Diagnosing Myeloma

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How is myeloma diagnosed? Dr. John Burke, an expert from Rocky Mountain Cancer Centers, explains the process. Dr. Burke reviews the tests used to diagnose a patient, including bone marrow biopsy and genetic testing, and their impact on treatment and prognosis.

Sponsored by the Patient Empowerment Network through educational grants from Onyx Pharmaceuticals and Millennium: The Takeda Oncology Company.  

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Jeff Folloder:

So how is myeloma diagnosed?

Dr. Burke:            

So initially, it’s often suspected based on the symptoms and abnormal blood tests that show an increased level of protein in the blood or increased level of antibodies in the blood.  And so when I’m seeing someone where I suspect that they might have myeloma, we do special blood tests and urine tests, and then we do a set of X-rays to look at the bones for what are called lytic lesions, which are, simply means hole, little holes in the bones.  And then we do a bone marrow biopsy, and that’s to look at how many of those cancerous plasma cells are filling up the bone marrow.  So those are the tests that we do to, to make a diagnosis of, of myeloma.

Jeff Folloder:     

Bone marrow biopsy.

Dr. Burke:            

Uh-huh.

Jeff Folloder:     

Has anyone here in the room had one? 

Dr. Burke:            

So they don’t need me to tell them what it is. 

Jeff Folloder:     

Just for my own information—and I’ve gone through this a couple of times; all right, if you’ve had one bone marrow biopsy, raise your hand.  If you’ve had two, three, four, five, six, seven.  All right, you’re the winner.  I’ve had six by the way, so I’m right there with you guys.

I’m gonna ask.  This, this is a, a pretty medieval diagnostic tool.  What’s the information you’re getting by drilling a hole in our hips?

Dr. Burke:            

Well, first of all, the ones I do don’t hurt at all, all right?  That’s no, I, it—you, you’re, you’re looking to see really a couple things:  what percentage of the cells of the bone marrow are plas—are plasma cells, which is how we make the diagnosis. 

And then, even more than that, once you have the diagnosis, we’re looking at what gene mutations that the cancer cells have in them.  These are not gene mutations that patients are born with.  These are gene mutations that have been acquired during your life in those cancer cells.  Why do we care about those?  Because those have implications for prognosis.  They give us a sense of how the myeloma’s gonna behave and how quickly it’s gonna progress.  And they may have some, some impact in how we decide to treat.  So those are the things that we’re really looking for on the results of a bone marrow biopsy.

Jeff Folloder:     

And you can’t get this information from the peripheral, peripheral blood, correct?

Dr. Burke:            

That is correct.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on February 9, 2015