Life with multiple myeloma has improved
Ahead of World Cancer Day, an appeal for early diagnosis and proper treatment
Every year in Israel, about 400 people are diagnosed with multiple myeloma, a cancerous bone marrow disease for which, until recently, there was hardly any medical treatment. In recent years, innovative drugs have emerged that – while they cannot cure the disease – allow patients to lead a better life alongside their illness.
Multiple myeloma is the second-most common of the malignant diseases related to the circulatory system. In patients with the disease, increased production of malignant cells called plasma cells causes significant damage to several bodily systems, including the bones, kidneys and circulatory system. The osseous damage causes severe bone pain, to the point of fractures; damage to the renal system results in kidney failure; and damage to the circulatory system leads to anemia – a decrease in the number of red blood cells.
The earlier the disease is diagnosed, the more possible it is to prevent some of the complications of the disease. Therefore, it is important to pay attention to the various signs that may be an expression of the disease. One of the characteristic signs is back pain that “travels” along the spine. This pain persists over many days, even weeks, and is not relieved by changes in position. Another common feature of the disease is weakness and early fatigue, a result of the anemia caused by the disease. At times it is also possible to note a particularly dramatic deterioration in kidney function. In these cases, it is important to find out, using special blood tests, whether the deterioration is the result of myeloma or has a different cause.
The average patient age is 65, and in most cases, the disease is diagnosed following general blood tests. Therefore, it is recommended that all persons over the age of 60 get referred for general blood tests every six months, especially if one of the symptoms described, such as “traveling” back pain that persists for weeks, early fatigue, etc. is noted. The earlier the stage at which the diagnosis is made, the lower the risk of the various complications of the myeloma disease.
Multiple myeloma is a chronic disease that is characterized by many flare-ups and periods of recession. Today, existing treatments provide a solution for disease flareups and may lead to a recession that lasts months or even years. However, there is currently no treatment that leads to a cure.
In the last two decades, treatment of multiple myeloma has progressed due to the discovery of new medications. These medications do not belong to the chemotherapy drug group, but to the immunotherapy group. That means these medications can influence the human immune system and create conditions in which the myeloma cells have a hard time surviving.
The medications are divided into three main groups. The first is the immunomodulatory drug group, the goal of which is to engineer a change in the immune system; the second group contains drugs whose purpose it is to inhibit an intracellular protein known as a proteasome; and the third group includes monoclonal antibodies.
In the last five years there have been dramatic developments, made possible by the widespread introduction of these new drugs. These medications enable patients to achieve extremely long periods during which there are no disease flare-ups. In addition, the drugs have a relatively small number of side effects compared to standard chemotherapy, enabling patients to lead almost completely normal lifestyles. In most cases, patients are not forced to put their lives on hold or leave their place of employment in order to cope with the disease.
There is no doubt that the ultimate goal is to find a drug that enables complete disease cure. However, there is still a long way ahead until this is achieved. Today, we anticipate more medications that can be taken orally by patients, thus further improving their quality of life and enabling them to manage their lives without having to go to outpatient care in order to receive treatment.
The writer is a physician who works at the Hematology unit of the Emek Medical Center in Afula.