What Is Bone Marrow Cancer? What Are The Symptoms And Treatment Methods?
Bone marrow cancer, also known as hematologic cancer, is a type of cancer that develops in the stem cells that produce blood cells in the bone marrow. The bone marrow is a spongy tissue located in the middle of large bones, responsible for producing and releasing blood cells into circulation. In bone marrow cancer, there is uncontrolled proliferation or developmental abnormalities in the stem cells. The most common type of bone marrow cancer is multiple myeloma. The exact cause of multiple myeloma is not yet fully understood. The disease presents with symptoms and signs such as bone pain, recurrent infections, kidney problems, weakness, and weight loss. While various medications are used to manage the symptoms, there is no curative treatment for bone marrow cancer.
What is bone marrow cancer?
Bone marrow cancer, also known as hematologic cancer, is a type of cancer that originates from the stem cells responsible for blood production in the bone marrow. Within the depths of the bone marrow, a spongy material located in the center of bones, there are stem cells that can differentiate into red blood cells, white blood cells, and platelets. Bone marrow cancer occurs when the cells in the marrow start to grow abnormally or at an accelerated rate. The cancer originating in the bone marrow is referred to as bone marrow cancer or blood cancer. The most common type among this group of cancers is multiple myeloma. Other types of cancer can also spread to the bone marrow, but they are not referred to as bone marrow cancer. The main types of bone marrow cancer include multiple myeloma, leukemia, and lymphoma. This article focuses on multiple myeloma, which is the most commonly seen bone marrow cancer.
What is multiple myeloma?
Multiple myeloma is the most common type of bone marrow cancer. It is called multiple myeloma because it often affects multiple areas of the body, such as the spine, skull, hips, and ribs. It originates from the plasma cells, a type of white blood cell that produces antibodies to protect the body against foreign invaders. When the bone marrow starts producing an excessive amount of plasma cells, tumors form. These tumors lead to bone loss and difficulties in fighting infections.
What are the symptoms of bone marrow cancer?
MULTIPLE MYELOMA SYMPTOMS
In the early stages of the disease, multiple myeloma may not cause any symptoms. It is often suspected after routine blood or urine tests. As cancer progresses, it can lead to a variety of complaints and signs, including:
Bone pain and tenderness: Typically affecting the back, ribs, or hips. The pain or tenderness is often constant and worsens with movement.
Easy fracturing of weak bones: Multiple myeloma can weaken the bones and increase the likelihood of fractures. Long bones in the arms and legs, as well as the spine, are most commonly affected.
Spinal cord compression: Fractures in the spine can lead to collapse, pain, and sometimes compression of the spinal cord. This condition manifests as serious problems such as numbness, loss of strength, loss of bladder and bowel control. Spinal cord compression is a medical emergency and requires immediate treatment.
Anemia: Multiple myeloma can affect the production of red blood cells in the bone marrow, leading to anemia. Anemia can also occur as a side effect of myeloma treatment. Symptoms of anemia include weakness, fatigue, and shortness of breath.
Recurrent infections: The disease impairs the immune system, hindering the body’s natural defense against infections and illnesses. As a result, individuals with multiple myeloma experience frequent and prolonged infections.
Hypercalcemia: Excessive release of calcium into the bloodstream can occur when affected bones release too much calcium. This condition, called hypercalcemia, presents with symptoms such as excessive thirst, frequent urination, constipation, abdominal pain, mental confusion, and drowsiness. Hypercalcemia is a medical emergency, and immediate medical assistance should be sought if these symptoms occur.
Kidney problems: Multiple myeloma can cause severe kidney damage that can progress to kidney failure. Symptoms of kidney failure include weight loss, loss of appetite, swelling in the ankles, hands, and feet, weakness, shortness of breath, itchy skin, and persistent hiccups.
Unusual bleeding: Some patients may experience unexpected bleeding, such as bruises under the skin, frequent nosebleeds, and heavy menstrual bleeding. This is due to excessive cancer cells in the bone marrow interfering with the production of platelets, which are responsible for blood clotting.
Reduced blood flow: In some individuals, multiple myeloma can cause the blood to become thicker than normal. This often occurs due to excessive proteins produced by myeloma cells. This condition, known as hyperviscosity, can lead to symptoms such as dizziness, shortness of breath, headaches, bleeding, and blurred vision.
Weight loss: Multiple myeloma generally does not cause mass formations. Instead, it damages the bones and affects the production of healthy blood cells. Weight loss can be a consequence of the disease.
It’s important to note that these symptoms can vary in severity and not all individuals with multiple myeloma will experience all of them. If you have any concerns or suspect you may have multiple myeloma, it is advisable to consult with a healthcare professional for an accurate diagnosis and appropriate management.
What are the stages of multiple myeloma?
In order to determine which treatment options are appropriate for a patient’s needs, it is necessary to know the stage of the disease and factors such as the growth rate of the cancer. To stage multiple myeloma, factors such as the number of blood cells, the amount of protein in the blood and urine, the level of calcium in the blood, and other diagnostic test results need to be examined. The TNM staging system used for other cancers is not used for staging multiple myeloma. Instead, two different staging systems are preferred.
The Durie-Salmon System takes into account the levels of monoclonal immunoglobulin, calcium, and hemoglobin in the blood, as well as the number of bone lesions. The use of this staging system is not common.
The more commonly used International Staging System is based on two main factors: the levels of albumin and beta-2 microglobulin in the blood.
Multiple myeloma is classified into four stages according to both staging systems: stage 0, stage I, stage II, and stage III.
How is the diagnosis of multiple myeloma made?
In some cases, multiple myeloma may be detected incidentally during a routine blood test for another reason. In other cases, suspicion of the disease arises based on the patient’s symptoms. Subsequently, further tests and imaging methods are used to make a definitive diagnosis.
Blood tests: Blood tests can detect M proteins produced by myeloma cells and substances called beta-2 microglobulin. Beta-2 microglobulin can provide clues about the aggressiveness of the cancer. Blood tests, complete blood cell count, blood calcium, and uric acid levels can be useful in diagnosing and evaluating kidney function.
Urine tests: M proteins, known as Bence Jones proteins when detected in the urine, can be shown through urine analysis.
Bone marrow biopsy: A sample is taken from the bone marrow using a long needle inserted into the bone. This procedure is called bone marrow aspiration biopsy. The collected sample is examined in the laboratory for the presence of myeloma cells.
Imaging methods: Various imaging methods such as X-ray, MRI, CT, or PET can be used to detect bone problems associated with multiple myeloma.
How is bone marrow cancer treated?
Treatment for bone marrow cancer aims to alleviate symptoms, control complications, stabilize the patient’s condition, and slow the progression of multiple myeloma. Patients who do not show any symptoms may not require immediate treatment, but they should be regularly monitored through periodic blood and urine tests. Treatment is initiated if specific symptoms or findings are present, or if disease progression is detected during monitoring. There are various treatment options available for multiple myeloma.
Targeted therapy: Targeted drug therapy focuses on specific abnormalities in cancer cells. These drugs can be administered through an intravenous route or taken orally as pills.
Biological therapy: This group of drugs utilizes the body’s immune system to fight against myeloma cells. Biological therapy strengthens the immune system cells that identify and attack cancer cells.
Chemotherapy: Chemotherapy drugs can cause harm to both myeloma cells and healthy body cells. They are administered intravenously or orally as pills. In preparation for a bone marrow transplant, high-dose chemotherapy drugs are used
