Tom Brokaw’s revelation that he has been quietly undergoing treatment for cancer for months brings new attention to his diagnosis, multiple myeloma.
While researchers have yet to find a cure, they have discovered very effective treatments for the cancer that affects blood cells in the bone marrow.
“A decade ago I would have been happy if half my patients responded to treatment — and for just a few years,” said Dr. Edward Stadtmauer, chief of hematologic malignancies at the Abramson Cancer Center of the University of Pennsylvania. “Now we expect treatments to have a 95 percent response rate. Patients can go decades with the disease doing fine, but still having it.”
Multiple myeloma is the second most common cancer of the bone marrow after lymphoma, striking about 10,000 Americans each year, Stadtmauer said. For perspective, about 200,000 women get breast cancer annually.
No one knows yet why some people develop the disease. It’s probably a combination of heredity, environment and luck, Stadtmauer said. What is known is that the disease strikes mostly seniors, with an average age of 70 at diagnosis.
Patients often show up in the doctor’s office with unexplained bone pain, fatigue or immune problems that can be traced to the malfunction of a certain type of white blood cell found in the bone marrow, known as plasma cells.
Normally these cells make the antibodies that fight infections. But sometimes plasma cells can go haywire and rapidly proliferate, crowding out red blood cells and other types of white blood cells. Patients become anemic and the immune system becomes depressed, leaving people more vulnerable to bacteria and viruses.
Making matters worse, the abnormal plasma cells send out the wrong signals to various parts of the body, including the bones. The result, Stadtmauer said, is “holes in the bone. The bones become crumbly and fractures can result. That’s why most people seek attention. They felt pain in their bones.”
Medications can keep people in remission.
“Just like high blood pressure and diabetes, people can live it for a long period of time,” Stadtmauer said.