Each year, about 24,000 people in the United States are diagnosed with multiple myeloma, according to the American Cancer Society. Most are over age 65, but people of all ages are diagnosed with this blood cancer.
Multiple myeloma is marked by the growth of malignant plasma cells found in the bone marrow. These myeloma cells typically make a protein found in blood and urine.
Over the past decade, we've made tremendous strides in treating multiple myeloma, enabling patients to live significantly longer.
Jatin Shah, M.D., associate professor in Lymphoma/Myeloma, recently spoke with us about how multiple myeloma is diagnosed and treated, as well as new therapies on the horizon.
Here's what he had to say.
How is multiple myeloma diagnosed?
The most common way to diagnose myeloma in its earliest stages before symptoms appear is through routine blood work. If a patient has elevated protein levels, several tests are conducted and their combined results interpreted in order to make a myeloma diagnosis.
What are common myeloma symptoms?
Before they receive a definitive diagnosis, myeloma patients often have problems with anemia, high calcium or renal failure. Or, they may have broken bones or lytic lesions, where sections of bone are basically destroyed.
Are some people more likely to develop multiple myeloma?
As people get older -- above age 65 -- their chances of developing multiple myeloma go up.
Multiple myeloma is slightly more common in African-Americans, as well as in men.
Those who've had prior radiation exposure are more likely to be diagnosed with myeloma. Agent Orange exposure also may put a person at increased risk.
Is there a standard treatment for multiple myeloma?
Unfortunately, there's not. The way we treat multiple myeloma has changed dramatically over the last 10 years. A whole host of new myeloma drugs have become available over the last decade. Bone marrow transplants also are an option in many cases. So treatment is really unique to each patient.
Are these new treatments helping patients survive myeloma and live longer?
Absolutely. With all these new treatments and new multiple myeloma drugs, there's been tremendous improvement in the last decade. Overall, twice as many people are surviving the disease than a decade ago, and patients are living with multiple myeloma for longer than ever before. That continues to improve as we get more and more therapies.
These improved survival rates raise some new challenges for those of us who treat myeloma patients. We need to start focusing on not just controlling the disease, but some of its long-term side effects. These include bone health, heart health, sexual health, mental health. All these things are important and we need to focus on them as patients live longer.
What new myeloma therapies are on the horizon?
In the last year, we've had two new drugs approved: carfilzomib and pomalidomide.
There also are clinical trials for some very promising drugs that use monoclonal antibodies to target specific proteins on the surface of the myeloma cells. These drugs are different than typical chemotherapies, which target a whole host of cells. Monoclonal antibodies bind to the surface of the disease cells and lead to the direct killing and cell death. Hopefully, these drugs will be approved for use for relapsed patients in 2015 or 2016.
One of the potential benefits of these new drugs is that they seem to have fewer side effects. We still see infusion side effects, such as chills, rigors, shortness of breath, but we don't see the typical side effects that you get with standard chemotherapy, like nausea, vomiting and hair loss. And that can make a big difference for our patients' quality of life.