- Giulia Granchi
- BBC News from Sao Paulo Brazil
Multiple myeloma is a type of blood cancer that affects the blood system, especially the complications of the kidneys and bones, with symptoms that are difficult to distinguish from many other diseases.
The disease affects plasma cells, a type of white blood cell that can produce antibodies to fight infections. Instead of healthy cells, malignant versions appear that proliferate and begin to produce abnormal antibodies, known as the M protein or monoclonal protein, which damage different parts of the body, which is why the disease bears the word “multiple” in its name.
Patients usually experience, before any other signs, back pain, a very general symptom, which may be the result of sleeping in a less comfortable position, too heavy a workout in the gym, or many other daily factors. . But this is also a major symptom of this rare cancer.
It was this discomfort that led the merchant Luiz Fernando Fontenele, 37, to take a long career in medical examinations and consultations until he discovered the disease. “I felt great pain and suffered the first fracture and was diagnosed only seven months later. I myself became suspicious because I read the symptoms on the internet,” he recalls.
As with Luiz Fernando, the disease can lead to fractures, as it weakens the bones due to anemia, an excess of bone marrow plasma cells, which leads to a reduction in the number of cells that make up the blood, and more severe. cases of kidney failure due to the damage caused by the disease to the renal tubules.
Although rare, it is the second most common blood cancer in the world. In Brazil, it is estimated that four out of a hundred thousand people suffer from the disease, an average of 7,600 new cases each year.
The disease is more common in people over the age of 60, but is diagnosed in younger people. The most emblematic case in world literature took place here in Brazil. An 8-year-old boy, a neighbor of El Salvador in Bahia, was diagnosed with the disease. According to the IMF (International Myeloma Foundation Latin America), he was the first child in history to be diagnosed.
Multiple myeloma can be detected by urine analysis or a blood test called serum protein electrophoresis, when symptoms indicate inflammatory disease, autoimmune disease, acute or chronic infection, liver or kidney disease.
“Although I don’t think the study should be a common practice for everyone – even if it could be a public expense that would take resources from other diseases – I find it unacceptable for a patient to be with the symptom for so long, and as a result. not having a study request, ”says Angelo Maiolino, a professor of hematology at the UFRJ (Federal University of Rio de Janeiro).
After receiving the first symptoms, 29% of patients with multiple myeloma need one year to be diagnosed, and 28% wait even longer, according to a survey by Abral (Brazilian Lymphoma and Leukemia Association).
“I’ve seen cases of people on dialysis, their kidneys are very dangerous, and they only found the disease three years later,” says Maiolino.
Since the first diagnosis of multiple myeloma, the XVIII. In the twentieth century, medicine has made progress in the evolution of biological knowledge and treatments for the disease, which now allows patients with this type of cancer to live longer and better well-being. .
There is no cure for the disease, but in many cases, treatments that allow patients to live well, with symptoms well controlled. “It’s like they have a chronic illness like diabetes, hypertension …” says Maiolino.
Early intervention, according to the doctor, is a way to prevent the progression of the disease from endangering the health of patients. “We use a different type of treatment for each phase of the disease, but if the condition is detected late, the patient will not be able to benefit from the initial care,” he explains.
Another very common option is to indicate a stem cell transplant. Prior to transplantation, chemotherapy or radiotherapy is performed to allow the existing bone marrow (the body to make blood, white and red blood cells and platelets) to form a new bone marrow.
The new bone marrow is a gelatin-like liquid that may come from a donor or be autologous (from the patient himself).
Luiz Fernando was transplanted, but he repeated, that is, the disease returned. “It was harder than getting a diagnosis. I have a specific treatment, every 28 days in a hospital setting with a combination of medicines and every 21 days at home. I found multiple myeloma at the age of 28 and I don’t remember. I spent the day without pain. “The combination of medicines allows me to lead a normal life.”
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