Multiple myeloma is notorious for being the most incurable form of cancer of the blood and bone marrow, the spongy tissue inside bones where blood cells are produced. Patients with cancer of the plasma cell – a type of white blood cell found in the bone marrow which produces antibodies to fight infection – tend to have multiple relapses. They tend to survive about four years after being diagnosed and treated with chemotherapy and stem-cell transplants.
In the last 10 years, however, the condition has become more treatable, thanks to new drugs which target the cancer better. Patients still suffer relapses but can live for seven years or more after treatment. The drugs – which can be taken orally or injected – also come with fewer side effects such as nausea and vomiting. Some oral drugs enhance the body’s immune system to manage the disease in the long term. More novel drugs are in the pipeline, making it more likely for this terminal cancer to be managed as a chronic problem in future. Patients with multiple myeloma may have a weakened ability to fight infection. The excessive proliferation of cancerous plasma cells can eat into the bones, causing bone pain and fractures. The high number of abnormal proteins they produce may lead to kidney failure. The tumour cells can also replace the oxygen-carrying red blood cells in the bone marrow, resulting in anaemia. Platelets that help with blood clotting may be affected.
Though rare compared to other cancers, multiple myeloma is the second most common type of cancer of the blood and bone marrow. It is less common than lymphoma, but about as common as adult leukaemia. There are about 100 new cases in Singapore every year. The cancer typically afflicts those in their 60s and older, although patients can be in their 40s. The incidence among Asians is lower than that among black Americans who are most at risk, followed by Caucasian Americans.
Source: Associate Professor Chng Wee Joo, senior consultant haematologist at the department of haematology-oncology at the National University Cancer Institute Singapore