Multiple myeloma is a cancer of the blood caused by the uncontrolled production of abnormal plasma cells. The prognosis for patients with multiple myeloma depends on how early the disease is detected. There is no cure for multiple myeloma at present, but with treatment, many patients experience periods of remission and a generously extended life expectancy.
Symptoms vary from patient to patient, and the course of treatment will vary as well. Typically, though, treatment will involve a two-fold approach. The first approach involves therapies that will directly treat your cancer, and the second is treatments that address the complications caused by multiple myeloma.
When multiple myeloma is in the early stages, a “watch and wait” approach is the only necessary treatment. Patients may only require monitoring to ensure more aggressive forms of the cancer do not develop. When symptoms manifest, treatment is required. The following are common therapies used to treat multiple myeloma directly:
Chemotherapy
The abnormal plasma reproduces rapidly and develops into masses, or tumors, that occupy space within your bone marrow. A single tumor is called a myeloma, whereas multiple tumors are referred to as multiple myeloma. Multiple myeloma inhibits your bone marrow’s ability to produce healthy blood cells, and this leads to bone weakness and fractures as well as anemia. According to the University of Texas MD Anderson Cancer Center, chemotherapy is a common first choice of treatment. The goal of chemotherapy is to eradicate the cancer cells.
Systemic corticosteroids are given as a piggy-back-type treatment to facilitate the reduction of swelling and inflammation. When given in conjunction with chemotherapy, these medications can help reduce nausea, vomiting, and pain. However, long term use may contribute to bone depletion and a weakened immune system.
Additional Drug Therapies
Certain medicines alter the immune system. This form of treatment may also be referred to as immunotherapy. You may be given immune-modulating medications, and these will target the growth of your cancerous cells by cutting short their supply of nourishment so that they are unable to thrive.
Additionally, other medications can foster the production of new and healthy blood cells. New blood cells will bolster your immune system and reduce your vulnerability to infections. Antibiotics may also be prescribed and may even include a daily dose of penicillin. Annual vaccinations are recommended, particularly those which may reduce your likelihood of acquiring pneumonia or influenza.
Patients may also participate in clinical trials at multiple myeloma research centers where they have access to newer and possibly more effective medications as well as experts specializing in finding a cure.
Radiation Therapy
Causing fewer side effects, radiation therapy is a more localized and more immediate course of action than chemotherapy when multiple myeloma is more concentrated in a certain area. It is often used to treat severe bone pain as well as to annihilate the source of bone tissue destruction. This treatment may cause fewer side effects than chemotherapy and yield quicker results by targeting specific areas.
Stem Cell Transplants
Patients with multiple myeloma will receive stem cell or bone marrow transplants. Chemotherapy will coincide with these transplants. Most patients receive autologous transplants, which means the bone marrow is extracted from the patient’s own body. During the stem cell transplant, the marrow is removed, chemotherapy is administered to kill the cancer cells, and then the bone marrow is reinserted.
Bone Loss, Pain, and Fractures
Chemotherapy and radiation will target the cancer that causes the breakdown of your bones. Additionally, drugs will be administered which help to reinforce them. Analgesics or pain medications will assist you with pain control. As your bones break down you may experience hypercalcemia, an excess of calcium in your blood, which can be dangerous. Patients with severe hypercalcemia will receive dialysis, a treatment which filters blood through a machine. IV fluids may be given to patients with hypercalcemia as well. Avoiding diuretics and staying well-hydrated is recommended.
Although there is no conclusive evidence to prove the efficacy of alternative therapies, many patients rely on acupuncture, meditation, or other relaxation techniques to assist with pain management. Of course, patients should always consult with their physician before trying alternative therapies.
Anemia
As the cancer crowds normal blood cells out of your bone marrow, fewer healthy blood cells are produced, and this causes a decrease in the amount of blood you have circulating throughout your body. This low amount of blood supply is known as anemia. Blood transfusions will help to raise your good blood cell levels. You may be given oxygen therapy to increase the amount of oxygen in your blood and relieve your shortness of breath. You may receive erythropoietin injections, which may stimulate blood cell production.
Kidney Dysfunction and Failure
Nearly half of all patients with multiple myeloma experiences some degree of kidney failure, according to the University of Texas MD Anderson Cancer Center. When the blood becomes thickened due to the heavy buildup of M protein, a by-product of the cancer cells that cause multiple myeloma, it may need to be replaced with healthy donated plasma. Plasma exchange therapy offers quick relief of symptoms. These plasma exchange procedures assist the kidneys in filtering the blood by reducing its viscosity, or thickness.
Patients may also receive dialysis, in which their plasma is externally filtered through a machine or an IV fluid therapy. Patients with multiple myeloma should avoid diuretics and anti-steroidal anti-inflammatory medications (NSAIDS), as they may contribute to a decrease in renal function.
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