WATCH: Multiple Myeloma: the silent cancer
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Deep-seated bone pain – a dull, persistent ache which is often made worse by movement – is one of the commonest symptoms of Multiple Myeloma, a cancer of the blood.
It’s not one of the cancers we often hear about, like breast or prostate cancer, but it does affect a significant number of people in South Africa. Before the arrival of HIV with its associated malignancies, Multiple Myeloma was one of the most frequently seen malignancies of the blood, says Dr Atula Lakha, consultant in the Department of Haematology at Chris Hani Baragwanath Hospital.
But it often affects people upwards of fifty, and it presents with some rather vague symptoms that are easy to ascribe to age – tiredness and pain are not unusual in the aging body. So it can take a while to diagnose – sometimes as long as three years or even more, according to Johannesburg clinical haematologist Dr Lucille Singh.
What is Multiple Myeloma?
It’s a cancer of the blood; it affects the bone marrow, that spongy material inside the hard sheath of bone where blood, in the form of white and red blood cells, is born. It may form masses inside the bone – hence the bone pain – and it reduces the number of red blood cells, which results in a fatigue caused by anaemia – a huge tiredness that just does not go away and gets worse over time. The impact on the white blood cells affects the immune system and results in a tendency to pick up infections easily.
These symptoms should be a red flag for general practitioners (GPs), physiotherapists and other medical professionals.
Very simple tests can be done to raise or allay suspicion that Multiple Myeloma is present: an X-ray can pick up damage to the bones; common causes of anaemia (iron or vitamin B12 deficiency or heavy bleeding) can easily be excluded; and the malignant plasma cells generally secrete a protein that can be picked up on a simple blood test or in a urine specimen.
Later symptoms are more dramatic – fractures of arm or leg bones, ribs or the spine; kidney failure – but the early warning signs are non-specific and all too often, the patient arriving at a local clinic complaining of pain will be sent away with little more than an analgesic, a painkiller like paracetamol, says Dr Lakha.
Although Multiple Myeloma remains incurable, both diagnostic tools and treatments have improved dramatically in the last twenty years. In the 1980s and 1990s, someone diagnosed with this blood cancer could expect to live two or three years – today the potential lifespan is much longer, perhaps ten years or more.
And better tools to fight the cancer and alleviate symptoms mean that the patient’s quality of life, their physical comfort and capability, can be much better. But this is much more achievable if the cancer is picked up as quickly as possible.
“Awareness by medical professions of the possible significance of symptoms like tiredness, bone pain and a tendency to pick up infections is critical,” says Dr Singh.