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 Lymphoma

A Simple Guide to Lymphoma
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What is Lymphoma?
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Lymphoma is a cancer of the tissue of the lymphatic system where there is a large number of abnormal white blood cells called lymphocytes causing swelling of lymph nodes or involvement of the other organs.
This can disrupt the immune-system cells and reduce a person's ability to resist infections and diseases. The lymph nodes become swollen forming painless lumps or tumours.
Although lymphomas usually begin in a lymph node, it also can originate in the stomach, intestines, skin or any other organ that contains lymphoid tissue.
Lymph nodes are found anywhere in the body, particularly in the neck, armpits, groin, above the heart and around the big blood vessels inside the abdomen.

Who are at risk of getting Lymphomas?
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1.Men are at a higher risk of getting lymphomas.
The disease is uncommon among younger men.
It often develops after the age of 50.

2. past history of severe viral infections which lowers your immune system eg. HIV virus

3.history of organ transplants and on immuno suppressive drugs

4.history of cancer and previous treatment with chemtherapy or radiation therapy

5. frequent exposure to chemicals, solvents,pesticides

6.family history of lymphoma

What are the types of Lymphoma?
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There are two main types of lymphoma.
They are:
Hodgkin's Disease
Hodgkin's disease is characterised by the presence of a specific type of abnormal cell called the Reed-Sternberg cell. This cancer can spread throughout the lymphatic system, affecting any organ or lymph tissue in the body.
Hodgkin's disease usually attack people in their late 20s or older than 50.

Non-Hodgkin's Lymphoma
Most lymph cancers are non-Hodgkin's lymphomas.
There are many types of non-Hodgkin's lymphomas.
Non-Hodgkin's lymphomas develops in the age group of 60 - 70.
Different types of lymphoma occur in different age groups.

1.Adult non-Hodgkin's lymphoma is classified by the size, shape and arrangement of the cancer cells in the lymph node. The appearance will determine the type of non-Hodgkin's lymphoma. The degree or seriousness of the disease is broken into three types (grades) -
1.low-grade (slower-growing),

2.intermediate grade and

3.high-grade (aggressive).

These grades are crucial in determining the treatment options to treat the cancer.

2.Childhood non-Hodgkin's lymphomas include lymphoblastic lymphoma, large cell lymphoma and small non-cleaved cell lymphoma (including Burkitt's and non-Burkitt's lymphomas).

What are the Symptoms of Lymphoma?
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The most common symptom associated with lymphoma is
1.lymph node swelling. A painless swelling initially surfaces in the early stages of the cancer. This swelling may persist or increase in size. The most common affected areas would be the neck, armpits or groin.
Other symptoms are:

2.unexplained constant fever,

3.sudden weight loss,

4. itchy skin or rashes,

5. night sweats and

6. abdominal pain

What are the causes of Lymphomas?
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There is no known cause for lymphomas.
However, it has been closely linked to several factors -
1) environmental influences, Environmental influences may take the form of extreme exposure to certain chemicals like herbicides and insecticides.

2) genetic factors
There are inherited immune-deficiency disorders from birth such as Wiskott-Aldrich syndrome which have been blamed for the cause of genetic factors that result in lymphomas.

3) viral infections. Viral infections such as the Epstein-Barr virus (EBV) and human immunodeficiency virus (HIV) have been associated with lymphomas.

What is the Treatment of Lymphoma?
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Hodgkin's Disease can only be treated with radiation therapy using high-energy X-rays to kill lymphoma cells in the affected area. This procedure may also be combined with chemotherapy.

Treatment for non-Hodgkin's lymphoma, can vary.
The treatment is based on the degree of grade of the disease.
1.Early stage and low-grade (slow-growing) lymphoma can be treated with radiation therapy and sometimes just simple observation is enough.

2. intermediate-grade lymphoma may be treated with chemotherapy.
The drugs are either injected directly into the bloodstream or swallowed as pills.
Each course of treatment is given at regulated intervals to kill cancer cells and allow the body to recover. The drugs circulate throughout the body and will reach cancer cells even when they are widespread.

Patients who are suffering from the more advanced stages and high-grade (aggressive) lymphomas will require a higher dosage of chemotherapy.
However, the high dosage has its own side effects.
Too much of it may kill healthy bone marrow that produces white and red blood cells and platelets (cells that prevent bleeding). Therefore, to assist patients tolerate the high dosage of chemotherapy treatment, stem cells or bone marrow from the patient or donor are collected beforehand. After a patient has received the chemotherapy, the stem cells or bone marrow are returned to the patient through a drip in a vein.

In addition to the above treatment methods, another option for treating lymphomas would be biological therapy. This procedure uses products such as immunoglobulin that boost the body's own immune system to fight cancer.
This therapy may be used alone or combined with chemotherapy.

In conclusion, the type of treatment sought or used depends very much on the stage, and grade of the lymphoma when diagnosed and the age and health of the patient.
Most doctors will advise their patients on the various treatment options that are the most beneficial and appropriate whilst considering the factors mentioned above.

What are the Prevention measures for Lymphomas?
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1.Where exposure to some toxins and chemicals which are known to cause lymphomas are possible, one should be properly attired and guarded from these chemicals, so as to decrease the risk of developing the disease.

2.Since HIV / AIDS carriers are also related to lymphomas, one should be aware of the importance of safe sex and should stay away from drugs, as far as possible.

3.regular visits to the family doctor helps in detecting any sign or symptom that may eventually lead to the cancer.

4.healthy lifestyle and proper balanced diet are always important in the prevention of any cancer.