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Multiple Myeloma Stages

Jun 22, 2017

Blood is made up of two parts – white cells and red cells. White blood cells monitor and determine different types of medical disorders. One form of these cells is called plasma. Plasma generates antibodies which attack germs and aid in fighting off infection throughout the body. Multiple myeloma is one type of plasma related cancer where the cancer cells pool in the bone marrow and make it difficult for healthy cells to function. This results in the production of abnormal proteins which weaken the body and contribute to kidney problems. There are different multiple myeloma stages and successful treatment depends on how far the disease has progressed in the patient.

How Is Multiple Myeloma Staged?

The stages of multiple myeloma are determined with two different systems which categorize the disorder as stage I, II or III.

The first is ISS or International Staging System. This system is based on serum albumin and beta-2 microglobulin levels. The ISS stages are outlined as follows:

  • Stage I – Beta-2 microglobulin level is less than 3.5 mg/L; albumin level greater than 3.5 g/dL.
  • Stage II – Beta-2 microglobulin level is greater than 3.5 mg/L but less than 5.5 mg/L with any levels of albumin. Or when the Beta-2 level is less than 3.5 mg/L and the albumin level is less than 3.5 g/dL.
  • Stage III – Beta-2 microglobulin is 5.5 mg/L or higher.

The second system for staging is the Durie-Salmon system. This system bases the levels on four different factors which are blood calcium levels, bone damage, hemoglobin levels and levels of abnormal monoclonal immunoglobulin. The stages are outlined as follows:

  • Stage I – Myeloma cell count is low. Hemoglobin level is below normal but above 10g/dL. Bone damage is minimal and located to one area of the body. Calcium levels are normal. Immunoglobulin in urine or blood is minimal.
  • Stage II – Myeloma cells are found in the blood and it is between stage I and stage III.
  • Stage III – High myeloma cell count. Hemoglobin level below 8.6 g/dL. Calcium in blood above 12 mg/dL. Multiple areas of bone damage. High levels of immunoglobulin in urine or blood.

Know the Symptoms of Multiple Myeloma Stages

Diagnosing blood disorders can be a slow process at your local medical office. With disorders such as multiple myeloma, it is often necessary to test for other disorders first and rule them out before diagnosing the true condition. Once diagnosed, patients will face an array of symptoms depending on the stage of the disease. Symptoms based on stages of multiple myeloma are as follows:

Stage I

In stage I, patients will experience aches and pains around the body, fatigue that can be light or feel like exhaustion, pain within the bones, problems with the kidneys, and an increase in episodes of infections. In average, patients with stage I multiple myeloma in terms of the ISS system can still live for another 62 months.

Stage 1 indicates the disease has not progressed beyond the early phases. In some cases, more treatment options may be available than with other stages of this disease.

Stage II

Stage II is an advanced state of the disease where patients may feel aches and pains, exhaustion, and chronic illness with basic colds or infections. The immune system is compromised which makes patients to suffer more in this stage. However, it is also possible for patients to have little to no symptoms in stage II.

Life expectancy for those diagnosed at this stage is about 44 months.

Stage III

The terminal phase of this disease is stage III. At this point, the cancer is untreatable. Symptoms include body pain, chronic infection, muscle weakness, weight loss, thirst, decreased appetite, nausea, fatigue and constipation.

Life expectancy at this stage, based on the ISS system, is less than 29 months.

How to Treat Multiple Myeloma

Treatment for multiple myeloma comes in many variants and is designed to slow the progress of the disease and help patients live as normal of a life as possible. You can choose the following methods to alleviate symptoms of different multiple myeloma stages:

1. Wait and See

Patients who are in stage I or without any symptoms will likely not need any treatment. But a physician will test your blood and urine regularly for changes or signs that indicate the disease is progressing. If symptoms do show up, you can turn to the following treatments.

2. Corticosteroids

Corticosteroids including dexamethasone and prednisone may be prescribed to help regulate your immune system and minimize inflammation in the body. They are offered in pill form but may also be injected if a patient is hospital bound.

3. Targeted Therapy

Targeted drugs focus on certain abnormalities in cancerous cells that make them thrive. Medications like carfilzomib (Kyprolis) and Bortezomib (Velcade) can block the breakdown of proteins in cancer cells, leading to the death of myeloma cells. These drugs are injected via veins in your arms.

4. Radiation Therapy

Using the power of light energy like X-rays, radiation therapy damages cells to inhibit growth of cancer. This quick process will shrink the cells in one area and possibly relieve some types of pain.

5. Chemotherapy

Chemotherapy is the go-to option for treating many types of cancers like multiple myeloma. Patients will get high doses of chemotherapy drugs in an effort to kill the multiple myeloma cells and prevent further growth. You can get these drugs in pill form or get injected through veins in the arms.

6. Biological Therapy

Biotherapy is a unique process where doctors prescribe specific drugs to help activate the immune system and help it fight off the infection. Some of the drugs used are pomalidomide (Pomalyst), thalidomide (Thalomid) and lenalidomide (Revlimid), which can be taken in pill form.

7. Stem Cell Transplant

Among all multiple myeloma stages, stem cell transplantation is the last resort. If you qualify, stem cell transplantation may be an option for more advanced cases of multiple myeloma. For this to work, first you have to find a donor whose blood type matches yours or you can use healthy stem cells of your own; then your diseased bone marrow are destroyed by chemotherapy; at last, healthy stem cells are infused into your body and to your bones. The body is then able to rebuild bone marrow, if the transplant is successful.

8. Other Treatment Methods

In addition to these treatment options, some patients may receive treatments for the various symptoms of multiple myeloma. For example, pain medications or surgery may be used to control bone pain, dialysis for kidney problems, vaccines to minimize infections, and supplements to combat anemia. Any patient who believes they have the symptoms of multiple myeloma should seek medical attention for a blood panel to determine if they are in fact in one of the stages of this life threatening disease.