Myelomas facts and figures
17th most common cancer in the UK, approximately 4,700 new cases diagnosed each year, accounting for approximately 1% of all new cancer cases. Slightly higher incidence in men. The incidence rises sharply form 55 years of age with the highest incidence being in the 85+ years age group, an average of 43% occur in those over 75 years of age.
Risk factors include exposure to high levels of radiation (nuclear power industry), family history of malignant myeloma and occupational exposure to chemicals in rubber production, petrochemicals, farming and painting.
Malignant myelomas are cancers that arise in the plasma cells developing in the bone marrow. In myeloma, the plasma cells become abnormal and excessively multiply and cause problems in multiple places due to the build-up of abnormal plasma cells in the bone marrow.
- In early stage, there are likely to be no symptoms.
- Abnormal bruising and bleeding.
- Persistent infections.
- One pain: 70% of cases present with bone pain, most often lower back and ribs, which is caused by the large number of plasma cells collecting in the bones and damaging them.
- Hypercalcaemia: symptoms may be nausea, thirst and tiredness.
Diagnosis of myelomas
Investigations may include:
- Physical examination.
- Blood tests.
- Urine tests.
- X-rays (particularly if areas of bone pain).
- CT scan.
- MRI scan.
- Bone marrow biopsy.
Depends on several factors:
- The stage of the disease.
- Age and general health.
- Treatment will either be intensive (usually younger and fitter) or non-intensive (older or less fit).
Chemotherapy is the main treatment, usually melphalan or cyclosphophamide, dexamethasone or prednisolone and either thalidomide or vercade. Patients who receive high dose chemotherapy may have a stem cell transplant.
Bortezomib is a proteasome inhibitor which blocks the myeloma cells ability to recycle and grow and therefore causes destruction of the cells.
Radiotherapy is sometimes used palliatively to treat bone pain.