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Wellstar Health System provides superior care for multiple myeloma, offering a comprehensive spectrum of top-notch physicians, treatment options and diagnostic tools. In addition Wellstar offers such innovative advances in the fight against multiple myeloma, including:
Plasma cells are white blood cells that can produce antibodies. Like all blood cells, they are produced in the bone marrow. When an infection is detected, B cells are customized into plasma cells to fight the particular infection; each plasma cell is capable of secreting hundreds or thousands of proteins called antibodies per second; these antibodies attack and kill germs. Plasma cells are a critical part of the immune system.
In multiple myeloma, some plasma cells reproduce uncontrollably, crowding out healthy red or white blood cells or platelets. This can cause problems like:
The malignant plasma cells produce antibodies, but they are not useful for fighting infection.
Malignant plasma cells can gather in clumps, causing isolated tumors (plasmacytomas), usually in bone. If there is only one such tumor, it is called an isolated plasmacytoma; in the much more common case when there are more than one, it is called multiple myeloma.
The malignant plasma cells also produce osteoclast activating factors which cause the bones to lose calcium to the blood, which can result in dangerously high levels of calcium in the blood (hypercalcemia), and holes in bones (osteolytic lesions). Some patients suffer vertebral collapse or spontaneous fracture.
The cancerous plasma cells also produce excessive monoclonal immunoglobulin, referred to as an M-protein. This protein can overload the kidneys, leading to abnormal kidney function and even kidney failure.
Scientists do not yet understand the cause of multiple myeloma, so there is little a person can do to lower his or her risk of being diagnosed with the disease. One controllable risk factor is being overweight.
No routine screening tests, like mammography for breast cancer or colonoscopy for colorectal cancer, exist for multiple myeloma. Occasionally, routine blood or urine tests detect the excessive proteins that malignant plasma cells produce.
Screening tests, like mammograms for breast cancer, are used to detect illness in a general population, including people who have no symptoms.
There are no screening tests for multiple myeloma.
If your symptoms indicate the possibility of multiple myeloma, your Wellstar physician will prescribe various lab and imaging tests.
A complete blood count will be run on a sample of your blood. This reveals:
A blood test called serum protein electrophoresis separates blood proteins and detects the presence of M proteins, called an "M spike," in your blood. Parts of M proteins may also be detected in a urine test; when found in urine, these parts are referred to as Bence Jones proteins.
If your doctor discovers M proteins, you'll need additional blood chemistry tests to measure levels of calcium, uric acid and creatinine. You may also have other blood tests to check for beta2-microglobulin, another protein produced by myeloma cells
A small piece of bone, blood, and marrow are extracted in in a bone marrow aspiration and biopsy. This tissue is examined under a microscope by a pathologist for abnormal plasma cells. This is the only definitive test for multiple myeloma.
In a fine needle aspiration (FNA) a very thin needle and a syringe are used to sample a small amount of tissue from a tumor or lymph node. The core needle biopsy is much the same, but a larger needle is used and a larger tissue sample is removed.
Before a Positron emission tomography (PET) scan, radioactive sugar is injected into your bloodstream. Since cancer cells are growing very quickly, they absorb high amounts of sugar, which is visible to the PET scan. When a patient appears to have a solitary plasmacytoma, a PET scan may be used to look for others.
When myeloma is diagnosed, your Wellstar physician will categorize it by the current stage. Staging may require additional tests, such as blood tests, a CT scan and an MRI. Each stage describes the progression of the disease and whether the cancer has spread to other parts of the body. You should talk to your Wellstar physician to understand each stage, and what it means for your treatment plan.
Once cancer has been detected, biopsied and “staged,” your team of specialists in hematologic oncology, radiation oncology, radiology and pathology will work together to assess the best course of multiple myeloma treatment for you. This will include formulating a coordinated plan of personalized treatment consistent with the highest standards of care.
Your treatment will be tailored to you, and, in the case of smoldering multiple myeloma, it may only involve “watchful waiting”. In watchful waiting, no symptoms are present, and your WellStar physician may recommend carefully monitoring your disease through blood tests and urinalysis to determine whether you may need active treatment.
Treatment may involve drug therapy, radiation therapy, stem cell transplants, or a combination. Before drug therapy begins, you will be assessed to determine whether you are a good candidate for a stem-cell transplant. Your decision about whether to have a stem cell transplant may affect what drugs your WellStar physician prescribes for your treatment. Your Wellstar physician is highly trained to guide you through this decision-making process.
Although there's no cure for multiple myeloma, with good treatment results you can usually return to near-normal activity.
Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells. It can be used to assist in the cure of cancer patients or to prolong life or the quality of life.
Several drugs are used to treat Multiple myeloma.
Patients who plan to have a stem cell transplant may be treated with drugs that will not weaken the bone, including thalidomide (Thalomid®) and dexamethasone, bortezomib (Velcade®) and dexamethasone, or Velcade, pegylated liposomal doxorubicin (Doxil®) and dexamethasone.
Patients who do not plan to have a stem cell transplant may be treated with several drugs at one time, depending on the aggressiveness of their cancer.
Radiation therapy is typically used for myeloma patients whose disease has not spread to multiple sites, or whose myeloma is attaching a site on a bone. Sometimes, patients receive radiation therapy before a stem cell transplant. Also, patients whose pain is not controlled with drugs alone may receive radiation therapy in an effort to relieve pain.
Wellstar offers standard radiation and cutting-edge techniques to treat multiple myeloma. In most cases, radiation will be administered five days a week for several weeks to the area of your body in which the myeloma is located. Your Wellstar radiation oncologist is highly expert in administering the proper dose as well as pinpointing the precise area that needs radiating, thus limiting the amount of healthy tissue affected by the radiation.
For a stem cell transplant, stem cells are harvested from your blood or bone marrow, or that of a compatible donor, and frozen. After your cancer cells are destroyed with intense chemotherapy, they are replaced with the donated cells.
You’ll be referred after your recovery from multiple myeloma to Wellstar’s medical oncology team for treatment, surveillance and survivorship programs. These comprehensive programs focus on diet, exercise and nutrition to help you reduce the risk of recurrence.
Cancer care at Wellstar is more than advanced technology, clinical research, and highly specialized physicians and nurses. It includes an array of supportive care services to improve the patient experience before, during and after treatment. All of these services are available within the Wellstar system, including:
Wellstar’s certified palliative care physicians and certified registered nurses are dedicated to providing compassionate, quality care in various settings, including home hospice, inpatient hospice nursing homes, assisted living facilities and nursing homes. Wellstar offers caring and compassionate hospice care for patients and their families in one of Georgia’s oldest hospice programs serving Bartow, Cherokee, Cobb, Douglas and Paulding counties.