Myeloma Explained

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What is multiple myeloma?  Drs. Faith Davies and Frits van Rhee, both from the University of Arkansas for Medical Sciences Myeloma Institute, explain this cancer of the plasma cells.

Dr. van Rhee describes symptoms and clarifies why a patient would experience them.  Dr. Davies focuses on the genetics, stressing that patients do not cause their myeloma nor do they pass it down to their children.

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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. 

Andrew Schorr:

Dr. van Rhee, I want to just help people understand what is myeloma. Some people—Sean is going to tell us how he had terrible bone pain. But it’s not bone cancer. And some people have all of these blood tests, and we say is it in our blood, is it in our bones? What is myeloma?

Dr. van Rhee:      

Myeloma is a form of cancer of the plasma cells.

Plasma cells limit bone marrow. They can crowd out the normal blood forming elements so you can become anemic. Myeloma can affect the bones, so you can get fractures, for instance, of the vertebrae in the spine. The absorption of bone can also cause hypercalcemia. And then, the abnormal myeloma protein and the high blood calcium can cause renal failure, that is kidney impairment. So it can affect a number of vital organs.

Andrew Schorr:                  

Okay. But it starts with part of the blood. 

Dr. van Rhee:      

It starts in the bone marrow.

Andrew Schorr:                  

And then, it’s just a cascade of things that can happen. 

Dr. van Rhee:      

Yes. The myeloma cells, eventually, in more advanced disease, or in highly aggressive disease, can go outside the bone marrow. But that’s typically seen in patients with more advanced disease.

Or the occasional patient who is newly diagnosed who has got very aggressive disease. 

Andrew Schorr:                  

Okay. Now, is it a certain age, usually? Stephanie, we’re going to meet, 35 years old. Sean was 49, I think. Other people though might be in their 60s or 70s. So age, or does that matter?

Dr. van Rhee:      

We’ve not found that the patients who are younger necessarily present with easier or more aggressive disease. I think it’s the genes and the biology that determine how a particular patient is affected and how are they going to fare under therapy. What is important, obviously, is age because age and physical fitness allow us to deliver certain therapies. So our up-front total therapy type of approach is, obviously, only suitable for the fitter patients. 

Andrew Schorr:                  

We’re going to explain that in a few minutes as we go on. So, Faith, let me ask you this. It can vary, not just the symptoms can vary, but your biology of your myeloma can vary, too. And you’ve been studying genetics. So you do very detailed testing here now to see is one person’s myeloma different from another, because you’re developing medicines that line up with those differences, right?

Dr. Davies:            

Yeah. So we can do a series of what we call genetic tests. So that’s not genetics on how it passes down the family or passes to children. It’s actually looking at the myeloma cells that we take from the bone marrow, and we can do a series of tests on that. And as you say, not all myeloma patients are the same. So we can actually look at the genetics and the genes of those cells, and we can split the myeloma into a number of different categories, some of which we know will do well with treatment.

Others of which we know that maybe some treatments won’t work so well. So we need to avoid those treatments and maybe give them slightly different treatments.

Andrew Schorr:                  

One question about genetics. Anybody who is diagnosed with a cancer said A) did I bring something to bring it on? And B) is there something in my genes that will give it to my children or runs in my family?

Dr. Davies:            

And that’s a really important question. So 1) no, as far as we’re aware, there’s not really evidence of something that can bring myeloma on. There are a very few families with myeloma. So but the vast majority of people it doesn’t pass down to families.

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 August 23, 2016