When veteran NBC correspondent Tom Brokaw revealed earlier this year that he has multiple myeloma, many people had never heard of the rare blood cancer. Rare as it may be, African-Americans are at a higher risk for this cancer of the bone marrow than other ethnicities. Dr. Rafat Abonour, a hematologist at the IU Health Simon Cancer Center and researcher at the IU School of Medicine, explains more about myeloma.
What is multiple myeloma?
Myeloma is a rare cancer of the bone marrow. It is called “multiple” myeloma because it can grow in a number of places: inside bone marrow, in the area surrounding the marrow and also in the bone itself. Bones are constantly replenishing themselves, but myeloma weakens the bones and disrupts the formation of new ones.
The way I describe it to patients is, when grass grows in your driveway, you get little holes in the cement. Myeloma cells create a lot of holes in the bones. It accounts for 1 percent of all cancers. In the U.S., approximately 22,000 myeloma cases are diagnosed each year.
What are the symptoms of multiple myeloma?
The most common symptoms are bone pain, back pain, broken bones, bones weakened due to osteoporosis and fatigue due to anemia. About 25 percent of patients experience kidney failure or very high calcium levels in their blood. Multiple myeloma can be mistaken for osteoporosis and anemia, so a bone biopsy can aid proper diagnosis.
What are the risk factors for multiple myeloma?
Unfortunately, we don’t know what causes multiple myeloma. About 7 percent of patients have a family history of multiple myeloma or a similar disorder. African-Americans have the highest incident rate of multiple myeloma – twice that of Caucasians.
Genes that are more common in African-Americans may predispose them to grow abnormal plasma cells, which become myeloma cells. The average age of diagnosis is in the late 60s to early 70s, so Mr. Brokaw – at 74 – is exactly in that age group. It’s very rare to see it in patients under the age of 40. I must emphasize that it is a rare cancer and accounts for only 1 percent of all cancers, so not every back pain is multiple myeloma. However, if the pain does not go away in a month, an x-ray of the area can help make a diagnosis.
How do you treat multiple myeloma?
We have a newer class of targeted medications – which we’ve offered in clinical trials here at the IU Health Simon Cancer Center– that can have a dramatic effect on the myeloma cells and very little effect on other parts of the body. This is why you can see patients like Brokaw continue with his daily activities. The chemotherapy drugs that can cause hair loss and a drop in blood count aren’t used as much with patients that have multiple myeloma. Treatment can be followed by a stem cell transplant.
What is Miles for Myeloma?
Miles for Myeloma is a two-day bicycle ride from Michigan to Indiana with the goal of raising money for multiple myeloma research. This September will mark the 10th anniversary for our ride, in which we have biked more than 1,500 miles and raised more than $2 million for research.
When I started at the IU Health Simon Cancer Center, I was the only physician treating multiple myeloma. Now, we have a team of five international physician researchers. We’ve been able to bring novel drug treatments to our patients and really put Indiana on the map for treatment of this disease.
