Imagine experiencing back pain so severe that it keeps you in bed for weeks at a time. Imagine that someone has told you that you can no longer pick up your child or tightly embrace loved ones out of fear of breaking a bone. Imagine knowing that your symptoms could worsen to the point where you might become completely debilitated and that modern medicine, even with its breakthroughs, has no answers. Imagine that you have just been diagnosed with multiple myeloma.
Multiple myeloma is a cancer of the bone marrow caused by the uncontrolled growth of plasma cells. Manufactured in the bone marrow, plasma cells are a critical part of the bodys immune system. In adults, the most active bone marrow is concentrated in the pelvis, spine, and skull, as well as in the long bones of the arms and legs. Normally, plasma cells make up less than 5 percent of the cells in the bone marrow, but individuals with myeloma have a significantly higher concentration of plasma cells in their bone marrow greater than 10 percent and sometimes more than 90 percent. The danger associated with this high number of plasma cells stems from the fact that they are malignant and can invade and destroy the surrounding bone and displace the normal blood-producing cells in the marrow. The increased malignant plasma cells can actually dissolve bone, weakening areas of the skeleton and causing a severe osteoporosis-like appearance to the bones. The displacement of normal marrow causes anemia and reduced levels of white blood cells and platelets.
Causes
No single factor has been consistently associated with multiple myeloma. Overall it appears that certain occupations, as well as exposure to certain chemicals or radiation, can sometimes cause the disease in predisposed individuals. The diversity of possible exposures and genetic susceptibility factors make proof difficult. Recently, researchers have proposed infection, particularly viral infection, as a causal or trigger factor. Several studies have linked multiple myeloma to HIV, hepatitis, herpes virus infections (especially herpes virus 8), Epstein Barr Virus (EBV), as well as new stealth adapted viruses such as mutated cytomegalovirus (CMV). The significance of these viruses with regard to multiple myeloma remains to be fully explored.
Signs and Symptoms
Many multiple myeloma patients first visit their physicians with a complaint of pain along the lower back and ribs. Onset of sudden pain may be a sign of a fracture or collapse of a vertebral body caused by the excessive growth of malignant plasma cells and their destructive nature. In about two-thirds of patients, anemia (lowered red blood cell count) is present at diagnosis. Approximately 30 percent of multiple myeloma patients may first begin to experience excessive tiredness, thirst and exhaustion caused by hypercalcemia a condition in which high amounts of calcium are released as bone is dissolved, resulting in high levels of calcium in the bloodstream. Still others are likely to experience bruising, nose bleeds, hazy vision, headaches, gastrointestinal bleeding, sleepiness and a variety of neurological symptoms caused by reduced blood and oxygen supply to the nerve tissue.
Patients with multiple myeloma often suffer complications such as pneumococcal pneumonia and deterioration of kidney function. The most serious complication is bone destruction, experienced by 80 percent of patients with multiple myeloma. Effects associated with the loss of bone density include brittle bones that can fracture easily and a severe loss of height. Without prompt and proactive management of the disease, the bone destruction becomes so severe that it leads to immobility
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