A Simple Guide to Multiple Myeloma

A Simple Guide to Multiple Myeloma
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What is Multiple Myeloma?
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Multiple myeloma is cancer of the bone marrow which occurs from the uncontrolled growth of plasma cells, a form of immune-protective white blood cells.
Normally plasma cells make antibodies to fight infections.
The disease is called multiple myeloma because myeloma cells can occur in multiple bone marrow sites in your body.

What are the Risk factors in Multiple Myeloma?
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1.Age. The majority of people who develop multiple myeloma are older than 50, with most diagnosed around age 70.

2.Sex. Men are more likely to develop the disease than are women.

3.Exposure to radiation and working in petroleum-related industries.

4.History of a monoclonal gammopathy of undetermined significance.

5.Obesity. Your risk of multiple myeloma is increased if you're overweight or obese.

What are the causes of Multiple Myeloma?
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The exact cause of Multiple Myeloma is not known.
However doctors do know that multiple myeloma begins with one abnormal plasma cell in your bone marrow . This abnormal cell then starts to multiply. Because abnormal cells don't mature and then die as normal cells do, they accumulate slowly reducing the number of healthy cells.
Myeloma cells may circulate in low numbers in the blood, populating other bone marrow sites far from where they began. Uncontrolled plasma cell growth can damage bones and surrounding tissue.

What are the Symptoms of Multiple Myeloma?
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Common symptoms include:
1.Anemia or pallour can occur as myeloma cells replace oxygen-carrying red blood cells in your bone marrow,
2.fatigue
3.Bone pain.
4.Nausea
5.Loss of appetite
6.Mental confusion
7.Presence of abnormal proteins produced by myeloma cells in your blood or urine. These proteins which are antibodies are called monoclonal, or M, proteins.
8.High level of calcium in your blood. This can occur when calcium from affected bones dissolves into your blood. A high calcium level in your blood may cause symptoms such as:
9.Excessive thirst and urination
10.Constipation

How do you diagnose Multiple Myeloma?
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Multiple myeloma can be diaqgnosed before you ever have symptoms through blood and urine tests.Blood and urine tests
1.blood test called serum protein electrophoresis separates your blood proteins and can detect the presence of M proteins in your blood.
When found in urine, they're referred to as Bence Jones proteins.
2.Another blood test to check for beta2-microglobulin — another protein produced by myeloma cells
3. Imaging.
a.X-rays of your skeleton can show whether your bones have any thinned-out areas, common in multiple myeloma.
b. magnetic resonance imaging (MRI) or computerized tomography (CT) scanning.
4.Bone marrow examination is done by using a needle to remove a small sample of
bone marrow tissue. The sample is then examined under a microscope to check for myeloma cells.

What are the Complications of multiple myeloma?
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Multiple myeloma can result in several complications:
1.Impaired immunity. Myeloma cells inhibit the production of antibodies needed for normal immunity which may make you more likely to develop infections, such as pneumonia, sinusitis, bladder or kidney infection, skin infections and shingles.

2.Bone problems. Multiple myeloma also can affect your bones, leading to erosion of bone mass and fractures. The condition may cause compression of your spinal cord. Signs of this medical emergency include weakness, or even paralysis, in your legs.

3.Impaired kidney function.
Higher calcium levels in the blood related to eroding bones can interfere with your kidneys' ability to filter your blood's waste. The proteins produced by the myeloma cells can cause similar problems, especially if you become dehydrated.

4.Anemia. As cancerous cells crowd out normal blood cells, multiple myeloma can also cause anemia and other blood problems.

What are the Treatment of Multiple myeloma ?
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There is no cure for multiple myeloma.
However, with good treatment results you can usually return to near-normal activity.
The appropriate multiple myeloma treatment depends on the stage of the illness, medical status and general health.
Chemotherapy.
Chemotherapy involves using
1.Anti Cancer medicines taken orally as a pill or given through an intravenous (IV) injection to kill myeloma cells. Chemotherapy is often given in cycles over a period of months, followed by a rest period.
2.Corticosteroids. Corticosteroids such as prednisone and dexamethasone (Decadron) have been used for decades to treat multiple myeloma.
3.Thalidomide is currently FDA-approved in conjunction with the corticosteroid called dexamethasone for the treatment of newly diagnosed cases of multiple myeloma. This drug is given orally.

Radiation therapy.
This treatment uses high-energy penetrating waves to damage myeloma cells and stop their growth. Radiation therapy may be used to target myeloma cells in a specific area to more quickly shrink a tumor that's causing pain or destroying a bone.

Stem cell transplantation.
This treatment involves using high-dose chemotherapy usually high doses of melphalan along with transfusion of previously collected immature blood cells (stem cells) to replace diseased or damaged marrow. The stem cells can come from you or from a donor, and they may be from either blood or bone marrow

Treating complications
Back pain. Taking pain medication or wearing a back brace can help relieve the back pain you might experience with multiple myeloma.
Infections. Antibiotics may be necessary to help treat infections or to help reduce your risk of them.
Bone loss. You may take medications called bisphosphonates which bind to the surface of your bones and help prevent bone loss.
Anemia. If you have persistent anemia, your doctor may prescribe erythropoietin injections. Erythropoietin is a naturally occurring hormone made in the kidneys that stimulates the production of red blood cells. .
Kidney complications. People with severe kidney damage may need dialysis

A Simple Guide to Blood Cancer

A Simple Guide to Blood Cancer
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What are Blood Cancer?
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Blood cancer consists of mainly lymphoma, leukaemia and multiple myeloma.

These cancers developed either in the bone marrow or the lymphatic tissues of the body. These three types of blood cancers all involve an uncontrolled growth of abnormal cells within the blood and bone marrow.

Who is at risk of getting Blood Cancers?
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The risk of developing blood cancers increases with age.

Adults therefore are more prone to blood cancer than children.

The acute leukemia tends to affect children.

The chronic leukemia is more common in adults.

However children and adults can develop any kind of leukaemia.

In Multiple myeloma, the average onset is at age 60.

Lymphoma
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(refer to my blog on A Simple Guide to Lymphoma)

Lymphoma is a cancer of the lymphoid tissues which are composed of several types of immune-system cells that work together to fight infections.

Lymphoma usually begins in a lymph node as a primary cancer.

It can also begin in the stomach, intestines, skin or any other organ that contains lymphoid tissue.

Leukaemia
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Leukaemia is a cancer that affects the blood-forming system of the body which include the bone marrow and the lymphatic system.

Leukaemia can be classified as either acute or chronic.

The acute leukemia tends to affect children while the chronic leukemia is more common in adults.

Acute leukaemia
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In acute leukaemia, immature blood cells reproduce quickly in the bone marrow, slowly killing the normal cells.

These abnormal cells can also spread to other organs, ultimately leading to disruption and distortion of these organ functions.

Acute leukaemia can be further divided into two types according to the predominant type of cells affected:

1.Lymphoblasts are immature cells that normally develop into lymphocytes, a type of white blood cell

2.myeloblasts are immature cells that normally develop into other cells such as neutrophils, another type of white blood cell.

1. Acute lymphoid leukaemia (ALL) -
here the lymphoblasts reproduce without developing into normal blood cells.

These immature lymphoblasts block out the healthy blood cells and frequently congregate in the lymph nodes, causing a swelling in that area.

2. Acute myeloid leukaemia (AML) -

here the myeloblasts reproduce without developing into normal blood cells.

The immature blast cells gather in the bone marrow and upset the production of healthy normal cells.

Anaemia results due to lack of sufficient red blood cells.

Frequent infections occurs due to the low levels of white blood cells which fight infections.

Chronic leukaemia
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Chronic leukaemia occurs when there is over-production of blood cells that appear to be mature. Unfortunately these cells actually lack the normal functions of mature blood cells.

Chronic leukaemia usually has a slower, less dramatic course than acute leukaemia.

Chronic leukaemia can also be broken into two groups:

(a) Chronic lymphoid leukaemia (CLL) -
Here there is production of too many apparently mature lymphocytes in the bone marrow. The abnormal cells appear to be fully developed lymphocytes, but cannot fight infections as well as normal lymphocytes.

(b) Chronic myeloid leukaemia (CML) -
here the over-production of apparently mature but defective myeloid cells, reach a point where almost no healthy cells remain.


Multiple Myeloma
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(refer to my blog on A Simple Guide to Multiple Myeloma)

Multiple myeloma is cancer of the bone marrow which occurs from the uncontrolled growth of plasma cells, a form of immune-protective white blood cells.

Normally plasma cells make antibodies to fight infections.

In multiple myeloma, there is a malignant proliferation of plasma cells.

What are the Symptoms of Blood Cancer?
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All three blood cancers have similar symptoms.

Among the common warning signs are:

1.weight loss,

2.constant infections such as flu and diarrhoea,

3.bleeding of gums or nose and slow healing cuts or frequent bruises

In addition to the above,

4.severe kidney problems,

5.general numbness of the skin

6.pain in the bones
may indicate the existence of multiple myeloma and leukemia as the disease progresses.
The pain can radiate to the back, ribs and arms of the victims. The pain is a result of an increase in the number of myeloma cells where the bone marrow is being damaged.

7.swelling of lymph nodes in the neck, the armpits or in the groin may indicate more likely a diagnosis of lymphoma

8.Persistent fever

9.loss of appetite

10.generalised weakness and pallour

What are the Causes of Blood Cancer?
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1.Exposure to excessive radiation

2.hazardous chemicals like benzene, asbestos, herbicides and pesticides are known to be the primary causes of blood cancer. Avoid these harmful materials as much as possible.

3.certain genetic abnormalities, such as Down Syndrome and the inheritance of a particular chromosome called the Philadelphia chromosome, have also been linked to the development of specific forms of leukaemia. This is controversial.

How do you diagnose Blood Cancer?
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1.a full medical history and full examination especially for signs of:
anaemia,
enlarged liver and spleen,
bleeding tendencies in the skin such as petechie and ecchymoses
enlarged lymph nodes

2.a full blood and urine test should be done to examine the blood cells under the microscope for cancer cells as well as to assess the patient's kidney, liver functions and the severity of anaemia.

3.A bone marrow aspirate using a syringe and needle can be examined for further evidence of blood and bone marrow cell abnormailties.

The presence of the Philadelphia chromosome may suggest evidence of leukemia.

What is the Treatment of Blood Cancer?
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Before any cancer treatment is done, because of the patients's anaemia and bleeding tendency, blood transfusions are usually given to improve the general health and resistance of the patient.

Chemotherapy and radiation therapy have always been used to treat blood cancer effectively.

Besides these treatments, stem cells infusion and bone-marrow transplants also give patients and their families another source for a cure.
Unlike chemotherapy and radiation therapy that are used to treat all the three kinds of blood cancer, bone-marrow transplants are more frequently used to cure lymphoma and leukaemia only .

It is also more successful for younger patients and when the disease is in the early stage.
Patients shuold know that dangers and side effects of bone-marrow transplants exist.

In extreme cases when the transplant fail, death may occur.

What are the Prevention measures for Blood Cancer?
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1.When exposed to dangerous chemicals and radiation, take extra precautions by wearing protective and appropriate clothing.

2.The threat of contracting lymphoma can be reduced by avoiding the risk of HIV. Patients infected with HIV are known to have a higher rate of lymphoma because of their low immune-system cells to fight infections.

3.Any family member of a leukemia patient should go for genetic testing and regular check-ups to spot the symptoms early.

A Simple Guide to Dizziness

A Simple Guide to Dizziness
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What is Dizziness?
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Dizziness has been used to describe different sensations.
Some may liken it to giddiness, light-headedness, unsteadiness or simply feeling faint.

The symptom of "dizziness" needs to be separated from vertigo, which is a feeling that the room is moving or spinning, or that the person is moving when they are not (or even a floating sensation).

Balance difficulty is also a separate topic where a person feels they are about to fall, has difficulty staying balanced, or may actually fall.

What are the Causes of Dizziness?

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There are many causes of dizziness:
1.insufficient blood flow to the brain

2.Lack of sleep

3.Low blood sugar

4.Low or very high blood pressure

5.Anaemia

6.Fever

7.Stress & Anxiety

6.Cochlea imbalance(Motion Sickness)

7.Cold or Influenza

8.heart disease9. Medicines

10.Brain condition such as Parkinson,brain tumours

Most dizzy spells are minor and go away after a while.

However, dizziness can also point to more serious disorders. These include:

1.Vertigo

There is a spinning sensation or feeling that your surrounding is moving around you.

It is often accompanied by nausea and vomiting.

Nystagmus, a jerky movement in the eye, is a common sign.
Vertigo often indicates an inner ear problem.

Viruses, such as those causing the common cold or flu, can also attack the inner ear and its nerve connections to the brain, resulting in severe vertigo.
In a more serious case, a bacterial infection such as mastoiditis can make a person lose his hearing and sense of balance.
Poor blood flow to the inner ear can also lead to vertigo. This is often due to the hardening of the arteries (arteriosclerosis) which is commonly seen in patients with diabetes, high blood pressure or high blood cholesterol.

2.Light-headedness

A typical form of light-headedness occurs when you stand up too fast for the blood to reach your brain. This form of light-headedness is often transient and harmless. More persistent forms of light-headedness can be caused by:

Loss of body fluids, for instance, loss of water in excessive sweating.

Changes to your blood pressure caused by medicines such as anti-hyptensives, diuretics and anti-depressants.

Medical conditions such as diabetes, Parkinson's disease and Anaemia.

3.Motion sickness or sea-sickness

People prone to this condition can experience nausea and even vomiting when travelling in cars, airplanes, boats, or ships.
Motion sickness occurs when the central nervous system receives conflicting messages from four different systems of the body. They are the inner ears, the eyes, pressure receptors in our skin and sensory receptors in the muscles and joints.

It is the complex interaction of these four systems that gives us our sense of balance and equilibrium.

The inner ears, specifically the three semicircular canals in each ear, detect motion in three dimensions, that is, forward-backward, up-down, and left-right.

The central nervous system (that is, the brain and spinal cord) receives all the information from the four systems to make some sense of the body's position in relation to the environment.
Thus, if you are sitting in the back seat of a moving car, your inner ears and skin receptors will detect the motion of your travel. And if your eyes see the same motion, you will not become "car sick". But if you are reading in the car, your eyes see only the pages of your book, so your brain receives conflicting signals and you become "car sick."

How to diagnose Dizziness?
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History:
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1.duration of dizziness - to determine if acute or chronic.

2.any evidence of vertigo i.e. episodic sudden sensation of circular turning motion of your body or your surroundings - this is a sign of nervous system or ear disease.

3.sensation of lightheadedness, floating, giddiness, unsteadiness, fainting - all known as pseudovertigo and are more likely to be a sign of cardiovascular disease. 4.occasional dizziness episodes - e.g. benign positional vertigo attacks are brief, usually lasting a minute, and then subside rapidly.

5. Continous dizziness episodes may indicate Meniere's syndrome which is characterized by paroxysmal attacks lasting 30 minutes to several hours of vertigo, tinnitus, nausea and vomiting, sweating and pallor and progressive deafness.

6. effect of position (of head or body) or a change in posture on the dizziness - e.g. benign positional vertigo is a common type of vertigo that is induced by changing head position, especially tilting the head backwards, changing from lying to sitting position or turning to the affected side.

Physical examination

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1.Observe for pallor of skin or conjunctiva. Moderate or severe anemia will cause lightheadedness and dizziness, but usually not true vertigo

2.Blood pressure taken when lying down and again after rapidly arising to standing position. Very High blood pressure may cause true vertigo or lightheadedness.

Low blood pressure or postural drop in blood pressure is more likely to cause lightheadedness not true vertigo

3.Examine the ear for abnormalities. Abnormalities on ear examination with no other abnormalities found on nervous system examination may suggest ear wax, otitis media (middle ear infection), cholesteatoma or petrositis

4.Complete nervous system examination should be performed including visual acuity, inspecting for nystagmus, cranial nerve and cerebellar signs.

If abnormalities are found may suggest multiple sclerosis, advanced brain stem tumor, acoustic neuroma or basilar artery insufficiency

What is the Treatment of Dizziness?
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Treatment of dizziness depends on whether the symptom indicates a more serious condition.

Most cases of dizziness and motion sickness are mild and self-treatable disorders.

1.Medications given usually act to balance the inner ear nerves or increase blood flow to the inner ear. Iron and vitamin supplements may be given to treat anaemia.

Other than medicines, the following may relieve some of your discomfort:
2.Avoid rapid changes in position, especially standing up quickly from lying down or turning around from one side to the other.

3.Avoid extremes of head motion (especially looking up) or rapid head motion (especially turning or twisting).

4.Remove or reduce using products that impair circulation, e.g. nicotine, caffeine, and salt.

5.Avoid stress or anxiety, or substances that can trigger dizziness. These include substances that you are allergic to.

6.Avoid hazardous activities such as driving a car, operating dangerous equipment or climbing a ladder.
7.Avoiding motion sickness

Always travel in a manner such that your eyes will see the same motion that your body and inner ears feel.

When in a car, look forward into the distance.

On a ship, watch the horizon

In a plane, choose the window seat if you can, and look out of the window.
Do not read while travelling and do not sit in a seat facing backwards.

8.Treating balance disorders

The main way is to treat the underlying disease or disorder that may be causing the imbalance in the first place. These diseases include ear infection, stroke, multiple sclerosis and other diseases of the nerve.

A Simple Guide to Anaemia

A Simple Guide to Anaemia
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What is Anaemia?
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Anaemia is a blood condition in which the haemoglobin is lower than the average value of a normal person. The Haemoglobin is the red chemical in red blood cell which carries oxygen around our bodies.

What Causes Anaemia?
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The commonest causes of anaemia is:

1. blood loss such as excessive menstrual flow or
internal bleeding from the stomach or bowel

2. deficiency in the diet for foods rich in iron, vitamin B12 or folic acid.

3.inherited abnormalities (Thalassaemia)

4. kidney failure ,liver disease

5. cancer patients

5.certain drugs such as anti cancer drugs and toxic substances such as lead

6. infections (haemorhagic dengue fever) & worm infestation

7.radiation therapy,

8.surgery on the gastro-intestinal tract, particularly the stomach.

What are Symptoms of Anaemia?
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Easy fatigue :
This is due to lack of oxygen in the red blood cells
Pale skin :
The lack of haemoglobin cause the redness of the blood cells to be reduced hence the pale appearance of the skin.The finger nails and lower eyelids can be checked for the paleness.
Dizziness:
Giddiness occurs when there is insufficient oxygen supply to the nerve cells in the brain.
Unusually rapid heart beat:
Rapid heart beat may occur becuse the heart has to pump faster to supply enough oxygen to the body
Difficulty concentrating and headache:
These are caused by insufficient oxygen to the brain.
Leg cramps
Leg cramps are due to insufficient oxygen to the muscles.
Shortness of breath:
Breathing difficulty may occur as a result of insufficient oxygen in the lungs

What is the Treatment of Anaemia?
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1.Treat the underlying cause of the anaemia.

2.Eat a well-balanced diet that includes good sources of
iron (liver, meat, peas, beans, whole grain),
vitamin B12 (foods of animal origin only, including meats, liver and kidney, milk, cheese, fish, shell fish and eggs)
folic acid( present in most vegetables).
Vitamin C can make the stomach more acidic and can improve the absorption of iron in your diet.

3.Reduce your consumption of caffeine products and tea as they can decrease the absorption of iron.