Multiple Myeloma

Multiple Myeloma Treatment: Symptoms, Diagnosed Causes & Doctors in India

Myeloma sometimes referred to as Multiple Myeloma, is a type of bone marrow cancer. Bone Marrow is the spongy tissue found at the center of some bones. It produces the body’s blood cells. Myeloma affects the plasma cells inside the bone marrow. It does not usually take the form of a lump or a tumor, instead, the Myeloma cells divide and expand within the bone marrow, damaging the bones and affecting the production of healthy blood cells.

Myeloma often affects many places in the body (hence called Multiple Myeloma) – commonly affected areas include the spine, skull, pelvis, and ribs. 

Symptoms of Multiple Myeloma

During the early stages, Myeloma may not cause any symptoms, however, it will eventually cause a wide range of problems including: 

  • Pain in the bones, especially in the back, ribs, and skull
  • Weakness
  • Fatigue
  • The feeling of very thirsty
  • Frequent infections and fevers
  • Changes in frequency of urination
  • Restlessness
  • Nausea and vomiting
  • Loss of appetite
  • Weight loss
  • Numbness, especially in the legs.

What causes Multiple Myeloma?

Multiple Myeloma is an uncommon type of cancer and it is not known what causes the condition, however, it is more common in:

  • Men
  • Adults over 60 years of age – most cases are diagnosed at around the age of 70; cases affecting people under the age of 40 are rare.

How is Multiple Myeloma diagnosed? 

Myeloma can be difficult to diagnose because it’s an uncommon type of cancer that initially has few or no symptoms.

The doctor on suspicion of Myeloma will order the following tests, such as:

  • Electrophoresis to test immunoglobulin
  • BUN (Blood Urea Nitrogen) to check how well the kidneys are working
  • CBC (Complete Blood Count) to measure and count the cells in the blood
  • Urine test
  • Bone test

If Myeloma is suspected, a GP will refer the case to a Hematologist & a Hemato-Oncologist for further tests and subsequent treatment. And, to confirm the diagnosis of Myeloma, the Hematologist will perform a Bone Marrow Biopsy to check for myeloma cells.

How is Multiple Myeloma treated?

While treatment can often control Myeloma, and improve the quality of life, it can’t usually be cured. And additional treatment is needed when cancer relapses. 

A Hematologist or Hemato-Oncologist has two main objectives while beginning the treatment of Myeloma, 

  • Bring the Myeloma under control
  • Prevent and treat problems associated with Myeloma such as Anemia and Bone Pain. 

To bring Myeloma under control, the Hemato-Oncologist prescribes a combination of anti-myeloma medicines that might include: 

  • Chemotherapy – mostly administered in a tablet form
  • Steroid Medicines that help destroy myeloma cells, thus making chemotherapy more effective
  • Thalidomide or Bortezomib that helps kill myeloma cells

In some cases, the treatment could include a Stem Cell Transplant/ Bone Marrow Transplant that helps the bone marrow to recover. 

Along with the above treatment, the doctor would need to administer treatment to help relieve the problems caused by the condition, such as painkillers, radiotherapy, blood transfusions, dialysis, and plasma exchange.

What are the side effects of treatment?

  • Side Effects of Chemotherapy: The side effects are often mild and might include: increased risk of infections, feeling sick, vomiting and hair loss. 
  • Side Effects of Steroid Medicines: Heartburn, Indigestion, Increased Appetite, Mood Changes, Problems Falling Asleep.
  • Side Effects of Thalidomide or Bortezomib: Sleepy, Constipation, Dizziness, Rashes, Numbness or Tingling in the Hands & Feet, Tiredness, Nausea, Diarrhoea.

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Dr. Vikas Dua

Head and Senior Consultant, Pediatric Hematology Oncology, and Bone Marrow Transplant

Dr. Vikas Dua is Paediatric Hemato Oncologist and bone marrow transplant specialist of the generation. Dr. Dua's results in the field of Paediatric Haematology Oncology and BMT have been some of the best. He and his team has done 200 + paediatric transplants. 

About Dr. Rahul Bhargava

Hematologist, Hemato-oncologist & Stem Cell Transplant Physician

With over 20 years of experience, Dr. Rahul Bhargava is currently the Director of Haematology, Paediatric Haematology, Immunology and Stem Cell Transplant at Fortis Memorial Research Institute (FMRI), Gurgaon – India’s first integrated Centre of Excellence in Haematology, Paediatric Haematology, and Stem Cell Transplant.

Dr. Aniruddha Dayama

Hematology, Pediatric Oncology & Bone Marrow Transplant Specialist

Dr. Aniruddha Dayama in 2015 led the efforts to get NMDP, USA approval for one of the leading hospitals in Gurgaon. He and his team have popularised autologous transplants in multiple sclerosis. The team has been credited for establishing six low-cost centers across North India.