Multiple Myeloma
Pamela Haverly B.S.N., R.N.
Multiple Myeloma
Multiple Myeloma is a cancer formed by malignant plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system. Plasma cells become cancerous and grow out of control they can produce a tumor called a plasmacytoma. Theses tumors can develop in a bone but are also rarely found in other tissues. If there is only a single plasma cell tumor, it is called an isolated or solitary plasmacytoma. When there is more than one plasma cell tumor, it is called multiple myeloma.
In the United States , the risk of getting multiple myeloma is 1 in 149% (0.67%). The American Cancer Society estimates in 2013: About 22,350 new cases will be
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High calcium levels can cause extreme thirst, nausea, constipation, confusion, and appetite loss. * Kidney failure can be caused by high levels of M protein. (M proteins are found with multiple myeloma, and other conditions and is found by urinalysis). * Anemia-related fatigue occurs when there is a decrease in red blood cells (RBCs). This happens when myeloma cells replace RBCs in the bone marrow. * Bone injuries and fractures occur when the myeloma cells invade the bone. Osteolytic bone fractures appear as punched out areas on x-ray. Bone pain is experienced especially in the back, pelvis, ribs and skull. * Nervous systems symptoms large myeloma can cause the blood to thicken (hyperviscosity) causing blood flow to slow to the brain and confusion, dizziness and stroke like symptoms. * Weakness or numbness especially in the lower extremities, related to the myeloma cells can be nerve toxic. * Weight loss. * Chronic infections.
How is multiple myeloma diagnosed? Most cases are detected before any signs are present. Routine physical exams, blood and urine tests can add evidence of myeloma.
Blood counts and detection of M proteins are performed. X-rays, MRI’s and CT scans are used to determine bone involvement and bone marrow biopsies are performed. Staging is the process of finding out how much the cancer is advanced . A new staging system called the international staging system for
There are often no symptoms in the early stages of myeloma. In some cases, myeloma may be exposed by an accident in the course of routine blood testing and if symptoms are present they may be indistinct and related to those of other medical conditions.
Multiple Myeloma is a form of cancer which affects the plasma cells of the body, which are white blood cells. Multiple Myeloma, first described in 1848, is a disease “characterized by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein.” To understand how Multiple Myeloma affects an infected person’s plasma cells, it helps to have a general understanding of how normal blood cells are formed and how they act. Most blood cells develop from stem cells, which can be found in bone marrow (soft material inside our bones – the “filling”). Stem cells mature into white blood cells, red blood cells, or platelets.2 The purpose of white blood cells is to fight off infection, while
The phase of cancer at the point of diagnosis varies for different cancers. Therefore, staging is performed by means of various methods such as MRI (Magnetic resonance imaging), CT (Computed tomography), X-rays, blood tests and special surgery. The three main reasons why staging of cancer is performed are: it determines the depth of the disease, helps determine the treatment by the phase of the cancer and helps determine the patient's projection of treatment and survival.
Osteosarcoma is also called osteogenic sarcoma in medical term (“Osteosarcoma”, n.d.). This cancer usually develops in growing bones. Although it can occur at any age, it‘s most commonly found in teenagers and young adults and is slightly more common in males than females. Any bone in the body can be affected, but the most common sites are the arms or legs, particularly around the knee joint(“Osteosarcoma: An Introduction.”, 2012). This cancer is caused by benign tumors and other bone diseases, radiation exposure, genetic factors, children, adolescents, males more than females.(“Osteosarcoma: An Introduction.”, 2012)
Tests to see if you have other types of tumors in other parts of the body.
People who have Myelodysplastic Syndrome may not experience symptoms at the beginning of the disease. However, there are three main signs that can develop and alert healthcare providers that something is wrong. One of these is a low red blood cell count, or Anemia. Most patients that have myelodysplastic syndromes exhibit this indicator when first diagnosed. A normal red blood count can vary between 4.0 and 6.1 million red blood cells per microliter of blood in the body, depending on the age and sex of the patient. A red blood cell count lower than normal is characteristic of Anemia (Cafasso, Jacquelyn, and Gotter). Not only is Anemia shown by constantly low hematocrit, but it can also be characterized by constantly low hemoglobin. A normal hemoglobin count is between 12.0 and 15.5 grams per deciliter of blood for females, and 13.5 to 17.5 grams per deciliter of blood for males. Levels lower than these show a low hemoglobin level (Mayo Clinic, Hemoglobin Test). Hemoglobin is the protein in blood that carries oxygen to the different tissues in the body.
However, with medicine advancing, we are able to understand osteosarcoma a little better. Recent studies in the past couple of months have looked at cadavers with osteosarcoma, thanks to patients who have donated their bodies to science. Upon this research they found many new discoveries, such as the direction it tends to grow and where the cancer is most likely to spread. The advancement of medicine found out that the most common way to die from osteosarcoma was pulmonary metastatic disease. This disease is caused from cancer cells spreading to the lungs.When the cancer from the osteosarcoma spreads throughout the body, it often ends up in the lungs, which then begins the vicious stages of lung cancer. Symptoms of osteosarcoma include pain and swelling, usually around the upper arm or knee, and bones that are easily fractured. The bones tend to fracture very easily where the osteosarcoma is
Mr. Jacobs is a very pleasant, 69-year-old gentleman who presents to the oncology clinic for evaluation and treatment of a myelodysplastic syndrome with excess blasts in transformation RAEB-2. Patient states he was in a normal state of health until 01/2017 when he was evaluated to have anemia and leukopenia. He was referred to a hematologist/oncologist and underwent a bone marrow biopsy. The results revealed a mild dysplastic syndrome with excess blasts in transformation RAEB-2. Flow cytometry showed 11% myeloblasts. He was subsequently given one unit of packed red blood cells and started on erythropoietin every three weeks
There are different types of chemotherapy induced peripheral neuropathy: sensory neuropathy, motor neuropathy, and autonomic neuropathy. Sensory neuropathy is what most would think of when discussing neuropathic symptoms. This includes the feelings of numbness and tingling that can lead to burning sensations. Many describe this feeling as “pins and needles”. Motor neuropathy is related to feelings of muscles weakness and loss of control, which can lead to decreased coordination. Finally, autonomic neuropathy presents itself with symptoms of abdominal
Patients with a tumor that has spread to the spinal bones possibly will build up nerve damage that can lead to paralysis or loss of the use of the legs and/or arms (Fischer and Quinn, 2011).
Fear of falling and lost capacity associated with chemotherapy is associated with falls. Niederer et al. (2014) cite that strength, particularly in the lower extremities, tends to alter gait and balance. Also, a common side effect of most chemotherapy treatments is neuropathy. Neuropathy can alter sensation in the lower extremities increasing the risk of a fall. Through these physical changes, oncology patients may become more fearful of ambulating, thus limiting their overall mobility (Niederer et al., 2014).
Myelodysplastic syndromes (MDS) are a group of disorders that occur when there is a disruption in the bone marrow’s ability to produce healthy blood cells. It is a rare condition that most often affects older adults. In some cases, there is a chance that MDS could eventually progress to leukemia. For that reason, it is sometimes called preleukemia. Some forms of the disorder have no obvious cause, while others appear as a response to chemical exposure or cancer treatments such as chemotherapy and radiation therapy. In addition, subjection to heavy metals increases the risk of experiencing MDS.
Osteosarcoma patients don’t really feel sick, but they do limp more than usual because there knee/arm is heavier and hurts a lot. The bones also start to swell and get bigger which also causes the limping to happen. Most people think that this is just “growing pains” but as they get older they get worse and the pains hurt more. With Osteosarcoma, there is also limitation to movement because of the tumor. There is a lot of bad thing that come with Osteosarcoma, but there is some ways to discover and help get rid of the tumor. Osteosarcoma is usually found out by x-ray machines. They use the x-ray to scan the tumor and to make sure that it is Osteosarcoma, or if it is another type of bone cancer. Usually once they find out about the tumor they will do a biopsy. There are two different kinds of biopsies, a needle aspiration and a surgical biopsy. Whichever they choose may change the outcome of the surgery. Now knowing that there are many bad and good things that can happen there is still one more thing to learn about. Daily
Other symptoms include poor memory ringing in the ears, rapid heartbeat, shortness of breath on exertion, slow healing of wounds, mental confusion.
Bone cancer is a disease that occurs on or inside a bone. Usually, bone cancer involves a tumor filled with abnormal cells that will occasionally appear on the exterior of the bone. Similar to other types of cancer, bone cancer can be life threatening. Doctors are not completely sure what causes cancer, but they continue the search to find an answer. There are five different types of bone cancer that can affect people from ages 10-60 years old. Bone cancer can occur in any bone in the body from the legs to the head. Unfortunately, symptoms of bone cancer are not always obvious. Most of the time, pain is the most apparent symptom. When recognizing symptoms at an early stage, doctors can complete testing and supply treatment to