We Treat
Myeloma
Myeloma is a cancer that affects plasma cells, which are a type of white blood cell found in the bone marrow. Plasma cells are an important part of the immune system, as they produce antibodies that help the body fight infections. Although myeloma is a chronic condition, advances in treatment have significantly improved outcomes for many patients. Treatments such as targeted therapies, immunotherapy, chemotherapy and stem cell transplants have helped patients manage the disease, leading to longer, more fulfilling lives.
Myeloma is a relatively rare form of cancer, though it is the second most common blood cancer in the United States. Each year, about 35,000 people are diagnosed with myeloma in the U.S. alone. It is more commonly diagnosed in older adults, with the majority of cases occurring in people over the age of 65.
We recognize that a cancer diagnosis can be an incredibly daunting experience, often bringing about feelings of stress and anxiety regarding the future. If you need a hematologist, our team at SCRI Oncology Partners is committed to supporting you every step of the way. We provide the essential guidance and information to help you navigate your treatment journey with assurance and compassion.
What is Myeloma?
Myeloma, or Kahler’s disease, is a cancer of the plasma cells. It develops in the bone marrow and is marked by an overgrowth of malignant plasma cells and excess production of an abnormal antibody known as M protein. As these cancerous multiple myeloma cells grow, they outnumber and crowd out healthy platelets, red blood cells, and white blood cells. This can weaken the immune system.
Myeloma is often called multiple myeloma (MM) because at least 90% of patients have more than one bone lesion at diagnosis or throughout their illness. There are two main myeloma groups: active myeloma and smoldering myeloma.
What are some of the signs and symptoms of myeloma?
People with myeloma may experience a wide range of symptoms but the following are common signs and symptoms to watch for:
- Unexplained weight loss
- Unexplained bruising or bleeding
- Recurrent infections or fevers
- Shortness of breath or persistent fatigue
- Unexplained pain in your bones or joints
- Drenching night sweats
- Swollen lymph nodes, or an enlarged liver or spleen
Paying attention to symptoms such as anemia, high calcium levels, or easily fractured bones is especially important when considering myeloma. We want you to know that many symptoms associated with blood cancer can often be attributed to other, less serious conditions. Just because you’re experiencing one or more of these symptoms doesn’t necessarily mean you have cancer.
That said, if you have persistent health concerns, we encourage you to consult with your physician. Taking this step can offer you peace of mind and ensure you receive the compassionate care and support you deserve.
Risk Factors
Staging
Treatment
Clinical Trials
How are myeloma cases diagnosed?
If there is a possibility that you have myeloma, we recommend seeing an experienced hematologist in your area for further testing and treatment. One of the initial tests you might undergo is a complete blood count (CBC) test. This test offers valuable insights by measuring the levels of red blood cells, white blood cells, and platelets in your blood, helping to identify any irregularities. Additionally, your hematologist will also perform a physical examination and ask for additional information about your medical history, symptoms and family history.
After the initial test is completed, your care team may recommend additional tests to gain a deeper understanding of how different elements of your blood are functioning. This may include examining the hemoglobin levels and the shape of your red blood cells, as well as assessing whether your bone marrow is producing enough healthy red blood cells. For white blood cells, your healthcare team might take a closer look at the various types and subtypes to ensure they are functioning properly.
For any disorder, your hematologist may also order a peripheral blood smear (or PBS) to examine your cells under a microscope more closely or may order additional tests to measure enzymes and proteins in the blood. In some cases, a sample of blood marrow may be taken to see how well your bone marrow is producing blood cells. Bone marrow testing requires bone marrow aspiration—a sample removal of the liquid portion of bone marrow. It may also include a bone marrow biopsy, the removal of a small, solid piece of bone marrow to confirm the presence of malignant plasma cells.
In addition to these tests, your doctor may also order various imaging tests- such as CT, MRI or PET scans to look for bone damage or other signs of cancer.
Rest assured, our compassionate team is here to guide you through each step, ensuring that you receive the care and attention you need.
Risk factors for myeloma
Risk factors are elements that may elevate your likelihood of developing myeloma. It’s important to understand that having risk factors does not mean you will definitely develop myeloma, just as not having risk factors does not guarantee you will remain cancer-free. Being aware of your risk factors empowers you to take proactive steps in managing your health.
Some common risk factors for myeloma include:
- Previous cancer treatment, especially involving chemotherapy or radiation therapy
- Genetic disorders such as Down syndrome
- Non-cancerous blood disorders such as myelodysplastic syndrome
- Smoking
- Family history of cancer
- Viral or bacterial infections such as the Epstein-Barr virus, human herpes virus or HIV
- Lowered immune systems
- Exposure to radiation, asbestos, petroleum, agricultural or woodworking chemicals, benzene, dioxins, pesticides, and herbicides increases risk
It’s also crucial to recognize that those of African American descent are more than twice as likely to be diagnosed with multiple myeloma compared to other racial or ethnic groups. They often face this diagnosis 5 to 10 years earlier than others.
Staging
If you are diagnosed with myeloma, your physician will carefully assess the stage of your cancer to create the most effective treatment strategy for you. For most solid tumor cancers, staging is based on the size of the tumor and its spread within the body. In the case of blood cancers, which do not form tumors, the stage is described by the number of cancerous cells present and their accumulation in other organs. This detailed understanding helps your care team offer you the best possible support and treatment.
When staging myeloma, your provider will use the Revised International Staging System (RISS) to determine how advanced it is. Four factors are considered when assessing the stage of the disease:
- Albumin level. Albumin is a protein produced in the liver and, at a healthy level, prevents fluids from leaking out of the blood vessels into other tissues.
- Beta-2 microglobulin level. B2M is a protein found on the surface of cells. High levels can be an indication of blood and bone marrow cancers.
- Assessment of the specific gene abnormalities (cytogenetics) of the cancer. Cytogenetic testing looks for chromosome changes. These chromosome changes can be categorized as not high risk, intermediate risk, or high risk.
- LDH level. Lactate dehydrogenase (LDH) is an enzyme that helps the body produce energy. A high LDH level can indicate tissue damage and is considered an inflammatory marker.
Staging helps your care team plan the best treatment for your diagnosis. If you have questions or need additional information, speak with your doctor about what treatment options are available to you.
How can myeloma be treated?
If you have been recently diagnosed with myeloma, your cancer care team will help you develop a treatment plan that best fits your cancer and your overall goals for your health. The treatment your physician recommends may depend on the type of myeloma you have and the stage your cancer is in. If you have any questions about your treatment options, always ask your doctor.
Chemotherapy
Chemotherapy is used to treat myeloma by using anti-cancer drugs that are either given as an injection or taken by mouth. This is often an effective treatment for blood cancers because chemotherapy drugs enter through the bloodstream and can reach the entire body.
Immunotherapy
Immunotherapy leverages your immune system to fight myeloma. Immunotherapy drugs are used to either boost your immune system to help it target and attack cancer cells or to change the way your immune system works to fight the myeloma cells.
- Monoclonal antibodies, which are man-made versions of the proteins made by your immune system to fight your infection, can be used to treat myeloma. These drugs work by targeting a substance on the surface of lymphocytes, the cells where myeloma starts.
- Immune checkpoint inhibitors may also be used to treat myeloma. Your immune system keeps itself from attacking normal cells in the body with “checkpoint” proteins, which determine whether an immune response is started. Cancer cells can use these checkpoints and avoid being targeted by the immune system. Immunotherapy drugs target these checkpoints to start an immune response.
- Certain types of myeloma may also be treated with drugs called bispecific antibodies, which attach to both cancer cells and immune system cells. This brings the two cells together, helping the immune system destroy the myeloma cells.
- Chimeric antigen receptor (CAR) T-cell therapy may be used for some myeloma cases. This treatment removes immune cells called T-cells from the patient’s blood and alters them in a lab. The altered cells have receptors that attach to the proteins on the surface of myeloma cells to destroy them.
Targeted therapies
Targeted therapies with drugs known as tyrosine kinase inhibitors (TKIs) can also be used as a form of treatment in some myeloma cases. These cancer cells contain an abnormal gene that produces a protein which leads to uncontrolled cell growth and division. TKIs target this specific protein to stop growth. If initial treatment with TKIs does not stop the cancer growth, your physician may increase the dose of the drug or switch to another type of TKI. Chemotherapy or a stem cell transplant may be an option for some patients.
Bone marrow/stem cell transplantation
Hematopoietic stem cell transplants (HPSCT), sometimes referred to as bone marrow transplant, can be used to treat myeloma cases that have not responded to chemotherapy or radiation, or to cases that have come back after treatment. Blood and bone marrow transplants allow doctors to give a patient a higher dose of chemotherapy. Doses of chemotherapy drugs are usually limited to minimize damage to the bone marrow, where new blood cells are made. In this treatment, patients receive a high dose of chemotherapy, and the transplanted cells create healthy bone marrow.
Myeloma clinical trials
Today’s clinical trials are tomorrow’s treatment options. A clinical trial can help determine if a treatment, drug or procedure shows a better way of treating a particular cancer or condition. At SCRI Oncology Partners we are committed to offering the latest clinical trials to improve your outcomes and ensure access to cutting-edge scientific advancements for our patients in the community.
If you are looking for a local oncologist in Nashville, Tennessee or you are interested in participating in a clinical trial for myeloma through our collaboration with Sarah Cannon Research Institute (SCRI), a global leader in oncology research, the first step is to talk to our healthcare team.
Contact Us
Whether you are newly diagnosed, previously treated or seeking additional care or research options, we are here to support you every step of the way.
Contact Us
Whether you are newly diagnosed, previously treated or seeking additional care or research options, we are here to support you every step of the way.
Contact Us
Whether you are newly diagnosed, previously treated or seeking additional care or research options, we are here to support you every step of the way.