What is plasmacytoma and multiple myeloma? Plasmacytoma is a cancer where abnormal plasma cells called myeloma cells form a tumor in the bone. Multiple myeloma is when you have more than one tumor. Multiple myeloma is a rare and life-threatening cancer of the bone marrow. When my husband was diagnosed with plasmacytoma in February of 2011, we were told that multiple myeloma was not hereditary, and his mother passed from multiple myeloma in 2005. After much research I have found out that there is a four times greater chance of getting it if a parent or sibling has had multiple myeloma.
However, this has only been found in a small number of cases. Plasmacytoma comes from a type of white blood cell called a plasma cell. Normal white blood cells grow and produces antibodies to help fight off infections. These cells normally grow old, die, and new cells take their place. However when the old cells do not die they form a mass or a tumor. These abnormal cells called myeloma cells form in the bone marrow. The bone marrow is the spongy tissue inside the bones. Bones that are rich in marrow are the breastbone, spine, ribs, skull, pelvic bones, and the long bone of the thigh.
The myeloma cells begin to multiply uncontrollably it becomes multiple myeloma. Myeloma tumors keep the bone marrow from producing enough healthy blood cells. Bone marrow normally makes three types of healthy blood cells. The first is red blood cells that carry oxygen to all the tissues of the body. Second are white blood cells that fight off infection and disease. Third are platelets that form blood clots to help prevent bleeding. Myeloma cells also damage and weaken the bones. Multiple myeloma is the second-most common blood cancer after non-Hodgkin lymphoma. It accounts for 1% of all cancers.
It occurs in about 20,000 people in the United States each year, and is responsible for the deaths of 10,000 Americans each year. Multiple myeloma is more common in African Americans and least common in Asian Americans. It is also more common for males to be diagnosed than women. It is rare for people under 40 to be diagnosed, the average age is 60. According to the American Cancer Society, approximately 1 out 161 people in the United States will develop the disease at some point in their life. Multiple myeloma occurs spontaneously and the cause has not been determined.
There are a number of possible associations. Such as a patient exposed to high amounts of radiation such has atomic bomb survivors, nuclear weapons workers, and radiologists. Agricultural workers that use the pesticide dioxin may develop the disease. Also patients that work around petroleum, wood, and leather workers have been diagnosed. Older patients that have a decreased immune system can also be diagnosed. Some patients with HIV or the herpes virus-8 have shown signs of multiple myeloma. Most people with risk factor or even people with one or more risk factors may never develop cancer.
There are several symptoms that are associated with multiple myeloma. The most common is bone pain most often in the spine. The tumors can cause the bones to fractures or brake; this is when some patients are diagnosed. Compression of the spinal cord occurs in 10% to 15% of patients. This could lead to paralysis. Patients get anemia from low red blood cell counts which can cause fatigue, pale skin, easily bruising without injury, and shortness of breath. Patients also feel ill, have a fever, and have night sweats. Patients that have high levels of calcium in the blood cause excessive thirst, nausea, dehydration, and constipation.
Patients with advanced stages of multiple myeloma have recurring infections and kidney failure due to high blood calcium levels from dissolved bone tissue. There are several tests that are used to diagnose multiple myeloma. On an x-ray multiple myeloma looks like holes have been punch out of the bone. Multiple myeloma is named for the “clock face” appearance under a microscope. Blood tests are done to measure the amount of red blood cells, white blood cells, and platelets in the blood. A 24 hour urine test is done to check for the presence of proteins and calcium.
A physical exam is done to check for bone pain, bruising, or swelling in the spleen or lymph nodes. Bone marrow biopsies are done to remove some bone marrow, blood, and a small piece of bone to look for abnormal cells under a microscope. When treatment for myeloma is needed, it can often control the disease and its symptoms. People may receive therapy to help keep the cancer in remission, but myeloma can seldom be cured. People with smoldering myeloma or Stage 1 myeloma can put of treatment until they have the symptoms. This way they can avoid the side effects of treatment. However it may reduce the chance of controlling the myeloma.
This is called watchful waiting. You will have blood tests and urine tests every three months until the doctor starts to see the disease progressing. Radiation is to treat plasmacytoma when it is in one location and helps for treating bone pain. Chemotherapy helps to kill fast growing myeloma cells. However the drug can also harm normal cells. Multiple myeloma usually recurs within a year after chemotherapy. Targeted therapy uses drugs to block the growth of myeloma cells. Some steroids have an antitumor effect and can kill the myeloma cells. Stem cell transplantation can be done if you are considered to be a candidate.
Stem cells can come from you, a close relative, or sometimes a donor that’s not related to you. Soon after you go through three or four months of chemotherapy, you can undergo the stem cell transplant. You will more than likely start a new course of treatment with a drug combination that includes bortezomib and melphalan. Blood transfusions may be used to treat patients that have become severely anemic. Plasma transfusions may be used to thin the blood to treat hyperviscosity syndrome. Which can cause spontaneous bleeding, with neurologic and ocular (eye) disorders.
Patients with severe kidney complications may need dialysis. Medications called bisphosphonates are taken to help with bone loss. Patients with back pain can take pain medicine or wear a back brace, and antibiotics may be necessary to help treat or help reduce the risk of infections. In the long run when you are diagnosed with plasmacytoma it will come will eventually come back as multiple myeloma. Living with multiple myeloma is easy. There is always a lot of doctor’s appointment and blood tests. You are always tired, you feel sick all the time, and you don’t want to eat.
When you have children that are still in school it hard not knowing what special events you are going to miss next. Like graduation, your daughters’ wedding, or even your grandchildren. You just live life one day at a time.
Works Cited Arthur Schoenstadt, M. (2009, January 22). eMEDtv. com. Retrieved from eMEDtv. com: http://cancer. emedtv. com/plasmacytoma/plasmacytoma-p3. html Kindersley, D. (2004). Complete Home Medical Guide. Retrieved from Complete Home Medical Guide: http:.. elibrary. bigchalk. com. ezp-00rrw. lirn. net Unknown. (2008). National Cancer Institute.
Retrieved from National Cancer Institute: http://www.cancer. gov/cancertopics/wyntk/myeloma/page13 Unknown. (2012, September 28). National Cancer Institute. Retrieved from National Cancer Institute: http://www. cancer. gov/cancertopics/pdq/treatment/myeloma/Patient/page1 Unkown. (2011, January).
American Academy of Orthopedic Surgeons. Retrieved from American Academy of Orthopedic Surgeons: http://orthoinfo. aaos. org/topic. cfm? topic=A00086 Unkown. (n. d. ). Cancer Treatment Centers of America. Retrieved from Cancer Treatment Centers of America: http://www. cancercenter. com/multiple-myeloma/multiple-myeloma-information. cfmю