Multiple Myeloma Awareness Month: Understanding the Surge in Cases & How to Fight Back
Multiple Myeloma Awareness Month, observed every March, aims to shed light on multiple myeloma—a type of blood cancer that affects plasma cells in the bone marrow. Globally, over 176,404 individuals are diagnosed with this disease annually. In the United States alone, approximately 35,780 new cases were reported in 2024, with about 12,540 fatalities attributed to the disease.
In India, multiple myeloma accounts for about 1.19% of all cancer cases, with an age-adjusted incidence rate of 1.13 per 100,000 men and 0.81 per 100,000 women. The disease predominantly affects individuals aged 60-69 years. Raising awareness is crucial for early detection and improving survival rates. Organizations like the International Myeloma Foundation and Myeloma Canada are at the forefront of providing support, education, and funding research to combat this challenging disease.
Why Are Multiple Myeloma Cases Rising in India and Globally?
Multiple myeloma, a cancer of plasma cells, has seen a notable increase in incidence both globally and within India. In 2022, approximately 188,000 new cases were diagnosed worldwide, with about 121,000 fatalities attributed to the disease. This upward trend is partly due to aging populations and advancements in diagnostic technologies.
In India, multiple myeloma comprises around 1.19% of all cancer cases. The age-adjusted incidence rates are 1.13 per 100,000 men and 0.81 per 100,000 women, with the majority of cases occurring in individuals aged 60-69 years. Factors such as increased life expectancy, lifestyle changes, and improved healthcare access contribute to the rising incidence. However, the lack of comprehensive national cancer registries poses challenges in accurately assessing the disease’s true burden in the country.
Global Surge in Cases
Globally, multiple myeloma accounts for approximately 1% of all cancers and 10% of hematologic malignancies. In 2015, it affected 488,200 people worldwide, with 101,100 deaths attributed to the disease. The increase in cases can be linked to aging populations and enhanced detection methods.
What is Multiple Myeloma?
Multiple myeloma is a type of blood cancer that affects plasma cells in the bone marrow. These cancerous cells multiply uncontrollably, crowding out healthy blood cells and producing abnormal M protein that can damage the kidneys and other organs.
It can weaken bones, causing pain and fractures, and lead to fatigue, infections, and weight loss. Diagnosis involves blood tests, urine analysis, and bone marrow biopsy. Early detection and treatments like chemotherapy, immunotherapy, and stem cell transplants can improve outcomes.
Causes and Risk Factors of Multiple Myeloma
Multiple myeloma is a type of blood cancer originating in plasma cells, a subset of white blood cells responsible for producing antibodies. While the exact cause remains unknown, several risk factors have been identified:
- Age: The likelihood of developing multiple myeloma increases with age, particularly affecting individuals over 60.
- Gender: Men are slightly more susceptible to multiple myeloma than women.
- Race: Individuals of African descent have a higher incidence of multiple myeloma compared to other racial groups.
- Family History: A familial predisposition exists, with a higher risk observed in individuals with a close relative diagnosed with multiple myeloma or other plasma cell disorders.
- Obesity: Excess body weight has been linked to an increased risk of multiple myeloma, potentially due to related hormonal and inflammatory changes.
- Environmental Exposures: Prolonged exposure to certain chemicals, such as benzene and pesticides, as well as ionizing radiation, has been associated with a higher risk of developing multiple myeloma.
Understanding these risk factors is crucial for early detection and prevention strategies. Individuals with one or more of these risk factors should consult healthcare professionals for regular screenings and adopt lifestyle changes to mitigate potential risks.
Common Symptoms of Multiple Myeloma
Early detection of multiple myeloma is challenging because the symptoms are often subtle and may be mistaken for other health issues. Recognizing these early signs can lead to timely diagnosis and better treatment outcomes.
- Bone Pain – Persistent pain, especially in the spine, chest, or hips.
- Fatigue and Weakness – Constant feeling of tiredness due to anemia or bone marrow issues.
- Frequent Infections – Weakened immune system leading to recurring infections.
- High Calcium Levels – Causes excessive thirst, frequent urination, and digestive issues.
- Kidney Problems – Reduced kidney function, sometimes leading to swelling and electrolyte imbalance.
Identifying these symptoms early and seeking medical advice can significantly improve the chances of successful treatment and better quality of life.
Diagnosis and Screening
Timely and accurate diagnosis of multiple myeloma is essential for effective treatment. A combination of tests and screenings helps in confirming the disease and assessing its progression:
- Blood Tests – Measures abnormal protein levels, calcium levels, and kidney function.
- Urine Tests – Detects Bence Jones proteins, indicating abnormal plasma cell activity.
- Bone Marrow Biopsy – Examines bone marrow samples to confirm the presence of malignant plasma cells.
- Imaging Studies – Includes X-rays, MRI, CT scans, and PET scans to identify bone lesions and structural damage.
- Genetic Testing – Identifies specific gene mutations linked to multiple myeloma for targeted treatment.
Early and comprehensive screening increases the chances of successful treatment and better disease management.
Treatment Options for Multiple Myeloma
Treatment strategies for multiple myeloma are personalized based on factors such as the patient’s age, overall health, and the disease’s progression. The primary goal is to manage symptoms, control the disease, and improve quality of life. Key treatment modalities include:
- Targeted Therapy: Utilizes drugs designed to specifically identify and attack cancer cells without harming normal cells. For instance, proteasome inhibitors like bortezomib and carfilzomib disrupt the protein degradation process in myeloma cells, leading to their death. Monoclonal antibodies, such as daratumumab and elotuzumab, target specific proteins on cancer cells, enhancing the immune system’s ability to eliminate them. (Source): https://en.wikipedia.org/wiki/Multiple_myeloma
- Chemotherapy: Involves the use of cytotoxic drugs to kill or inhibit the growth of rapidly dividing myeloma cells. Common agents include melphalan and cyclophosphamide. Chemotherapy is often combined with other treatments to enhance efficacy.
- Immunomodulatory Drugs (IMiDs): Medications like thalidomide, lenalidomide, and pomalidomide modulate the immune system to target myeloma cells and inhibit their growth. (Source): https://en.wikipedia.org/wiki/Multiple_myeloma
- Corticosteroids: Drugs such as dexamethasone and prednisone help reduce inflammation and directly kill myeloma cells. They are frequently used in combination with other therapies to enhance treatment effectiveness. (Source): https://en.wikipedia.org/wiki/Multiple_myeloma
- Stem Cell Transplantation: An autologous stem cell transplant involves collecting a patient’s own healthy stem cells, administering high-dose chemotherapy to eradicate myeloma cells, and then reinfusing the stem cells to restore bone marrow function. This approach can lead to prolonged remission in suitable candidates.
- Radiation Therapy: Employs high-energy beams to target and destroy myeloma cells, particularly useful for treating localized bone pain or lesions that do not respond to other treatments.
- CAR-T Cell Therapy: A novel approach where a patient’s T-cells are genetically modified to recognize and attack myeloma cells.
Emerging treatments and ongoing clinical trials continue to expand the therapeutic landscape for multiple myeloma, offering hope for improved outcomes. Patients should engage in detailed discussions with their healthcare providers to determine the most appropriate and personalized treatment plan.
Role of Research and Innovation
Ongoing research and innovation are crucial in advancing the treatment of multiple myeloma, leading to the development of novel therapies, enhanced treatment efficacy, and improved patient quality of life. Key advancements include:
- Development of Novel Therapies: Biotechnology companies are actively engaged in creating innovative treatments. For example, HaemaLogiX is developing immunotherapy drugs like KappaMab and KMA.CAR-T, which have shown promising results in clinical trials, including a 46% reduction in the risk of death and an 83% response rate.
- Enhanced Treatment Efficacy: Pharmaceutical collaborations have led to more effective treatment combinations. A notable example is the acquisition of 2seventy bio by Bristol Myers Squibb, aiming to optimize the CAR T-cell therapy, Abecma, for multiple myeloma patients.
- Improved Patient Quality of Life: Research initiatives are focusing on early detection and prevention strategies. Dr. Irene Ghobrial’s work emphasizes understanding the progression from precursor conditions like MGUS to multiple myeloma, aiming to intercept the disease before it fully develops, thereby enhancing patient outcomes.
These advancements underscore the importance of continued research and innovation in the fight against multiple myeloma, offering hope for more effective treatments and better quality of life for patients.
Conclusion
Multiple Myeloma Awareness Month is an opportunity to educate and empower individuals about this complex disease. Understanding risk factors, recognizing symptoms, and advocating for early diagnosis are crucial steps in combating multiple myeloma. Continued research and awareness efforts are essential to improve outcomes for those affected.
Sources
- Distribution of multiple myeloma in India
- Multiple Myeloma Survivors
- Key Statistics About Multiple Myeloma
- The global multiple myeloma incidence
