Without the Whitecoat
Multiple Myeloma... a rare malignancy
It has been years now that I have seen another case of Multiple Myeloma since I left the shores of Manhattan when the rare disease struck a very good friend of the family when we were in New York in the person of our spiritual adviser Fr. Vincent of Mother Cabrini. It was in the face of dear Fr. Vincent that I've seen how the disease had consummated his life from the time it was diagnosed until the last years of his life. From the effects of chemotherapy until the time that he lost a lot of weight. After leaving this mortal world the Hospice Care wing of the medical institution was named after him. The next case I saw when the rare disease struck a former foreman of my house, it was a classical book presentation with the findings of "punch-out" lesions in his skull radiograph compared to Fr. Vincent in which the findings of "Bence-Jones" proteins was seen.
In time as part of the layman community, not all of us have the privilege to understand fully what is Multiple Myeloma. First, MM or multiple myeloma is a malignant condition that affects patients from middle to old age. It is the uncontrolled proliferation and the disordered function of cells specifically the plasma cells (class of white blood cells) of the bone marrow. A derivative or class of white blood cells, a type of B lymphocyte, responsible for making antibodies or immunoglobulins that normally helps to protect the body against infection. In the condition of multiple myeloma, the proliferating plasma cells produce excessive amounts of a single type of immunoglobulin while the production of other types is impaired, thus rendering the patient prone to any infection. Rare indeed since it only affects 3 persons in the population of 100,000. (3/100,000) The first presentation of the condition as its symptom is pain, brought about by the abnormal expansion of the plasma cells in the bone marrow and also causes destruction of the bone tissue. Numbness and paralysis are secondary on its effects to the spine causing collapse and compression of the spinal nerves. Another laboratory finding that we see is the rising levels of calcium in the blood as a sign of bone destruction. There is also an increase of end products from the breakdown of immunoglobulins of the plasma cells. We can also see cases of renal failure as a consequence in changes in the blood chemistry that may lead to the damage of the kidneys. When malignancy sets in there is a replacement of the healthy bone marrow with malignant plasma cells that leads to anemia and bleeding disorders and also increases the risk of further infections. Diagnosis is done by bone marrow biopsy with the excess of the single type of immunoglobulin. Treatment includes the use of anti-cancer drugs and medication hopefully will reduce the number of abnormal plasma cells. Radiation therapy is done to the diseased areas of the bone. Supportive measures like blood transfusion to correct anemia and the use of antibiotics to control infections, and the relief of pain with use of analgesics.
The outcome of the disease varies from one patient to another when it comes to severity and prognosis of multiple myeloma. One fifth of patients survive for four years or longer for the time of diagnosis.
Multiple myeloma may be rare but it already affects some close individuals of the family. It is better informed about the disease entity thus makes us more prepared than knowing nothing about it. As a malignancy let us prepare the patient to have "life" in the remaining years that he have in this world.