March is Multiple Myeloma Cancer Awareness Month. In honor of this and all the patients who have fought and are currently fighting this disease, the Paris Charter Against Cancer would like to contribute to the discussion and present some facts about the disease.
Statistics
- Around 176,000 people were diagnosed with this disease in 2020
- This accounts for 1.0% of all global cancer cases
- It is the 21st most common cancer in both sexes globally
- 19th most common in women
Institute for Health Metrics and Evaluation (IHME) Graphs of Death and Incidence Rate of Multiple Myeloma 1990-2019
Institute for Health Metrics and Evaluation (IHME) World Data Map showing the Multiple Myeloma deaths per 100,000 for both sexes in 2000 vs. 2019
What is Multiple Myeloma?
Multiple Myeloma, sometimes referred to as just Myeloma, is a type of blood cancer. It develops in the bone marrow and affects the plasma cells, causing them to develop abnormally. The abnormal plasma cells produce an antibody by the name of M-protein, or paraproteins, which can be detected in blood or urine. In healthy, typical bone marrow, plasma cells produce antibodies that help protect your body from infection. The M-protein formed by the abnormal plasma cells does not function in this manner and is thus not capable of protecting your body as well as the antibodies produced by normal plasma cells. Furthermore, M-proteins can build up in the blood and urine, causing damage to the kidneys and other organs. There is also the risk that the protein activates other cells located in the bone marrow, which can lead to bone damage (increased risk of fractures), bone pain, osteolytic lesions, and hypercalcemia.
The presence of M-protein does not automatically mean a person has multiple myeloma. It typically indicates a condition called Monoclonal Gammopathy of Undetermined Significance (MGUS), which can progress to Smoldering (Asymptomatic) Multiple Myeloma (SMM), a precancerous condition defined by low levels of M-protein in the blood and an increase of abnormal plasma cells in the bone marrow. The risk of SMM turning into active Multiple Myeloma is about 10% per year. If the abnormal plasma cells turn cancerous, they form plasmacytomas, which can then turn into Multiple Myeloma, however the risk of SMM turning into active Multiple Myeloma is about 10% per year.
Who does Multiple Myeloma primarily affect?
This type of cancer typically affects people aged 40 and over. According to the Multiple Myeloma Research Foundation, the average age at diagnosis is 69, and over half of the patients are older than 65. Multiple Myeloma is slightly more common in men than women
People with an autoimmune condition called pernicious anemia are found to be at a higher risk of developing myeloma as well as MGUS. There is an increased risk as well if you have a close relative that has MGUS or myeloma.
People diagnosed with MGUS are at a slightly higher risk than the average person of developing myeloma. Persons of African or Caribbean descent are twice as likely to be diagnosed with multiple myeloma in comparison to persons of other ethnicities. This is because MGUS is significantly more common amongst this group of people in comparison to other ethnic groups. White people have a higher risk of developing multiple myeloma than those of Asian descent.
For persons of African or Caribbean descent, the average age at diagnosis is also 5 to 10 years younger for Black people. Myeoloma is also more deadly for Black people. This is due typically to a discrepancy in quality and accessibility to the necessary care and treatment, and high-risk complications such as anemia and increased levels of lactate dehydrogenase (LDH) are more common in Black myeloma patients.
Prevention & Screening
Unfortunately, there are currently no specific risk factors associated with Multiple Myeloma, and it can be difficult to diagnose early as many people are typically asymptomatic. However, with early detection, meaning the plasmacytomas are still localized, the 5-year survival rate is 79%. It is encouraged that if you have MGUS you should get regular check-ups to ensure that your condition has not progressed into SMM.
There are treatment options for SMM that can aid in stopping it from becoming Multiple Myeloma. A study has shown that patients with high-risk SMM being treated with lenalidomide and dexamethasone delayed the progression to Multiple Myeloma. Additionally, there are a few ongoing clinical trials focused on immunotherapies, specifically stem-cell transplants, for treating SMM patients to reduce their risk of developing active Multiple Myeloma.
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