Myeloma cancer: A rare condition with lower life expectancy

01 Oct 2023 06:21pm
Image for illustrative purposes only. – FREEPIK
Image for illustrative purposes only. – FREEPIK

Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell.

Healthy plasma cells help fight infections by making proteins called antibodies. Antibodies find and attack germs.

It quite rarely happens, yet it could significantly impact its victim.

General medical practitioner Dr Zubaidi Ahmad said that the cure for this unusual disease was difficult to find.

A person's risk of developing myeloma increases with age, such that most would be diagnosed in their mid-60s, says the Mayo Clinic.

According to American Cancer Society data, one in 132 people, or 0.76 per cent of the world's population, was at risk of falling victim to cancer.

Meanwhile, the National Cancer Institute in the United States revealed that this year alone, about 35,000 new cases were recorded, and it is estimated that around 170,405 people in the country will die due to myeloma.

To answer whether it can be cured and how much a person's life can be affected due to this disease, SinarPlus sought some insight from Universiti Putra Malaysia's Internal Medicine and Hematology senior consultant Associate Prof Dr Bahariah Khalid.

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She said that myeloma was a cancer that involves white blood cells, which consist of the most mature lymphocyte cells called plasma cells.

Normal plasma cells were contained in the bone marrow and are an important part of the human body's immune system.

It is one of the groups of cells that work together to fight against infection and disease.

"When B-cell lymphocytes respond to infection, they mature and turn into plasma cells that produce antibodies to help attack germs and inflammation.

"Plasma cells that multiply uncontrollably and crowd out normal cells in the bone marrow are called multiple myeloma. Those cells will produce abnormal antibodies called monoclonal or M proteins," he said.

The condition will lead to the body's failure to fight infection, thereby lowering the body's immune system.

Commenting further, she shared that, as with many other cancers, scientists are still figuring out why some individuals suffer from multiple myeloma.

The Mayo Clinic also further said that those over the age of 60 were likely to be infected with the disease.

However, Dr Bahariah said that there were young people who have been diagnosed with cancer.

Genderwise, both men and women currently share just about the same degree of risk.

The health consultant also listed several factors that could increase the likelihood of the disease.

Among them are passive smokers, which are individuals who do not smoke but are exposed to and inhale cigarette smoke.

Following that are heavy smokers, hormone therapy, heredity or genetics, exposure to high and prolonged radiation, as well as pressure or stress.

Dr Bahariah added that patients rarely show symptoms or early warning signs. The abnormal condition would instead just suddenly trigger various complications such as a high level of calcium in the blood, kidney failure, anaemia (blood deficiency), bone fragility or fracture.

Commenting further, she said that people suffering from hypercalcemia or an increase in calcium level will get easily tired, have difficulty urinating, lose appetite, feel dizzy, be confused, or be unable to focus well.

"Myeloma protein can also damage the kidneys and cause the patient's legs to swell. The growth of plasma cells out of control will result in a reduction of red blood cells, which will usually cause a patient to get quickly tired, want to sleep, and be short of breath," she added.

Myeloma will damage a patient's bones, and the pain will be felt more in the spine.

"If the cancer cells attack the lumbar spine, the patient can be paralysed from the waist down. If it happens in the hands, the patient may not be able to lift things up, and the limited movement will definitely disturb his daily routine," she added.

Meanwhile, the American Cancer Society states that cancer patients are also very susceptible to germs.

There are several reasons, including their being less responsive to the treatment process.

"The condition causes them to feel unwell for a long period of time," it wrote.

In regard to treatment, we had approached Beacon Hospital's consultant hematology specialist, Dr Tengku Ahmad Hidayat Tengku K Aziz.

According to him, blood cancer treatment in Malaysia is carried out to reduce pain, control complications, and slow down the development of myeloma.

"For multiple myeloma, chemotherapy is rarely used unless the cancer cells are very aggressive.

Specialists will usually do a combination of targeted therapy and immunotherapy," he explained.

Targeted therapy aims to kill cells that grow uncontrollably.

Immunotherapy technique, on the other hand, uses the body's immune system to attack cancer cells.

Some cancers call for such a combination of therapies, said Dr Tengku.

There was also another approach, such as bone marrow transplantation.

However, its feasibility depended on a patient's age and health.

They must be less than 65 years old and not at risk of chronic diseases such as stroke or heart disease.

. The expert also pointed out that the side effects were mild and not the same as those of intensive therapy for leukaemia and lymphoma.

"Patients may experience symptoms such as hand numbness. Their digestive system may be slightly affected during treatment.

Sometimes, some patients would experience diarrhoea or constipation," he said.

However, in general, every procedure chosen is safe and appropriate, including for the elderly, but the treatment may need to be changed if the patient is diagnosed with kidney problems or liver failure.

In terms of cure rate, myeloma detected at an early stage has a better prognosis.

“Based on my experience, someone who is at level one can live for over 10 years.

"However, those at level three may have a lower survival rate, which is between two years and less," he said.

The Cleveland Clinic also agreed on the fact, elaborating that 78 per cent of patients with solitary plasmacytoma were still alive five years after diagnosis.

Based on a Revised Multiple Myeloma International Staging System report, the five-year survival rate for patients ranges from 40 to 82 per cent.

Dr Tengku implied that multiple myeloma is a cancer that can be controlled yet still carries the possibility of recurrence.

In a recurring case, the doctor would carry out a reexamination to identify the appropriate treatment and dosage for the patient.

In regard to nutrition, the expert objected to the claim that patients should not consume sugar at all.

He stressed that, most importantly, they should maintain a healthy and balanced diet for energy supply.

"Patients are forbidden to eat raw foods. This move is to reduce the risk of bacterial infection when the body's immune system is low," he said.

In the meantime, there was no problem for them to go about their daily activities unless they suffered from complications such as broken bones or kidney damage.

Finally, Dr Tengku revealed that there were no preventive measures that can be taken to avoid being affected by this particular cancer.

"Early detection is the best move so that treatment can be given as soon as the diagnosis is received," he advised.

Someone at level one can live up to more than 10 years," he said.