Multiple myeloma: A low-key kind of cancer

Multiple myeloma is a low-key kind of cancer. In fact, you probably haven't even heard of it, but it's the second most common blood cancer in Ireland and every year 250 people will be diagnosed with it. Multiple myeloma remains difficult to diagnose, due in part to low awareness, but also its non-specific range of symptoms. Most common in older people, the cancer originates within the immune system and goes on to attack the bone marrow and the blood. When the resulting symptoms begin, it can be hard to pinpoint multiple myeloma as the culprit.

Dr Denis O'Keeffe is a consultant haematologist at University Hospital Limerick. He tells Health Plus that multiple myeloma tends to stay below most people's radar, particularly in comparison to other cancers as even the very concept of it is hard to grasp.

“It is not as common as bowel cancer or breast cancer, so it is a challenge for people to understand what myeloma is – many think of cancer as being local or having spread but myeloma is very different.”

The disease involves an uncontrolled increase in plasma cells, the blood cells that produce large volumes of antibodies. This means that it presents in a variety of different ways, explains Dr O’Keeffe; “These include pain, bone problems, kidney problems, infection, etc. In that way it is difficult for people to understand that it is very different from solid organ cancers.”

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Treatments have improved significantly, but age, mental and physical fitness, other illnesses and the social support structure surrounding the patient will dictate the treatment pathway that they follow, he adds. Many patients will find themselves on maintenance treatment, and while this will delay disease progression, it comes with a price – such as fatigue, risk of infection, and the risk of blood clots.

“For many people, this is a disease they will be treated for the rest of their lives,” Dr O’Keeffe says.

According to Dr O’Keeffe, a diagnosis of multiple myeloma is not only a challenge for the patient and their family, but also the treating physicians and nursing team. There is no cure, but the emphasis is on improving quality of life. “Treatment has become more complex but also more fascinating, as we have many more options for patients. The future is hugely optimistic for multiple myeloma patients.”