Cancer that develops in the plasma cells, a type of white blood cell, is called multiple myeloma. The role of the plasma cells is to help combat different infections by releasing antibodies. These antibodies recognize germs and attack them. When someone has multiple myeloma, cancer tends to accumulate in the bone marrow. If that happens, the unhealthy blood cells crowd the healthy blood cells. Consequently, instead of producing good and healthy antibodies, these affected cancer cells release abnormal proteins, leading to severe complications.

Those who don’t present any signs or symptoms of multiple myeloma wouldn’t need any treatment. However, for those who do require treatment, there are a bunch of options available to combat or control the disease.

Symptoms

The symptoms of multiple myeloma might vary from one person to another. In the early stages, people might not even experience any symptoms. However, when these symptoms start showing, they include:

• Nausea
• Bone pain, followed by aggravated pain in chest and spine
• Fatigue
• Weight loss
• Not feeling hungry
• Constipation
• Confusion or mental fogginess
• Feeling excessively thirsty
• Numbness or weakness in the legs
• Getting infections frequently

Causes

There’s no clarity about what causes multiple myeloma. However, doctors believe that myeloma starts with a single unhealthy plasma cell in the bone marrow. Bone marrow is a blood-producing soft tissue that is present in the center of the bones. Unfortunately, abnormal cells tend to multiply at a rapid rate. Unlike normal cells, cancer cells do not mature and die on their own. As a result, cancer cells accumulate over time and hamper the production of healthy cells. In the bone marrow, the myeloma cells crowd the healthy red and white blood cells, causing fatigue and reducing the body’s ability to fight infections. Myeloma tries to produce antibodies, just like normal plasma cells, since they are infected, but they end up producing abnormal antibodies that lead to complications like kidney damage. These cancer cells also hamper the bones and bring about a serious risk of broken bones.

Relation to monoclonal gammopathy of undetermined significance

Initially, multiple myeloma starts as MGUS, which is a benign condition. Currently, there are approximately 3% of people over the age of three who suffer from MGUS. Every year about 1% of people who suffer from MGUS develop symptoms of multiple myeloma or any other related cancer. Just like multiple myeloma, MGUS is also confirmed when M protein is present in the body. These M proteins are released into the blood via abnormal plasma cells. However, the level of protein is lower in MGUS; hence, the damage is almost negligible.

Risk factors

There are a couple of factors that tend to increase the risk of multiple myeloma. These include:

• Age
  The risk only aggravates as one ages. It is most common in people who are in their mid-60s.
• Sex
  Usually, men are more likely to develop multiple myeloma.
• Ethnicity or race

It has been noted people of color are more vulnerable to multiple myeloma.

• Family history

One is at a higher risk of multiple myeloma if any of their family members have had it.

• History of MGUS

If one has a history of MGUS, they are more susceptible to multiple myeloma.

Complications
Some common complications experienced in multiple myeloma are:

• Regular infections

Since this condition inhibits the ability of the body to combat infections, infections are fairly more common.

• Anemia

Because multiple myeloma directly hampers the body’s healthy blood cells, one might develop anemia or other blood problems.

• Kidney damage

Multiple myeloma has a direct impact on the kidney’s function. It can also lead to kidney failure in the long run.

• Bone problems

Multiple myeloma also hampers the bone. It might lead to broken bones, pain in the bones, and thinning of the bones.

Diagnosis

Sometimes, multiple myeloma may be detected accidentally during a regular blood test for any other condition. But, doctors also suspect multiple myeloma depending on certain signs and symptoms. To confirm their suspicions, there will be some tests that one would have to undergo. These include:

• Blood tests

This test will showcase the presence of M proteins in the blood if someone has myeloma. In addition to the M proteins, another protein is abnormally produced by the unhealthy cells of myeloma, which is the beta-2-microglobulin. This test will help the doctor understand the aggressiveness of the disease. Furthermore, a blood test is also helpful to examine the kidney function, calcium levels, uric acid level, and blood cell counts. All of this is effective in the proper diagnosis of multiple myeloma.

• Urine test

Urine tests are done to learn about the presence of M proteins.

• Bone marrow examination

For this, doctors will take out a small sample from the bone marrow for a lab test. This sample is taken out via a long needle, which is inserted into the bone. The sample is then tested in the lab for the presence of myeloma cells. It will be followed by some advanced tests like the fluorescence in situ hybridization. This test helps to learn about the genetic abnormalities in the myeloma cells. Certain tests are also carried out to learn about the spread and multiplication rate of myeloma cells.

• Imaging tests
  Imaging tests, such as CT scan, PET scan, MRI, or X-ray, are performed to determine bone-related problems, which might occur as a result of multiple myeloma.

Finding out the stages of multiple myeloma

After the doctor is certain about the disease’s presence, the next step is to gather more information to ascertain the stage of the disease. It is classified into three stages: stage I, stage II, and stage III.
If a person is still in stage I, it means that the disease is less aggressive. On the other hand, if the disease has already reached stage III, it means that the disease is rapidly spreading, and has started to affect the kidney, bone, and other organs. Depending upon the risk and the stage of the disease, the healthcare professional will try to analyze the prognosis. Based on it, a treatment measure is chosen.

Treatment

When someone is already experiencing certain signs and symptoms of multiple myeloma, the doctor will carry out some treatment measures to relieve the pain and minimize the complications of the disease. It is necessary to stabilize the condition and reduce the spread of multiple myeloma.

Treatment

People who suffer from multiple myeloma but do not experience any symptoms would not need any immediate treatment. However, regular symptom monitoring would be recommended to understand the extent of the disease. For this, periodic urine or blood tests might be needed. In case the doctor sees a progression in the signs or symptoms, they will suggest that a treatment.

Some treatment techniques include:

• Biological therapy
  In this form of treatment, specific medicines that trigger the immune system to fight myeloma cells are used. It includes medicines such as pomalidomide and thalidomide. These work incredibly well to accentuate the immune system’s cells to identify and then fight the unhealthy cancer cell. Usually, all of the biological therapy medicines are taken in the form of a pill.
• Targeted therapy
  In this treatment, targeted medicines are used to overcome certain specific abnormalities caused by the cancer cells. These include ixazomib, carfilzomib, and bortezomib. All of these drugs restrict the action of a particular substance present in the cancer cells, which break down body proteins. As a result, the myeloma cells are killed. This type of medication therapy is either taken in a pill form or administered in the body via injection. A few other treatments involving targeted therapy include monoclonal medication that binds proteins found in the myeloma cells and reduces them.
• Bone marrow transplant
  Stem cell or bone marrow transplant is performed to replace unhealthy bone marrow with a healthier one. Before operating and performing the transplant, the stem cells are collected from the blood. After this, a high dose of chemotherapy is given to destroy the unhealthy bone marrow. Following this, the healthy stem cells are introduced in the body. So, now, these healthier cells travel to the bones and then lead to bone marrow re-building.
• Chemotherapy

Chemotherapy is used to kill all the rapidly-growing cancer cells, including the myeloma cells. These drugs are either taken in the form of a pill or are injected in the vein. The treatment method is primarily used before performing a stem cell transplant.

• Corticosteroids
  Corticosteroid medications like dexamethasone and prednisone are used to manage the immune system and inflammation. They also offer protection against cancer myeloma cells. These medicines are either taken in the form of a pill or are injected in the vein.
• Radiation therapy

In this type of treatment, a high beam of energy is used to combat myeloma cells and further prevent them from growing or spreading. This treatment might be used to quickly shrink the growth of myeloma cells in a certain area.

Multiple myeloma and diet

There are no diets to cure multiple myeloma. However, a diet can help manage the symptoms of the disease, such as anemia and kidney damage. These changes can also reduce the relapse of cancer.

Multiple myeloma might lead to anemia, which might cause folate, iron, and vitamin B-12 deficiencies. So, including nutrients to make up for these deficiencies would help.

Folate

Folate is a vitamin B variant that facilitates the formation of white and red blood cells in the bone marrow. The best sources of folate include:

• Black-eyes peas
• Broccoli
• Spinach
• Lentils
• Asparagus
• Cooked beans

Iron

Primarily, iron is of two types: non-heme and heme.

Foods for non-heme iron deficiency are:

• Lentils
• Nuts
• Beans
• Green leafy vegetables, like spinach
• Chickpeas

The best sources of non-heme iron include:

• Avocado
• Baked potato
• Tofu
• Soybean

To better absorb non-heme in the diet, one should include sources of vitamin C in their diet. This includes lemon, oranges, berries, and bell peppers.

Vitamin B-12

Both folate and vitamin B-12 combine to facilitate red blood cell formation. When there is a B-12 deficiency, it can reduce the ability of the bone marrow to produce red blood cells. Common B12 sources include:

• Dairy
• Cereals
• Nutritional yeast
• soy milk, almond milk, non-dairy milk, flax milk

Vitamin D
People undergoing treatment for multiple myeloma usually show a deficiency in vitamin D. The common sources of vitamin D include:

• Fortified milk, orange juice, or yogurt
• Sunlight

Anti-cancer foods
There are also certain foods that inhibit the growth of cancer cells. These include:

• Basil
• Apples
• Cranberries
• Rosemary
• Vegetables such as Brussels sprouts, broccoli, cabbage, and cauliflower
• Turmeric
• Blueberries

Generally, a wholesome diet rich in plant foods with little sugar content can be helpful to prevent cancer.

Foods to avoid
If one is suffering from multiple myeloma, they should avoid certain foods to overcome or reduce the impact of the symptoms. These include:

Foods that cause kidney damage
With multiple myeloma, there’s a noted decline in kidney function. When that happens, the intake of fluids, potassium, and phosphorous consumption should be limited.

Potassium-rich foods

• Banana
• Citrus foods
• Tomatoes
• Avocadoes
• Green leafy vegetables like spinach

Phosphorus-rich foods

• Bran cereals
• Sunflower seeds
• Nuts
• Whole-grains
• Oats
• Breads

Though potassium or phosphorus-rich foods aren’t harmful, they can be fatal for people with multiple myeloma.

Foods to avoid during chemotherapy

• Raw sprouts
• Undercooked or raw meat
• Poultry
• Seafood
• Deli meats
• Undercooked eggs