Be­low the radar: a low-key kind of can­cer

Mul­ti­ple myeloma is dif­fi­cult to di­ag­nose, due in part to low aware­ness, but also its non-spe­cific symp­toms

The Irish Times - Tuesday - Health - - Health Multiple Myeloma - Danielle Bar­ron

Mul­ti­ple myeloma is a low-key kind of can­cer. In fact, you prob­a­bly haven’t even heard of it, but it’s the sec­ond most com­mon blood can­cer in Ire­land and ev­ery year 250 peo­ple will be di­ag­nosed with it. Mul­ti­ple myeloma re­mains dif­fi­cult to di­ag­nose, due in part to low aware­ness, but also its non-spe­cific range of symp­toms. Most com­mon in older peo­ple, the can­cer orig­i­nates within the im­mune sys­tem and goes on to at­tack the bone mar­row and the blood. When the re­sult­ing symp­toms be­gin, it can be hard to pin­point mul­ti­ple myeloma as the cul­prit.

Dr De­nis O’Ke­effe is a con­sul­tant haema­tol­o­gist at Univer­sity Hos­pi­tal Lim­er­ick. He tells Health Plus that mul­ti­ple myeloma tends to stay be­low most peo­ple’s radar, par­tic­u­larly in com­par­i­son to other can­cers as even the very con­cept of it is hard to grasp.

“It is not as com­mon as bowel can­cer or breast can­cer, so it is a chal­lenge for peo­ple to un­der­stand what myeloma is – many think of can­cer as be­ing lo­cal or hav­ing spread but myeloma is very dif­fer­ent.”

The dis­ease in­volves an un­con­trolled in­crease in plasma cells, the blood cells that pro­duce large vol­umes of an­ti­bod­ies. This means that it presents in a va­ri­ety of dif­fer­ent ways, ex­plains O’Ke­effe; “These in­clude pain, bone prob­lems, kid­ney prob­lems, in­fec­tion, etc. In that way it is dif­fi­cult for peo­ple to un­der­stand that it is very dif­fer­ent from solid or­gan can­cers.”

Treat­ments have im­proved sig­nif­i­cantly, but age, men­tal and phys­i­cal fit­ness, other ill­nesses and the so­cial sup­port struc­ture sur­round­ing the pa­tient will dic­tate the treat­ment path­way that they fol­low, he adds. Many pa­tients will find them­selves on main­te­nance treat­ment, and while this will de­lay dis­ease pro­gres­sion, it comes with a price – such as fa­tigue, risk of in­fec­tion, and the risk of blood clots.

“For many peo­ple, this is a dis­ease they will be treated for the rest of their lives,” O’Ke­effe says.

Ac­cord­ing to O’Ke­effe, a di­ag­no­sis of mul­ti­ple myeloma is not only a chal­lenge for the pa­tient and their fam­ily, but also the treat­ing physi­cians and nurs­ing team. There is no cure, but the em­pha­sis is on im­prov­ing qual­ity of life. “Treat­ment has be­come more com­plex but also more fas­ci­nat­ing, as we have many more op­tions for pa­tients. The fu­ture is hugely op­ti­mistic for mul­ti­ple myeloma pa­tients.”

The fu­ture is hugely op­ti­mistic for mul­ti­ple myeloma pa­tients


Joe O’Brien has been liv­ing with mul­ti­ple myeloma for more than six years, hav­ing been di­ag­nosed in 2011 when he was 51.

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