Myeloma is a type of cancer that forms in the bone marrow cells known as plasma cells. Bone marrow is found inside the inner part of the larger bones in our body. The bone marrow is responsible for producing the different types of blood cells, such as the red blood cells and the white blood cells. In fact, plasma cells are also a type of white blood cells itself. The primary role of plasma cells is to recognize and fight any foreign invaders and infections. It is possible for myeloma to develop at any place in the body where plasma cells are present. This cancer is also sometimes called as multiple myeloma. Multiple myeloma is a very rare type of cancer and does not present with any symptoms until it reaches stage 3 of the disease. By the 3rd stage, myeloma cancer has already reached late-stage and it is likely that it has already metastasized to many parts of the body. We take a look at the treatment and outlook for stage 3 myeloma.
What is Multiple Myeloma?
Multiple myeloma is a type of rare cancer that affects the plasma cells of the body. Plasma cells are found within the bone marrow and are responsible for identifying any germs that invade the body and plasma cells also instigate the body to start fighting off any infection. Multiple myeloma is a cancer of the blood, as plasma cells are a type of white blood cells.
In multiple myeloma, cancer cells start building up in the bone marrow and ultimately take over the healthy blood cells. The cancer cells also produce abnormal proteins which cause damage to the kidneys.
Multiple myeloma can affect any part of the body that has bone marrow. Over a period of time, myeloma cancer cells start to deplete the body of the very important white blood cells, inhibiting your ability to fight off infections.
Stage 3 Multiple Myeloma
By the time myeloma reaches stage 3, the cancer is already considered to be at the last stage. By this time, a huge number of myeloma cells are present within your body and your hemoglobin levels will fall below 8.5 grams per deciliter. You will also notice that the calcium blood levels are quite high. By this stage, myeloma would have caused multiple areas of bone destruction.
At stage 3 myeloma, an individual has a survival rate of 29 months; or around two to three years.
Symptoms of Stage 3 Multiple Myeloma
The problem with myeloma type of cancer is that symptoms usually do not show up till the cancer reaches stage 3. The primary symptoms of multiple myeloma include brittle bones that are easily broken and bone pain. Apart from this, patients may also experience- Muscle weakness, excessive thirst, weight loss, constipation, frequent fevers and infections, increased urination, nausea, fatigue, pain, weight loss and decreased appetite.
Treating Stage 3 Multiple Myeloma
The early stages of myeloma do not need any immediate treatment. Treatment for stage 3 multiple myeloma focuses on reducing the discomfort the patient is experiencing due to the cancer. Treatment of stage 3 myeloma also comprises of slowing down the progress of the cancer and also trying to stabilize the cancer.
Some of the commonly used treatments for stage 3 multiple myeloma includes-
Immunomodulatory Drugs for Treatment of Stage 3 Myeloma
Immunomodulatory drugs are usually referred to as biological therapies. These drugs are designed to create your body into a cancer-fighting machine by boosting your immune system. Some of these drugs used to treat stage-3 multiple myeloma include- Pomalyst (pomalidomide), Thalomid (thalidomide) and Revlimid (lenalidomide).
Treatment of Stage 3 Myeloma with Chemotherapy
Chemotherapy is a standard treatment for all types of cancer, not just multiple myeloma. Chemotherapy focuses on seeking out and destroying the cancer cells that are present in the body. Some of the chemotherapeutic agents that are used for specifically for treating stage 3 multiple myeloma include- Alkylating agents, Doxil, Adriamycin (doxorubicin hydrochloride).
Protease Inhibitors for Treating Treatment of Stage 3 Myeloma
Protease inhibitors are a type of medications that form the basis of targeted therapy for treating stage 3 myeloma. Protease inhibitors are the drugs that hone in on the specific mutations in the multiple myeloma cancer cells that boost the cancer cells’ survival rate. By targeting these abnormalities, the protease inhibitors medications prevent these cells from growing and thriving and are able to stop the progression of the disease further. This eventually causes the myeloma cancer cells to ultimately die. Some examples of protease inhibitors used in treating multiple myeloma are- Velcade (bortezomib) and Kyprolis (carfilzomib).
Treatment of Stage 3 Myeloma with Corticosteroids
Corticosteroids are medications that activate and regulate the body’s immune system. Corticosteroids also control the inflammation within the body. Only recently have medical experts started using corticosteroids for the treatment of stage 3 multiple myeloma and the medications have shown great promise. Corticosteroids used in treating stage 3 multiple myeloma are- Decadron (dexamethasone) and Deltasone (prednisone).
Treatment of Stage 3 Myeloma with Stem Cell Transplant
One of the more complicated treatment options for treating stage 3 myeloma includes stem cell transplant, which replaces your cancer-filled bone marrow with a cancer-free and healthy bone marrow. However, this involves you to undergo a high-dose of chemotherapy before you can undertake the transplant.
Combination Therapies for Treatment of Stage 3 Myeloma
Your doctor may also prescribe a combination of various myeloma treatments. For example, you might be put on an immunomodulatory drug, a corticosteroid, and a protease inhibitor, all at the same time. Such kind of combination treatment regimen has shown promise and is also known to have a higher success rate when compared to treating with only one method.
Advances in Multiple Myeloma Treatment
As of today, there is no cure present for multiple myeloma. The treatment for stage 3 myeloma primarily only revolves around managing and controlling the symptoms of the disease. However, there is a lot of research going on that is successfully moving towards finding a treatment that will eliminate the myeloma cancer itself completely. In fact, the US Food and Drug Administration (FDA) has already approved many new types of treatments and they are today getting much closer to actually developing a cure for multiple myeloma.
Prognosis or Survival Rate for Stage 3 Multiple Myeloma
As mentioned above, the average rate of survival for stage 3 myeloma is 29 months. However, due to the latest advances in the treatment of multiple myeloma, there has been a significant increase in survival rates. Research is also ongoing to find better and more advanced treatments that can prolong the survival rate of stage 3 myeloma even further.
However, the average survival rate is not applicable to everyone. There are also several factors that have an impact on your survival rate from stage 3 myeloma. These include-
Genes- Some people have certain chromosomal mutations or changes that may lead to a poorer outcome of stage 3 myeloma.
Age- Elderly people who have stage 3 multiple myeloma are unlikely to have a better survival rate when compared to younger people. They are unlikely to live longer than a year with stage 3 multiple myeloma.
Kidney Function- The cancer cells of multiple myeloma, over a period of time, cause damage to the kidneys. If your kidneys were already in an unhealthy condition before your diagnosis, then your outlook is going to be worse. If cancer has caused significant damage to your kidneys, then also your outlook for stage 3 myeloma becomes poorer.
Cell Growth Rate- The rate at which the cancer cells are growing helps doctors understand and get a clearer idea about your prognosis. If the cancer cells of myeloma are growing rapidly, then they are likely to overtake your healthy cells at a faster rate. This will also lead to a poorer outlook of stage 3 myeloma.
Conclusion
Once you have been diagnosed with stage 3 multiple myeloma, you will then begin your treatment with an oncologist and a healthcare team. Your oncologist will help you understand the disease and help you find a treatment plan that will not only have an aggressive approach to treating the stage 3 myeloma, but will also allow you to feel a sense of control over your situation. It is important to maintain a healthy lifestyle and have a positive outlook while undergoing treatment for stage 3 multiple myeloma.
References
Kumar, S.K., Lee, J.H., Lahuerta, J.J., Morgan, G., Richardson, P.G., Crowley, J., Haessler, J., Feather, J., Hoering, A., Moreau, P. and LeLeu, X., 2012. Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib- a multicenter international myeloma working group study. Leukemia, 26(1), p.149.
Eleutherakis-Papaiakovou, V., Bamias, A., Gika, D., Simeonidis, A., Pouli, A., Anagnostopoulos, A., Michali, E., Economopoulos, T., Zervas, K. and Dimopoulos on behalf of the Greek Myeloma Study Group, M.A., 2007. Renal failure in multiple myeloma- incidence, correlations, and prognostic significance. Leukemia & lymphoma, 48(2), pp.337-341.
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