Multiple Myeloma (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Multiple myeloma facts
- What is multiple myeloma?
- What causes multiple myeloma?
- What are risk factors for multiple myeloma?
- What are multiple myeloma symptoms and signs?
- How do health-care professionals diagnose multiple myeloma?
- What types of specialists treat multiple myeloma?
- What are the stages of multiple myeloma?
- What is the treatment for multiple myeloma?
- What is the prognosis for multiple myeloma? What is the survival rate for multiple myeloma?
- Is it possible to prevent multiple myeloma?
- What support systems are available for multiple myeloma?
- Find a local Oncologist in your town
What is multiple myeloma?
Multiple myeloma is a type of cancer that starts in the plasma cells of the bone marrow. These are protein-making cells that normally make all of the different kinds of antibodies of the immune system. In multiple myeloma, the plasma cells undergo what is referred to as a malignant transformation and become cancerous. These myeloma cells stop making different forms of protein in response to the immune system's needs and instead start to produce a single abnormal type of protein, a monoclonal or M protein. Multiple myeloma plasma cell populations accumulate in the bone marrow and these collections of cells called plasmacytomas can erode the hard outer shell or cortex of the bone that normally surrounds the marrow. These weakened bones show thinning of the bone such as is seen in nonmalignant osteoporosis or what appear to be punched out or lytic bone lesions. These lesions may cause pain and even breaks or fractures of the weakened bones. They may cause other systemic problems listed below. Multiple myeloma is often referred to simply as myeloma (also termed Kahler's disease after the physician who first described this cancer).
What causes multiple myeloma?
What triggers plasma cells to become malignant in multiple myeloma is not known. The cancerous myeloma plasma cells proliferate and crowd out normal plasma cells and can etch away areas of bones. The proteins produced in large amounts can cause many of the symptoms of the disease by making the blood more thickened (viscous) and depositing the proteins in organs that can interfere with the functions of the kidneys, nerves, and immune system.
What are risk factors for multiple myeloma?
The definitive cause of multiple myeloma has not been established, but research has suggested several factors may be risk factors or contribute to multiple myeloma development in an individual. A genetic abnormality such as c-myc oncogenes and others have been associated with multiple myeloma development. Currently, there is no evidence that heredity plays a role in multiple myeloma development so it is not considered to be a hereditary disease. Environmental exposures to herbicides, insecticides, benzene, hair dyes, and radiation have been suggested as causes but definitive data is lacking. Inflammation and infection have been suggested but again not proven to cause multiple myeloma. However, a benign proliferation of a plasma cell can result in a situation where a monoclonal antibody is produced in high amounts (but not as high as seen with multiple myeloma). This result is termed monoclonal gammopathy of unknown or undetermined significance (abbreviated as MGUS). About 19% of MGUS patients develop multiple myeloma in about two to 19 years after MGUS diagnosis.
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