Marrow cancer: what it is, symptoms and treatment

Marrow cancer: what it is, symptoms and treatment
 
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Bone marrow cancer: its characteristics, symptoms and treatment
Learn how bone marrow cancer, also known as multiple myeloma, affects Senator Alonso Lujambio.
Tuesday, September 25, 2012 at 2:58 PM
| Another source: CNNMéxico

The National Action Party (PAN) senator, Alonso Lujambio, died Tuesday after fighting against bone marrow cancer, said the PAN parliamentary faction in the Upper House.

Lujambio was 50 years old. On November 1, the Secretary of Public Education, of which he was at the time, announced that he had been hospitalized for two weeks because of "severe kidney failure", which is one of the common complications of bone marrow cancer. Ten days later, the office of the Presidency of the Republic informed through a statement that the then secretary was fighting against bone marrow cancer.

On August 29, Lujambio took protest as senator. He presented himself in a wheelchair, notoriously thin, without hair and with his right eye covered with a black patch.

One of the consequences of bone marrow cancer is bone problems that can cause leg paralysis and chemotherapy and radiation therapy, both treatments to fight cancer, cause hair loss, according to Cancer.Net, the information site of the American Society of Clinical Oncology, in the United States.

Approximately 15% of patients with bone marrow cancer die within three months of diagnosis, and the death rate is approximately 15% per year, according to the Department of Family Medicine of the National Autonomous University of Mexico (UNAM) ).

To better understand this disease, we consulted with Mayo Clinic, a non-profit, integrated group practice that provides health information resources. We present the characteristics of bone marrow cancer.

What is the disease?

Bone marrow cancer, or multiple myeloma, is cancer of the plasma cells, a type of white blood cell that is present in the bone marrow. Bone marrow is the soft tissue that fills the center of most bones. Plasma cells produce proteins called antibodies, which help us fight infections.

The disease occurs when a group of abnormal plasma cells (myeloma cells) becomes cancerous and multiplies, thereby increasing the number of plasma cells above the normal level.

Since abnormal cells do not mature and die, as normal cells do, they accumulate, and eventually outgrow the production of healthy cells. In healthy bone marrow, less than 5% of cells are plasma. But in people with multiple myeloma, more than 10% of the cells can be plasma.

Because these cells normally create proteins (antibodies), the level of abnormal proteins in the blood can increase.

Because myeloma cells can circulate in small groups in the blood, they can populate the bone marrow in other parts of the body, even far from where they started. Therefore, the disease is called multiple myeloma. The uncontrollable growth of plasma cells can damage the bones and the surrounding tissue. It can also interfere with the ability of the immune system to fight infections, since it inhibits the normal production of antibodies in the body.

The health problems derived from this condition can affect the bones, the immune system, the kidneys and the level of red blood cells.



When you have multiple myeloma without symptoms, doctors can limit themselves to monitoring the condition. There are also many treatments available to help control symptoms and disease.

symptom

The symptoms of bone marrow cancer vary in patients.

The condition may not show symptoms in the early stages, but as the disease progresses, it is likely that one or more of the following will be experienced:

    High level of calcium in the blood

Hypercalcemia can occur when the calcium in the affected bones dissolves in the blood. And the high level of calcium in the blood in turn can cause: thirst and excessive urination, constipation, nausea, loss of appetite and mental confusion.

    Renal insufficiency

The high levels of some abnormal proteins (monoclonal globulin), known as M proteins, Bence Jones or free light chains, damage the kidneys.

    Fatigue related to anemia

This occurs when the myeloma cells replace the red blood cells that carry oxygen to the bone marrow.

    Fractures and damage to bones

The type of bone damage caused by multiple myeloma is known as osteolytic or lytic lesions and on x-rays it is seen as dark spots in the bones. Pain in the bones is also a common symptom, particularly in the back, pelvis, ribs and skull.

Other signs and symptoms are:

    Repeated infections, such as pneumonia, sinusitis, kidney or bladder infections, skin infections and herpes.
    Weightloss.
    Weakness and numbness of the legs.

Prevalence and risk

Multiple myeloma is not a contagious disease. Most people who develop it do not have clearly identifiable risk factors.

    Age. The majority of those who develop multiple myeloma are over 50 years old and there are more diagnoses in the mid-60s range. There are few cases in people under 40 years of age.
    Sex. Men are more likely to develop the disease than women.
    Race. Black people are twice as likely to develop bone marrow cancer compared to whites.
    History of monoclonal gammopathy of uncertain significance. Approximately 1% of people with MGUS in the United States develop multiple myeloma.
    Obesity. The risk increases if the person is overweight or obese.

Other factors that may increase the risk of developing this disease are exposure to radiation and work in the hydrocarbon industry.

When should you see a doctor?

It is necessary to go to a doctor's office if the common symptoms of bone marrow cancer develop such as persistent fatigue greater than before, weakness, weight loss, bone pain and persistent nausea.

How is it detected?

In many cases, multiple myeloma is discovered as part of a routine examination of the blood or urine. To increase the likelihood of detecting this and other serious diseases as soon as possible, follow the recommendations of general medical examinations for your age and sex.

If you have common symptoms of multiple myeloma - such as back pain, weakness and fatigue, poor appetite, weight loss or repeated infections - consult your doctor.

Some tests for your diagnosis

    Blood and urine tests

A blood test called serum protein electrophoresis separates proteins from the blood and can detect the presence of M proteins. Parts of the M protein can also be detected in urine tests; known in this way as Bence Jones proteins.







 


If the doctor discovers M proteins, it is likely that he will need additional blood tests to measure the red blood cell count and the levels of calcium, uric acid and creatinine. They can also perform blood tests to detect beta-2 macroglobulin - another protein produced by myeloma cells - or to measure the percentage of plasma cells in the bone marrow.

    Imaging

An x-ray of the skeleton can show if the bones have weakened areas, which is common in multiple myeloma. When you need a deeper revision of the bones, the doctor can use magnetic resonance imaging (MRI), computer tomography (CT) or positron emission tomography (PET).

    Bone marrow examination

The doctor can also perform an examination of the bone marrow by removing, with a needle, a small sample of the bone marrow tissue. The sample is examined with a microscope to detect myeloma cells, and the rate of division of plasma cells.

    Classification of stages

These tests can help confirm if you have bone marrow cancer or any other disease. If the tests indicate that you have multiple myeloma, the results will allow your doctor to classify the stage of the disease as stage 1, stage 2 or stage 3. People in the third stage of myeloma are more likely to have one or more symptoms of a advanced disease, including a greater number of myeloma cells and kidney failure.

    Standard treatments for myeloma

Although there is no cure for multiple myeloma, the result of good treatment usually may be that the patient returns to normal activities.

The most common treatments are corticosteroids such as prednisone, chemotherapy with annihilating agents such as melphalan, cyclophosphamide or chlorambucil; Stem cell transplantation and radiotherapy.

Most people who receive treatment for multiple myeloma eventually relapse into the disease. And in some cases, none of the currently available first-line therapies prevent the growth of cancer cells from multiplying.

Complications

    Disorders in the immune system

Myeloma cells inhibit the production of the antibodies necessary for normal immunity. Having multiple myeloma can make you more likely to develop infections such as pneumonia, sinusitis, bladder, kidneys or skin and herpes.

    Bone problems

Multiple myeloma can also affect the bones, causing erosion of the bone mass and fractures. The disease can cause compression of the spinal cord. Some symptoms of this condition are weakness and even paralysis in the legs.

    Renal insufficiency

It can cause kidney function problems including kidney failure. Higher levels of calcium in the blood are related to bone erosion and can interfere with the ability of the kidneys to filter waste from the blood. The proteins produced by myeloma cells can cause similar problems, especially if they coexist with dehydration.

    Anemia

As cancer cells outgrow normal red blood cells, multiple myeloma can cause anemia and other blood problems.

Treatment of complications

Because multiple myeloma can cause a series of complications, you may also need treatment for those specific conditions. For example:

    Back pain. Medications for pain or the use of a back girdle can help relieve pain.
    Kidney failure. People with severe kidney failure may need dialysis.
    Infections Antibiotics may be needed to help treat infections or to help reduce the risk of getting them.




The loss of bone You can take medications called bisphosphonates such as zoledronic acid (Leuzotev), which bind to the surface of bones and help prevent bone loss. Treatment with these drugs is associated with the risk of damage to the jaw. If you take these medications consult your doctor before undergoing dental procedures. 

   Anemia. In the presence of persistent anemia, the doctor may prescribe injections of erythropoietin (Mircera, Alveritin, Bioyetin, Epocryn, Erlan, Exetin-A, Recormon). Erythropoietin is a natural hormone produced by the kidneys and stimulates the production of red blood cells. The research suggests that its use erythropoietin may increase the risk of blood clots in some people with myeloma.