Types of Blood Cancer Myeloma: Treatment, Definition, Causes, Diagnosis, Prognosis

blood cancer myeloma via sitcancer.org

Hello my name is Raja Kumar I am a professor of medicine at Mayo Clinic I am part of the myeloma team here at the clinic who takes care of patients with multiple myeloma and

related diseases so multiple myeloma is a cancer of a certain type of white blood cells now we

 all have several different types of white blood cells the common function of white blood cells

is to try and attack the various infectious organisms that can invade the body now the particular type of white cell white cells that are responsible for multiple myeloma are called

plasma cells become the function of plasma cells is to make proteins called antibodies which

helps our body fight infections the reason why patients develop multiple myeloma is not well

 known at this time however we have learned a lot about this particular cancer and we realize

that multiple myeloma is probably not a single type of cancer but a collection of different

types of cancers all of which affect the plasma cells so the triggers that makes the plasma cell

 cancerous may be different particularly the genetic abnormality that initiates the

development of cancer may be different in the different types of myelomas given the changes

 that have happened in this disease in the past decade it is important that patients with

multiple myeloma see a specialist who deals with this disease more often it is not necessary

that all the treatments have to be done by a specialist but it is good to have a specialist at

least take a look at the characteristics of the disease and formulate a treatment plan that

which can be then carried out in collaboration with the primary hematologist who in most of

the time would be much closer for the patient and logistically easier there's approximately

20,000 patients diagnosed in this country each year with this particular cancer patients with

multiple myeloma are living a lot longer than what they used to 10 or 15 years ago in fact the

 survival of patients with myeloma have more than tripled in the past ten years now there are

 several reasons for this we are using autologous stem cell transplantation for treating multiple myeloma much more uniformly in addition to that and probably more important than that

there are several new medications that have been introduced for treatment of patients with

multiple myeloma now what has happened in this disease is a combination of the introduction

 of new therapies as well as a better understanding of the biology of this disease we have a

better understanding of which patients are likely to do well with this diagnosis and which

patients need particular attention because their myeloma is aggressive to this extent we have

 identified several genetic abnormalities that can be seen in the multiple myeloma cells which

helps us to identify those patients ahead of time right at the time of diagnosis now these

particular type patients need a special attention especially in terms of the type of treatments

 we would like to use we have developed very detailed treatment strategies for patients with

multiple myeloma based on the particular risk category that we put those patients in based on

the genetic abnormalities that we can find some of this information is available on the web at

the website M smart dot o-r-g this particular website has lot of treatment details which we as a team continuously review and continue to update based on information as and when they

become available the treatment options in multiple myeloma as I mentioned have

significantly changed what has changed is the introduction of two very effective class of

medications one of them here is called protease on inhibitors and the first medication in that

group of medications was a drug called bortezomib or Velcade the other class of medications

that have been introduced are what we call the amino modulate ray drugs and the second class

of drug have all been derived from a medication called thalidomide now the thalidomide was

something that has been around for a long time but it's used in myeloma was only discovered

about ten or twelve years ago now the both these classes of drugs are very effective in treating

 multiple myeloma and we use them either alone or in combination with other drugs in both in

 patients with myeloma that have recently been diagnosed asuras in myeloma that have

relapsed after prior treatments now all these medications do come with some side effects but

overall these medications are reasonably well tolerated so compared to ten 12 years ago when

 autologous stem cell transplantation and a particular drug called mal felon were the mainstays

 of treatment for multiple myeloma today we have a huge armamentarium of drugs that can

be used for treating this disease now this includes the drugs that I just mentioned as well as two

 other drugs which were recently approved for treatment of multiple myeloma the first drug is called car fills a map or Cabrales and this belongs to the class of medications called protease

inhibitors which are similar to the bortezomib or Velcade the second drug that was approved

recently is called pomalidomide or pomalyst which belongs to the group of

immunomodulatory drugs and both these drugs have been shown to be quite effective in

treating myeloma that have relapsed after previous therapies now in addition to this there are

several other clinical trials that are ongoing which are evaluating a whole host of very

exciting drugs not only are these new drugs belonging to the same class of drugs that we have

been using all these years but we also have several drugs that bill two totally different class of

drugs now this is a very important point multiple myeloma cells eventually become resistant

to the different therapies that we use none of the therapies that we used today in the clinic are

curative that means this myeloma will eventually come back and these cells will eventually

become processing with the medications that we are using currently so it is very important that we continue to develop new drugs especially drugs that work through different

mechanisms so that they can overcome the resistance mechanisms that these myeloma cells

have developed while they are being exposed to these currently available drugs again going

back to the point of being seen by a specialist also import is important from the point of view

 of having access to new clinical trials now if Center like Mayo Clinic which specializes in

rarer types of cancers especially cancers like multiple myeloma we have clinical trials with

several of these new drugs available for use in in patients who have relapsed after the currently available treatments even if patients are not eligible for going on a clinical trial there is a

second opinion will allow the patient to get the opportunity to consider alternative treatment

regiments that may not have been considered or combination of therapies that have

previously been treated which could still be of benefit even though the patients have stopped

responding to one or other of these individual drugs we will have access to new drugs through

 clinical trials for treating patients with multiple myeloma we will also have increasing

numbers of tools available in the clinic to get a better sense of which patients are going to do

 better it is important continue with our con going research in this disease so as we can

continue to identify why some patients with multiple myeloma do not do well so that we can

develop new strategies for treating these patients to this end we have a large amount of

research that is ongoing at Mayo Clinic where we study how patients have done so far we obtained blood and bone marrow samples from patients with multiple myeloma various

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changes of their disease to better understand why patients develop multiple myeloma in the

first place but also why multiple myeloma becomes resistant to therapies and devise new ways

treating this particular disease it's specifically going into the various treatment options that

we have we take particular pride in trying to understand how new drugs may develop in make

help patients with multiple myeloma by looking at these new drugs in the laboratory against

myeloma cell lines as well as patient myeloma cells now those drugs that we find find to be

very promising in the laboratory we try to take them forward into clinical trials both small

clinical trials are specifically looking at various stages of the disease that we do at the in the

clinic but also large-scale clinical trials where we are comparing these new therapies against all
 the therapies now clearly these large trails cannot be done in one institution so we partner

with other institutions as well as take part in large cooperative groups where these large trials

can be done by enrolling large number of patients and answering critical questions as to what

drugs hold promise for the future so clearly the eve the paradigm has changed patients with

myeloma living longer there are more treatment options and it's continuing to improve and I

am sure the day were multiple myeloma becomes a chronic disease is in too far away and

the the time where we can say that we will be able to cure this disease should shortly follow thereafter.

Tag:
myeloma treatment, myeloma definition, myeloma causes, multiple myeloma diagnosis, multiple myeloma prognosis, myeloma survival rate, myeloma symptoms, multiple myeloma life expectancy
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