Is Multiple Myeloma A Fast-Growing Cancer?

Multiple myeloma (MM) is one of the rare cancers accounting for about 1% of all cancers. It is about 10% of all hematological cancers. It’s a cancer of the plasma cells.

Plasma cells are white blood cells which produce antibodies that fight with infections. In multiple myeloma excessive number of abnormal plasma cells clumped together in the bone marrow, the name multiple myeloma implies abnormal plasma cells in multiple bones in the body.

Plasma cells have a key role in the immune system as they produce antibodies which are proteins that fight with pathogenic organisms, toxins, and other foreign particles. When the number of plasma cells are increased there is a rapid production of antibodies in the body. This rapid growth of plasma cells impairs the bone marrow function and reduces the healthy hematopoietic cell production. Most of the symptoms occur due to this reduced production of hematopoietic cells as each of these cells plays an important role in the body and because of the abnormal M proteins that damages the kidney.

Multiple myeloma is commonly seen in elderly people and the median age of multiple myeloma presentation is 60 years. Usually, it is very rare below the age of 40 years. The annual incidence of multiple myeloma is 4 per 100,000. It is more commonly seen in males and in Black Africans and it is seen less in Asians.

Multiple myeloma is a slow-growing tumor, it is not a fast-growing tumor. At the initial stages, most patients do not have any symptoms, with the progression of the disease only the symptoms develop. Some patients might have non-specific symptoms that can be related to other disease and most patients do not go to a doctor or follow up. Sometimes it may be detected as the blood proteins levels rise during the early stages of the disease, in case a blood protein level is checked this might be detected.⁽¹⁾

Some common initial symptoms seen with multiple myeloma are anemia, shortness of breath, bleeding from gums, bone pain. Other symptoms are bone fractures, recurrent infections, weight loss, loss of appetite and kidney problems.

A systemic review and meta-analysis were performed using MEDLINE and Embase databases studies were search regarding the onset of symptoms to diagnosis in the following categories patient interval (time from the first symptom to presentation to a doctor)

Primary care interval (time from the first presentation to first referral)
Referral to diagnosis interval (time from first referral to specialist to diagnosis)
Diagnostic interval (time from the first presentation to diagnosis)
Time to diagnosis (time from the first symptom to diagnosis)

Nine studies were included in this analysis. The results showed that the median patient interval was 26.3 days, median primary care interval was 21.6 days, the median diagnostic interval was 108.6 days, and the median time to diagnosis interval was 163 days. There were no studies reported on referral to diagnosis interval. So, approximately it takes more than 3 months to confirm the diagnosis of multiple myeloma.

There is no data in the literature regarding how long it takes for multiple myeloma to develop symptoms, but as most patients present late and most are in the advanced stages and it is a slow-growing tumor, so, we can think that cancer might have started maybe years back.⁽²⁾

Conclusion

Multiple myelomas is a slow-growing tumor therefore, it takes a long time for the symptoms to manifest. But cancer might have started years back before the onset of the first symptom. Most symptoms occur due to the suppression of the bone marrow function which causes a reduced production of hematopoietic cells and the abnormal M proteins secreted by the myeloma cells damage the kidney. To suppress the bone marrow to this extent, then the symptoms to develop it takes time. So, most patients with multiple myeloma are asymptomatic during the initial stages. Sometimes the blood proteins can be high if a blood protein test is done in any case, then myeloma can be detected in early stages. Approximately it takes more than 3 months to confirm the diagnosis of multiple myeloma after the first symptom.

References:

Also Read:

Is Multiple Myeloma A Fast-Growing Cancer?