, nonsurgical vertebroplasty or kyphoplasty before starting the actual chemotherapy.

Anemia

The growing number of myeloma cells can interfere with the production of all types of blood cells. Decreased red blood cell production can result in anemia, which is present in approximately 60% of patients at diagnosis. Other blood cells like platelets may also be reduced to greater extent. Biggest problem with low platelet count is that, it becomes difficult to provide best pain relief to the patients. So it’s advisable that bone pain because of bone loss in spine must be addressed at the earliest with the help of nonsurgical, minimally-invasive, keyhole pain relief intervention.

Kidney failure

Excess M protein and calcium in the blood overwork the kidneys as they filter blood. The amount of urine produced may decrease, and the kidneys may fail to function normally.

Impaired immune system

The number of myeloma cells also impacts the production of white blood cells. Reduced levels of infection fighting white blood cells leads to myeloma patients are especially prone to infection. Several preventative steps may be taken to decrease the risk of infections for multiple myeloma patients.

Bone Lesions and Damage

Bone lesions from multiple myeloma are the primary cause of bone pain, which is one of the most common symptoms of multiple myeloma. Bone lesions result in destruction of the bones in myeloma patients and primarily affecting the spine, pelvis or rib cage. In the majority of patients with myeloma, soft spots develop where the bone structure has been damaged. These can extend from the inner bone marrow to the outside surface of the bone. Soft spots appear as “holes” on a standard bone x-ray and are referred to as osteolytic lesions. These bone lesions weaken the bone, causing severe pain and increasing the risk of fractures. Bone loss frequently accompanies multiple myeloma, and 85% of patients diagnosed with multiple myeloma have some degree of bone loss. Doctors may use skeletal surveys to evaluate bone damage in myeloma patients. In many patients preventing fractures is priority along with pain relief.

You should know that treatment for pain is part of cancer treatment. It is important to resist the big myth that because cancer is a serious disease, pain is to be expected. Most people can get complete relief for their pain — or at least significant relief that allows them to enjoy the activities of daily life.

What is advanced Multiple myeloma

Advanced multiple myeloma includes stage 3 and stage 4 and terminal cancer. Stage 3 includes when cancer spreads to other tissues and / or lymph nodes. Stage 4 includes metastasis.

Metastasis happens when cancer cells break away from a primary tumor and enter the bloodstream or lymphatic system (the system that produces stores and carries the cells that fight infections). When cancer cells spread and form a new tumour in a different organ, the new tumor is a metastatic tumor, the cells of which come from the original tumor. The most common sites of metastasis from multiple myeloma are the liver, lungs, bones and brain. Cancer can spread to other parts of the body, too.

Some people with metastatic cancer do not have symptoms. Their metastases may be found by tests, which may be performed for other reasons such as PET, MRI or CT scan. When symptoms do occur, the type and frequency depend on the size and location of the metastasis. For example, cancer that spreads to the bones is likely to cause pain and can lead to bone fractures. Shortness of breath may be a sign of lung involvement.

What are symptoms of stage 4 multiple myeloma

Symptoms of this late-stage cancer include:

• nausea
• constipation
• pain
• fatigue
• frequent infections
• weight loss
• muscle weakness
• increased thirst
• decreased appetite

Liver metastasis

If they do have symptoms, they may be vague and can include:

• Loss of appetite or feeling full early
• Fatigue
• Fever
• Itching
• Pain in the abdomen
• Swelling in the legs
• Weight loss
• Yellowing of the skin or whites of the eyes, called jaundice

Lung metastasis

Because the lungs get blood flow from the rest of the body, cancer can travel there from other organs. Cancer that has spread to the lungs often affects breathing.

Symptoms include:

• A cough that doesn’t go away
• Chest pain
• Blood in the mucus
• Trouble breathing
• Weight loss

Bone metastasis

When cancer travels to the bones, it can weaken them and cause them to release stored calcium. Symptoms include:

• Bone pain
• Constipation, nausea, and loss of appetite from high calcium levels in the blood
• Broken bones
• Numbness or weakness in the legs and possibly the arms
• Pain in the back or neck

Are you suffering from pain?

Any cancer has only 4 treatments. Surgery, chemotherapy, radiation and pain relief treatment / pain management.

What is the stage of cancer? Stage decides the treatment. All advanced cancers cannot be treated by chemotherapy and / or radiation therapy. Chemotherapy / radiation therapy may not benefit in stage 4 cancer. Recent research tells that unnecessary chemotherapy may reduce quality & life span too. Pain is the most common problem in stage 3 or 4. Please remember Pain definitely can be controlled or treated at any stage of cancer. Even if you are taking ayurvedic treatment for cancer or homeopathic treatment, it will not help in pain relief – You must take pain management treatment. Pain relief is important for continuing any treatment. Pain relief needs dedicated pain management treatment usually offered by Pain specialist doctors. In addition to best cancer specialist, ACCN is proud to have best pain specialist doctor in Delhi and in India. Pain management and cancer treatment goes side by side. Demand a pain free cancer treatment.

One must always remember that in stage 3 / stage 4 / terminal cancer – palliative care and pain relief treatment is usually the priority treatment so that pain relief continues at home too.  Pain free journey of cancer ie pain free cancer treatment helps in prolongation of life.

Advanced-Cancer Care Network, Delhi, India, with its branches (contact) at Delhi and Rohtak (Haryana) is a unique conglomeration of super-specialist doctors, who believe in well-being of human life.  ACCN is the most advanced centre for stage 3 cancer, stage 4 cancer, advanced stage cancer, terminal cancer, Cancer pain management and palliative care. It offers the unique and state-of-the-art treatment for pain relief and cancer treatment in India.

Click on Pain relief in Multiple myeloma to know the best pain management methods at home for bone cancer.

Multiple myeloma in bone is a very frequent problem in breast cancer. Know more about it.

#wincancerpain

Palliative care

Palliative care is designed to give symptomatic relief to the patient, control the side-effects of illness or treatment and improve quality of life of cancer patients. Palliative care treatment is provided by a medical specialist, other than oncosurgeon or oncologist. This medical specialist is known as “Pain & Palliative Care Specialist”. India has very limited number of such specialists and if you are also not able to find one for yourself, please contact ACCN (Advanced – Cancer Care Network), we are proud to have India”s best and most qualified Pain Specialists and Palliative Care Specialists.

Click on Understanding palliative care to know the palliative care treatment for stage 3 cancer or stage 4 cancer or advanced stage cervical cancer.

Role of Palliative Care Treatment

It is usually said that role of palliative care starts, when cancer becomes incurable or advanced stage or terminal or at end-of-life. It is one of the biggest myths in cancer treatment protocols. Palliative care specialist must be consulted and involved in the cancer treatment right from the first day when cancer is diagnosed and treatment is started. Initially when cancer is at stage 1 or 2, complete focus is on cancer cure and palliative care has minimal but very important role. As the cancer (if) progresses, gradually role of palliative care also enlarges. In stage 3 or stage 4. role of palliative care becomes much more important than other regular cancer treatments.

Click on How we can help to know about our various services for advanced cancer patients.

Click on Symptom control to understand that how we can provide suffering free life to advanced cancer patient.

Benefits of Palliative Care

• Makes patient feel better and stay active during treatment
• Manages side-effects of cancer treatment
• Facilitates as high a quality of life as possible
• Helps cancer treatments do a better job
• Can be curative as well as life-supporting treatment
• Cancer diet planning
• Improves survival outcomes
• Increases immunity levels
• Improves communication between patient and family members
• Maintains hope and stick to principals of ethics