Twelve years ago in the year 2000, when Karen Thomas was 56 and living in Atlanta Karen Thomas began experiencing intense back pain. “I changed from an chiropractor and an ortho physician seeking some relief” the woman told SurvivorNet. The doctors increased her steroids but the pain continued. In the evening, the pain was unbearable that she asked her husband to drive her to the hospital. As she walked in the family room, she fell over. Karen became paralyzed starting from her neck down.

“It came to light that I had a massive tumor that was consuming the vertebrae of my body,” she explained. She was then scheduled for surgery, and then was transferred to a rehabilitation center that was affiliated with Emory University where she was diagnosed with multiple myeloma. This is which is a blood cancer type.

With the assistance of a group of healthcare specialists and Karen’s tireless work with determination and perseverance, Karen was able to gain the possibility of walking again – however, the cancer was still raging. The treatment was started in the hope that one day she would require an operation to transplant bone marrow. “It was just as bad as I was afraid,” she remembers. “I was sick like a dog and was in total in a secluded area.”

However, after a few months she was able to relocate together with her partner and her husband to Charleston, South Carolina, where scientists at the Medical University of South Carolina (MUSC) were developing the development of a new blood cancer treatment. She became the patient of Dr. Hamza Hashmi, a hematologist-oncologist at the Medical University of South Carolina. “The initial thing that he did was to take me off all the painful chemotherapy drugs that my previous doctors had told me I’d need for the rest my existence,” Karen recalls. “Then the doctor gave me more encouraging information. “I think that you’ve got rid of cancer, the doctor said. “We’re going to demonstrate it!”

The Dr. Hashmi told Karen about the test known as MRD (Minimal Residual Disease) which is a test that is used to detect blood cancers that includes myeloma as well as leukemia, lymphoma and various blood cancers. The MRD test is a way to identify cancer cells that have not been eliminated through chemotherapy, or any other treatments for cancer. This means that it helps determine whether a patient is complete remission or if they are at risk of relapse and require further treatments for cancer.

“To undergo this test, I had to undergo an os biopsy. Based on my previous experience I was scared and I delayed it for few days,” Karen says. “Finally I was able to get my nerve. Much to my delight the procedure for outpatients was an easy process.”

There was more good news. “A week after I received a call from Dr. Hashmi contacted me to ask”Are you still sitting?’ was thinking that he would tell me that the cancer had come back. But there was no. He told me, ‘Just as we believed, out of 3 1/2 million of cells examined in your body there’s nothing to show that there’s cancer.'”

“I define it as a functional cure” says the doctor. Hashmi. “Which means that you are able to give the patient a time limit for treatment. The cancer goes into remission, and patients stop treatment. If the cancer doesn’t develop again, it’s an indication of a cure. It can be difficult to attain for all blood cancers but especially myeloma.”

“Dr. Jeffrey Zonder, a medical oncologist and director of the Multiple Myeloma and Amyloidosis Multidisciplinary Team (MDT) and a member of the Hematology Oncology MDT at the Barbara Ann Karmanos Cancer Institute He says: “Right now there’s a considerable amount of debate within myeloma researchers on what to do with MRD testing, or whether we should do the tests. However, it’s becoming more popular as something that’s happening often and often.”

What is Multiple Myeloma?

Multiple myeloma, a blood cancer, is which involves plasma cells. They are a particular kind made up of white blood cells that are found in bone marrow and assist in fighting infections. In response to infections these plasma cells usually create proteins that aid your immune system fight infections.

In the case of multiple myeloma tumorous plasma cells expand uncontrollably in bone marrow. They also take over other white blood cells. This means that the immune system fails to fight infection, resulting in fatigue. If the cancerous cells known as myelomas, get to be too large within the bone marrow fractures may occur. The cancerous cells release abnormally high levels antibodies into bloodstreams and eventually, they end up in the kidneys for processing. Because kidneys aren’t able to handle the extra proteins, they accumulate and can cause damage to kidneys.

Multiple myeloma is classified into categories to aid doctors in determining what treatments and strategies are the most effective. “We typically divide them according to how risky myeloma is. However, other cancers are diagnosed based on the extent the cancer has been able to spread,” Dr. Nina Shah is a hematologist from UCSF Medical Center, explains.

There are three myeloma stages:

  • Multiple myeloma is a high-risk disease when the patient’s cells have DNA segments that are not present and/or switched segment.
  • Intermediate risk myeloma occurs when certain DNA mutations are not evident, but the patient does have increased levels of certain proteins in blood.
  • The risk of low-risk multiple myeloma is when a patient does not have any of these symptoms.

Doctor. Nina Shah, a Hematologist who is specialized in treating multiple myeloma, which is a form of cancer that affects the blood marrow, discusses a multi myeloma-related diagnosis.

Multiple Myeloma is a blood cancer that originates It is a kind of cancer which affects blood cells. It is due to modifications (changes) of the DNA in blood cells that cause the cells to behave in a way that is abnormal. Blood cancers comprise approximately 10% of all cancers diagnosed across the U.S. each year, according to Yale Medicine.

There are three main kinds of blood cancers:

  • Leukemia is among the prevalent blood cancer in children less than fifteen years old as per the Leukemia & Lymphoma Society. It’s a form of cancer that affects white blood cells, or cells that develop into”white blood cells. Leukemia hinders the white blood cells in fighting off infections within the body. It can be acute (which means it’s growing rapidly) as well as chronic (slow-growing).
  • Hodgkin Lymphoma and Non-Hodgkin Lymphoma. The most significant distinction in Hodgkin as well as non-Hodgkin lymphoma is in the form of lymphocyte (a kind of immune cell that is produced in bone marrow and can be found in lymph tissue and blood) which is affected. Lymphoma is a cancer that affects the lymphatic system. It is the most frequent type of blood cancer among adults (more than half of all blood tumors). The lymph nodes are affected which are responsible for remove harmful substances.
  • Multiple myeloma is a form of cancer of plasma cells which are lymphocytes that produce antibodies to defend against infection. Myeloma alters the immune system, making it more susceptible to infections.

Who Are At Risk of Multiple Myeloma?

The risk factors for developing multiple myeloma vary greatly dependent on various factors like:

  • Ethnicity and race. African Americans are at an greater chance of developing myeloma as they are more likely to suffer from diseases that could lead to myeloma.
  • Gender and age put males being at slightly higher risk than females
  • Precursor diseases are present. Myeloma with a full-blown recurrence is typically preceded by two conditions: MGUS (monoclonal gammopathy with undetermined significance) and myeloma with a smoldering blaze.

MGUS is a precancerous disease where an abnormal protein appears in blood. The protein, which is made by a specific type of white blood cell found in the bone marrow known as plasma cells, generally results in no health problems and the majority of people do not know that they suffer from MGUS until they are diagnosed through a blood test routinely.

In MGUS plasma cells constitute just a fraction of bone marrow. This isn’t enough to cause cancer. People who are healthy are likely to have an equivalent amount. This is the reason why the disease isn’t symptomatic and has a one per year risk for developing an active myeloma. But, not all people are at risk of becoming afflicted with MGUS. The risk of developing MGUS varies based on:

  • African-Americans of race are three times more likely to contract MGUS more frequently than Caucasians. The condition typically develops in earlier ages.
  • First-degree relatives of people who suffer from MGUS or active myeloma have an elevated risk getting the same illness.
  • As with many cancers and their concomitant conditions, the chance of developing MGUS also increases with age.

The second primary disease that is in the process of developing is smoldering myeloma. This is a type of disease that is extremely close to developing into active myeloma however, it does not show any signs or symptoms.

The probability that smoldering myeloma will progress to myeloma maligna is contingent on the risk of the suspected smoldering diagnosis.

Patients who have smoldering myeloma generally have a 10-year likelihood of progressing to active myeloma. However, those with high-risk myeloma with smoldering symptoms have a 50% likelihood of developing into active multiple myeloma in two years after diagnosis as per the Dr. Irene Ghobrial, myeloma specialist at the Dana -Farber Cancer Institute.

Dr. Irene Ghobrial, myeloma specialist from the Dana -Farber Cancer Institute, describes a growing myeloma diagnosis.

What are the signs from Blood Cancer?

“It’s extremely common for people to say, “You know, I’m getting very tired,” or ‘You know I noticed that I experienced more infections this winter than I can remember and that’s a common occurrence,” Doctor. Shah says in a prior conversation with SurvivorNet. “But when you see the first indication of something that isn’t normal is important to move to the next stage and ask yourself, ‘OK what’s going on? Do you think there’s something else that is causing this?’ That’s typically when we get the diagnosis of multiple myeloma.”

Other signs include bone issues such as muscle weakness or pain in the back hips, legs or skull. If you are diagnosed doctor. Shah says the first step is to have your blood examined to determine the amount of protein and an assessment of your blood’s count.

There are a variety of other tests that doctors are likely to do, including DNA tests. “The DNA test is crucial because it assists in putting individuals in risk categories. When we understand this, we’re able know how serious the condition has become and the best way to cure this condition.” Dr. Shah declares.

What are the Treatments?

“Humankind has made significant progress in terms of the treatment and diagnosis of cancer,” says Dr. Hashmi. “Multiple myeloma does not have to be a cause to be a cause of death. It’s now an ongoing condition that you get older as a result of it.”

When it comes to myeloma treatment, specialists who have been at the forefront of research over the last 20 years are all convinced that the treatment options they provide to patients are vastly superior to when they first started their careers. The treatments and research are extremely beneficial for those who are newly or recently diagnosed with multiple myeloma.

Doctor. Paul Richardson, Director of Clinical Research at the Dana-Farber Cancer Institute has told SurvivorNet in an earlier interview that newer treatments such as combination therapies, better-defined stem cell transplants and the recent development of immunotherapies have led to a sort of “paradigm shift” in the way we think about and treat myeloma.

“We’ve witnessed dramatic changes that keep happening and that’s why it’s been so exciting and a pleasure to work in this field since these changes have resulted in new advancements,” said Anderson.

The the average life expectancy for multiple myeloma is now more than four times the length it was two years ago. There’s been so much advancement that people who could only last just a few years following treatment now live for more than a decade and the odds will only increase from here.

Related: An Exciting Change in the Delivery of Daratumumab for Multiple Myeloma

The Dr. Shah explains what goes in making treatment choices for patients suffering from multiple myeloma.

What is MRD Testing?

MRD (Minimal Residual Disease) tests monitor the activity of blood cancer. It informs doctors of how many cancerous cells are left even after treatment. It also gives health professionals the ability to assess and debate how to best manage their treatment.

“MRD testing does not just benefit those who are patients” claims Dr. Hashmi, “but it helps the medical professional who utilizes the test to learn more about the myeloma of their patient and take decisions based upon the results of the test.”

MRD testing is part of what’s commonly referred to as “precision medication”. It’s sometimes referred to as “personalized medication.” This test gives doctors a glimpse into the proteins and genes found in cancer cells. This information helps them develop a treatment plan that is most effective for a patient’s particular cancer.

An MRD evaluation is so precise that it could detect a single cancerous tumor among 10,000 to 100,000 nucleated cells according to the Leukemia and Lymphoma Society. If the results are negative for MRD, it means there are no signs of cancer that can be detected. MRD-positive indicates that cancerous cells are present.

There could be some discomfort the process of having a bone marrow sample collected to test. It’s best to inquire with your doctor about what you can expect and if pain medications are available.

If You’ve been diagnosed with Multiple Myeloma What should I ask the Doctor?

  • What are the most effective treatment options to treat multiple myeloma?
  • What kind and health experts will I have part of the medical staff of my doctor?
  • What are some adverse reactions I can expect from this disease or treatment?
  • Do my condition or treatment impact my daily life? Do I have the ability to carry on working?
  • Do I require an additional opinion?
  • What is the cost of treatment and do you have funds to support them?
  • Dr. Hashmi is also adamant that patients inquire if there are clinical trials being conducted and if they qualify.

Find out more about the rigors of SurvivorNet’s medical review process.

Robin Westen is a contributor at SurvivorNet. Read More