DR. WALKER

Understanding Multiple Myeloma

Multiple myeloma is a type of blood cancer, specifically of the plasma cells. It accounts for 1% of all cancers and is the 2nd most common hematologic malignancy after lymphoma. Plasma cells are very important in the immune system for fighting infections, and other diseases. When these plasma cells grow out of control however, it is termed multiple myeloma. Normal bone marrow is made up of multiple other cells to include red cells, platelets and white blood cells. The problem with multiple myeloma is that as these cancerous cells begin to increase concentration in the bone marrow, they are able to crowd out other normal healthy cells.

What are the symptoms of multiple myeloma?

Symptoms of multiple myeloma can be variable. Common symptoms are vague or without visible signs. More common symptoms however, would include:
Bone pain, especially around the spine and chest.
Mental confusion.
Constipation.
Fatigue.
Weight loss.
Numbness and weakness in the legs.
Frequent infections.

Risk factors for multiple myeloma?

Older age. Risk for multiple myeloma increases as you get older. Less than 1% percent of those diagnosed are less than 35 years old. Most people are diagnosed in their mid-60s.
Black male. Black males are almost twice as likely to develop multiple myeloma than their white counterparts.
Family history. Having a sibling or parent with multiple myeloma places you at an increased risk for this disease. Some patients however have no affected family members, but this is a minority of cases.
Having plasma cell disease. Multiple myeloma traditionally starts out as MGUS (monoclonal gammopathy of undetermined significance). MGUS places someone at high risk for developing multiple myeloma.
Gender. Men are more likely to develop multiple myeloma than women.

What are complications of multiple myeloma?

Infections. Antibodies made by multiple myeloma cannot help to fight infections. Normal cells produce antibodies that are able to attack and kill germs. Multiple myeloma is able to crowd out these normal cells. When this occurs, the body is unable to fight off or prevent several infections. People with multiple myeloma are significantly more susceptible to otherwise simple infections.
Bone problems. More than 80% of people with multiple myeloma have some type of bone loss. As the bone loss increases, there is worsening bone pain with an increased risk for broken bones. Additionally, as bone is being destroyed, there is increased levels of calcium in the bloodstream which could result in kidney failure.
Decreasing renal function. Kidney complications to include kidney failure may result as the kidneys try to remove excess calcium and proteins from the blood. One sign of diminishing kidney function is decreased urine output. More than half of all individuals with multiple myeloma will experience some degree of kidney dysfunction during the course of the disease.
Anemia. More than half the people with multiple myeloma will be diagnosed with anemia at some point. Some of the symptoms of anemia would include dizziness, fatigue, weakness, and shortness of breath.
Hypercalcemia. As the bones are being destroyed, there is an excess release of calcium into the bloodstream. In severe cases, hypercalcemia could result in renal failure or cardiac arrest.

How is multiple myeloma diagnosed?

Urine test. Evaluation of the urine may detect Bence Jones proteins, which are actually M protein when detected in the urine.
Imaging test. Imaging test include x-rays, computer tomography, MRI, ultrasound, and PET scan may show abnormal appearance of the damaged bones.
Blood test. Evaluation of the blood could show M Proteins, or beta-2- microglobulin which are produced by myeloma cells. Finding M protein in the blood is a hallmark of multiple myeloma. Blood test may also show elevated calcium and uric acid levels. Additionally, albumin a protein in the blood, may be low in the presence of a more aggressive disease.

Self-Care Tips:

Supplements to consider:
Turmeric/curcumin. Curcumin is the active ingredient in turmeric, and has been used in traditional Indian medicine for centuries. Curcumin possesses natural antioxidants, anti-inflammatory, and analgesic properties. Additionally, curcumin has shown anti-proliferative effects on multiple tumors to include multiple myeloma. Some studies even suggest that curcumin may actually kill multiple myeloma cells and prevent them from multiplying.
Fish oil. Fish oil is a dietary source of omega-3 fatty acids. Fish oil contains two omega-3s called docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Multiple myeloma suppresses the effects of natural killer cell functions preventing it from being destroyed. It is thought that EPA/DHA can reduce suppressive effects of multiple myeloma. Additionally, fish oil helps to reduce the effects of cancer cells by reducing inflammation. Know that omega-3 fatty acids cannot be manufactured by the body. Sources of omega-3 include salmon, mackerel, trout, oysters, and crab.
Magnesium. Most patients with multiple myeloma will experience lytic lesions/holes in the bones, and bone thinning at some point. Magnesium when combined with vitamin D and K2 may help to improve bone mineral density. This combination helps to regulate calcium levels and may help to reduce the effects of peripheral neuropathy.
Vitamin D. Vitamin D has an important role in maintaining bone health. Specifically, vitamin D helps to decrease pro-inflammatory cytokines that play a significant role in multiple myeloma pathophysiology. That being, said, the prevalence of vitamin D deficiency is high amongst multiple myeloma patients. Vitamin D deficiency has been linked to abnormal metabolism and often predicts a poor prognosis for patients with multiple myeloma. Worse outcomes were seen in patients who had low vitamin D levels, specifically in black participants. Some studies have suggested that low levels of vitamin D put one at increased risk for multiple myeloma.
Vitamin C. Vitamin C/ascorbic acid is one of the most popular supplements given to people with cancers. Vitamin C helps protect cells from further damage and inhibits cancer cells from progressing. Studies suggest that vitamin C inhibits toxicity of several cancers in human through direct interaction.
Green Tea. Green tea has a natural antioxidant known as epigallocatechin-3-gallate, EGCG which has been found to reduce the risk of several cancers to include multiple myeloma. Green tea has the highest amount of EGCG which is known to inhibit cancer cell growth, and even induce cell death. EGCG green tea may prevent multiple myeloma cells from dividing. It is thought that EGCG may slow the progression of a pre-cancerous condition (MGUS) of myeloma from progressing to full-blown multiple myeloma. Also remember that antioxidants help to neutralize free radicals, and as a result of decreasing overall body inflammation.