What is myeloma?

Myeloma is a cancer of plasma cells in the bone marrow. Bone marrow is a spongy material inside our bones. The main bones it’s in are the hip bones, breastbone, arm bones, leg bones, ribs and spine. Bone marrow is part of the immune system, which protects us from infection and disease.

TYPES OF MYELOMA: 

Myeloma is really not just one disease. It's a disease with several subtypes. In all cases of myeloma, abnormal plasma (blood) cells produce an unusually high number of only one of the types of antibodies – or immunoglobulins, as doctors often call them. The specific type of immunoglobulin that is overproduced by cancerous blood cells can vary from one person to the next, and determines the subtype of myeloma that the patient has. When plasma cells are exposed to foreign substances (antigens), they produce different antibodies called immunoglobulins. Immunoglobulins are made up of two types of protein: Heavy chains (A, G, M, D and E)Light chains (kappa [?] or lambda [?])About 60-65% of all cases of myeloma involves the overproduction of immunoglobulins (Ig) made with "G" heavy chains (IgG). When too much of the same immunoglobulin is produced, this is referred to as monoclonoal protein (M-protein), monoclonal spike (M-spike), monoclonal peak (M-peak) or paraprotein.Subtypes of Myeloma :MGUS(Monoclonal Gammopathy of Undertermined Significance) :Benign condition where M-protein (or paraprotein) is present, but there is no underlying disease (ie, no anemia, renal failure, excessive calcium in the blood or bone lesions)Although there may be more abnormal plasma cells than usual in the bone marrow, they account for less than 10% of blood cells (the threshold for a diagnosis of myeloma)Approximately 3.2% of the general population 50 years of age and older have MGUS. Of those, about 1% per year will develop active myeloma.MGUS is usually monitored but not treatedAsymptomatic or Smouldering Myeloma :Transitional state between MGUS and active/symptomatic myelomaM-protein is present in the blood and/or urineAbnormal plasma cells may account for up to 10% of blood cells in the bone marrowStill no symptoms or organ damageUsually monitored but not treatedSupportive care may be givenSymptomatic or Active Myeloma :SLiM CRAB CriteriaThe International Myeloma Working Group (IMWG) recently expanded the definition of active myeloma, to include any one of the following "SLiM" criteria to confirm the diagnosis of myeloma:Sixty (60) percent or greater abnormal plasma cells on bone marrow examinationLight chain ratio (free, involved/uninvolved) of 100 or more in the blood (involved must be at least 100 mg/L)MRI (magnetic resonance imaging) with more than one bone lesion (5 mm or greater)Traditionally, the diagnosis of myeloma was based on:M-protein is present in the blood or urineAbnormal plasma cells account for 10% or more of blood cells in the bone marrowSymptoms or complications may include one or more of the following "CRAB" criteria:Calcium elevation in the bloodRenal insufficiency (kidney failure)Anemia (low red blood count)Bone disease (pain, increased risk of fractures, etc.)Requires treatmentRisk factors and causes : It is slightly more common in men than women. Doctors don’t know what causes myeloma, but a number of things are known to increase the risk of it developing:MGUS – Research shows that almost everyone with myeloma has had MGUS first. But not everyone who has MGUS goes on to develop myeloma.Age – The risk of myeloma increases with age. It’s rare in people under 40 and is most commonly diagnosed after the age of 65.Race – Myeloma is twice as common in African-Caribbean people than white people.Radiation – People who have been exposed to high levels of radiation may have a higher risk. This includes people who work in the nuclear power industry.Family history – People who have a close family member with myeloma have a slightly increased risk of developing it.Weight – Some research suggests that being overweight may increase the risk of developing myeloma. Keeping to a healthy body weight may reduce the risk of myeloma and other cancers.A weakened immune system – A weak immune system increases the risk of developing myeloma. Some conditions reduce immunity, such as HIV. People taking medicines to weaken (suppress) their immune system after an organ transplant are also at a higher risk.Autoimmune disease – Autoimmune diseases develop when the immune system attacks healthy body tissue by mistake. Some autoimmune disorders can slightly increase the risk of developing myeloma. These include pernicious anaemia, haemolytic anaemia and lupus.Occupation – It has been suggested that people in certain jobs have an increased risk of myeloma, possibly due to exposure to harmful substances. However, there is very little evidence to support this.Symptoms of Myeloma : Bone pain, especially in your spine or chestNauseaConstipationLoss of appetiteMental fogginess or confusionFatigueFrequent infectionsWeight lossWeakness or numbness in your legsExcessive thirstDiagnosis:Blood tests. Laboratory analysis of your blood may reveal the M proteins produced by myeloma cells. Another abnormal protein produced by myeloma cells — called beta-2-microglobulin — may be detected in your blood and give your doctor clues about the aggressiveness of your myeloma.Additionally, blood tests to examine your kidney function, blood cell counts, calcium levels and uric acid levels can give your doctor clues about your diagnosis.Urine tests. Analysis of your urine may show M proteins, which are referred to as Bence Jones proteins when they're detected in urine.Examination of your bone marrow. Your doctor may remove a sample of bone marrow for laboratory testing. The sample is collected with a long needle inserted into a bone (bone marrow aspiration and biopsy).In the lab, the sample is examined for myeloma cells. Specialized tests, such as fluorescence in situ hybridization (FISH) can analyze myeloma cells to understand their genetic abnormalities. Tests are also done to measure the rate at which the myeloma cells are dividing.Imaging tests. Imaging tests may be recommended to detect bone problems associated with multiple myeloma. Tests may include an X-ray, MRI, CT or positron emission tomography (PET).Role of Homeopathy for  Myeloma :  Myeloma being a chronic difficult disease of unknown origin, largely affecting the vital functions at the constitutional and immunological level, the homeopathic approach is, in turn, constitutional. The treatment is aimed at controlling the disease process of multiplication of the malignant cellular overgrowth and hence, trying to keep a check on the cellular destruction. Also, the medication is aimed at controlling the spread of the diseaseThere is no major study done to evaluate the role of homeopathy for a series of cases of MM. However, our brief experience is suggestive of using homeopathy as an important supportive measure during all the stages of  Myeloma. Some research is likely to throw light on a better defined role of homeopathy. In the light of the fact that homeopathy has an established role in the treatment of various immunologically mediated diseases,  Myeloma patients should not be deprived of the benefits of homeopathy. Homeopathy is safe and can be taken along with the traditional medicines for the treatment of Multiple Myeloma. Some of the commonly indicated medicines for Multiple Myeloma are Carcinosin, Thuja, Phosphorus, Radium bromatum, etc. depending on the indications which are based on a multi-factorial constitutional guidelines.