Download an uncommon malignancy - Toledo Clinic Cancer Centers

AN UNCOMMON MALIGNANCY:
UNDERSTANDING MULTIPLE MYELOMA
The Toledo Clinic
CANCER CENTERS
World Class Care – Close to Home
Reprint with permission from Healthy Living News – August, 2010
Mark Burton, MD
Accounting for only about one
percent of all cancers, multiple
myeloma is a potentially lethal form
of malignancy that, according to the
American Cancer Society, was
diagnosed in approximately 20,000
Americans in 2009. Though not
among the more common cancers,
multiple myeloma certainly warrants
awareness.
Dr. Mark Burton of The Toledo
Clinic Cancer Centers explains that
multiple myeloma is a cancer of the
plasma cells that develops in the bone
marrow and often manifests itself
initially through symptoms of bone
pain, anemia, and feelings of
tiredness, weakness and general
illness. “Multiple myeloma develops
when the DNA of a plasma cell is
damaged and then, that abnormal cell
begins to replicate” he says. “If you
get a group of these cancerous cells
they can physically damage the
bones, causing them to weaken and
even break. We often see multiple
spots in the bone that are damaged,
and the cancer usually spreads
through the body, potentially
affecting the back, ribs, pelvis, skull
and extremities. Patients sometimes
present with kidney failure as well.”
A plasma cell is a form of white
blood cell that, when healthy,
produces antibodies to help fight
infection, and different forms of
plasma cell make different types of
antibodies. Precisely why a healthy
plasma cell turns into an abnormal
myeloma cell is not understood. As
Dr. Burton observes, it could be the
result of random mutation, some sort
of toxic exposure, infection or other
influences.
Whatever the cause, as the myeloma
cells replicate and form tumors,
fewer red blood cells, white blood
cells and platelets are produced in the
marrow. Hence, in addition to
experiencing bone experiencing bone
damage, patients may feel weak and
fatigued, experiencing shortness of
breath, bruise or bleed more easily
and have difficulty fighting off
infections. In some cases, organs
such as the kidneys can also be
damaged.
Doctors can look for certain
abnormalities to help confirm a
diagnosis of multiple myeloma. For
example, calcium may be present in
the blood as a result of the
breakdown of bone tissue. The
presence of certain types of protein
(such as monoclonal protein, or M
protein, which is produced by
myeloma cells) or an abnormal ratio
of certain proteins in the blood can
also be suggestive.
There are no clearly identifiable risk
factors for multiple myeloma.
However, Dr. Burton points out that
the disease occurs, on average, in
people in their 60’s and that the
incidence is slightly higher in men
than in women-ratio of
approximately 55 to 45. Also,
according to the National Cancer
Institute, multiple myeloma is more
prevalent among African Americans
than among white people.
The initial treatment for multiple
myeloma is typically chemotherapy,
either in oral form or IV. Depending
on the patient’s age and other health
issues, a variety of other treatments
can be used as well.
Historically, the prognosis for
patients with multiple myeloma was
not encouraging; however, newer
therapies are showing promise in
prolonging survival and improving
quality of life. “With the treatments
available ten years ago, the survival
rate was only about 30 percent which
means 70 percent of those diagnosed
died within five years. But with
newer targeted biological treatment,
we’re seeing an improvement in
response rates and survival. In fact,
we’re even able to cure many patients
who are younger and in reasonably
good health at the time of diagnosis,
“ Dr. Burton says.
The Toledo Clinic Cancer Centers
also offer the latest in cancer research
studies through its’ active
participation with the Toledo
Community Hospital Oncology
Program (TCOP).
For more information, contact The
Toledo Clinic Cancer Center
(419)479-5605.