Multiple myeloma is a type of blood cancer that affects the hematological system and, mainly, produces complications in the kidneys and bones.
In addition, its symptoms are difficult to differentiate those of other diseases.
Multiple myeloma attacks plasma cells, a type of white blood cell that has the function of producing antibodies to fight infections.
Instead of healthy cells, malignant versions appear that multiply and begin to produce abnormal antibodies, known as M protein or monoclonal protein, which damage different parts of the body.
That is why the disease has the word “multiple” in its name.
Back pain, main symptom
Patients usually feel, before any other symptom, low back pain, a fairly generic condition that can be the result of a simple night’s sleep in an awkward position, intense training in the gym or many other day-to-day factors.
But low back pain is also considered as the main symptom of this rare cancer.
It was precisely this discomfort that led the merchant Luiz Fernando Fontenele, from 37 years, to embark on a long path of examinations and medical consultations until discovering the disease.
“I was in a lot of pain and only 7 months after suffering the first fracture I received the diagnosis. I raised the suspicion myself because I had read about the symptoms on the internet”, he recalls.
As happened with Luiz Fernando, the disease can lead to fractures, since it leaves the bones weaker; anemia, due to an excess of plasma cells in the bone marrow, which generate a reduction in the number of blood-forming cells; and in more severe cases, kidney failure, due to the damage it causes to the kidney tubules.
A rare cancer
Although rare, it is the second most common blood cancer in the world.
The disease is more common in people older than 60 years, but it is also diagnosed in younger people.
The The most emblematic case in world literature occurred in Brazil.
An 8-year-old boy, a resident of Salvador, Bahia, was diagnosed with the disease. According to the IMF organization (International Myeloma Foundation Latin America), he was the first child in history to receive the diagnosis.
Multiple myeloma can be detected through a urine test or a blood test called serum protein electrophoresis, ordered when symptoms indicate inflammatory disease, autoimmune disease, acute or chronic infection, liver or kidney disease.
“Although I consider that it is not necessary to routinely order the test for all people -because public spending could be generated that would subtract resources from the fight against other diseases-, I consider it unacceptable that a patient can remain with symptoms for so long, and that, due to the lack of knowledge of professionals who are not specialists, do not have a request for a test that leads to a diagnosis”, says Angelo Maiolino, professor of hematology at UFRJ (Federal University of Rio de Janeiro).
After the first symptoms, the 29% of patients with multiple myeloma in Brazil take one year to receive a diagnosis and the 28% waits even longer, according to a Abrale survey (Brazilian Association of Lymphoma and Leukemia).
“I have seen cases of people who were on dialysis, with very compromised kidneys, who only discovered the disease three years later”, says Maiolino .
Treatment
Since the first diagnosis of multiple myeloma, in the 18th century, medicine has advanced in the evolution of both biological knowledge of the disease and of treatments, which today allow patients with this type of cancer to live longer and in better health.
The disease has no cure, but in many cases there are treatments that allow patients You feel like living well, with good control of symptoms.
“It is as if they had a chronic disease such as diabetes, hypertension…”, says Maiolino.
Early intervention, according to the doctor, is the best way to prevent the progression of the disease from irreversibly compromising the health of patients .
“We use a type of treatment for each stage of the disease, but if the condition is discovered late, the patient will not be able to obtain the benefits of the initial phases of care”, he explains.
Another very common option is the indication of stem cell transplantation. Before performing the transplant, treatment with chemotherapy or radiotherapy is carried out so that the existing bone marrow (where the body produces blood, white and red blood cells, and platelets) makes room for new marrow to be created.
The new bone marrow is a gelatinous liquid that can come from a donor or be autologous (from the patient himself).
Luiz Fernando was transplanted, but suffered a relapse and the disease.
“It was more difficult than receiving the diagnosis. I have a specific treatment, with a combination of medications each 13 days in a hospital environment and every 21 days at home. I discovered multiple myeloma at 28 years and I don’t remember going a day without pain. It’s hard, but we learn to live with it. The combination of medications allows me to have a normal life”.
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