Sometimes, big problems can arise in our bodies without any outward symptoms. You might think, "Oh, how could that happen?" Well, yes, it can. Today we're going to talk about a specific condition that can develop silently, without showing any symptoms, but has the potential to develop into a serious cancer in the future. Doctors call this (Smoldering Multiple Myeloma - SMM) . Simply put, this is like an early stage of a disease called "chronic multiple myeloma."
What is Smoldering Multiple Myeloma (SMM)?
Simply put, Smoldering Multiple Myeloma is a condition that affects your blood and bone marrow. This can develop into a rare blood cancer called active Multiple Myeloma (MM) . Now you may be wondering, "What is this multiple myeloma?" Plasma cells are a type of white blood cell in our immune system. These are the ones that make antibodies that help our body fight disease. However, sometimes these plasma cells can mutate and become abnormal cells. That's when a condition called multiple myeloma occurs.
So, SMM is the "silent" stage before it becomes a cancer called multiple myeloma, without any symptoms. Sometimes it can take years for SMM to become active multiple myeloma. Surprisingly, some people with SMM never develop active multiple myeloma. That's why doctors regularly check people with SMM for signs that it could turn into active cancer.
Is (SMM) cancer?
This is a bit of a tricky question. SMM is not treated as a cancer per se. However, because it can develop into a cancer called active multiple myeloma, it is considered a precursor to cancer. Imagine you have an unusual spot on your skin, a birthmark. That could be an early sign of skin cancer, right? That's what SMM is. It means you have a certain chance of developing multiple myeloma. That's why doctors monitor people with this condition very closely .
Are there other predisposing conditions that affect multiple myeloma?
Yes, there is another one. It's called Monoclonal Gammopathy of Undetermined Significance (MGUS) . Like SMM, this is a condition that can occur before multiple myeloma develops. Doctors consider MGUS (pronounced "M-gus") to be a precursor to multiple myeloma.
How does (SMM) affect my body? What are the symptoms?
Here's the important thing: Many people with SMM don't have any symptoms . That means you may not feel any discomfort. Most people find out they have SMM when they have a routine blood test done for another reason. Those blood tests may show that you have an abnormal type of protein called M protein , which is made by abnormal plasma cells.
Blood tests show that these abnormal plasma cells are producing abnormal immune proteins (M proteins). Also, if you do a bone marrow biopsy, doctors can see these abnormal plasma cells in the bone marrow. However, during this "smoldering" phase, myeloma is not causing any problems in your body, so people with SMM usually don't have any symptoms.
Who can get (SMM)? Is this a common disease?
This condition usually affects people over the age of 60. The average age at diagnosis is between 62 and 67 years.
(SMM) is not a common disease. Researchers estimate that it affects only about one in 100,000 people. However, multiple myeloma affects only about seven in 100,000 people. So, (SMM) is an even rarer condition.
What is the risk of developing (SMM) into active multiple myeloma?
This is also important to know. Within the first five years after being diagnosed with SMM, about 10% of people with SMM develop active multiple myeloma each year. Over the next five years, that percentage drops to 3% per year. After the first 10 years, this risk drops even further to 1% per year.
This means that not everyone with (SMM) will develop multiple myeloma. However, there is a risk, so regular medical monitoring is very important.
Are there tests that can accurately predict whether someone will develop multiple myeloma?
Unfortunately, there is currently no test that can accurately predict whether someone will develop multiple myeloma. Doctors and researchers are continuing to analyze the genetic changes associated with multiple myeloma and are looking to see if they can identify whether someone with SMM will develop multiple myeloma.
What are the reasons for the emergence of (SMM)?
Researchers know that abnormal plasma cells and things called M proteins are a hallmark of multiple myeloma (MM) and multiple myeloma (MM). However, they still don't know exactly what causes normal, healthy plasma cells to become abnormal. They are investigating some potential causes:
- Genetic mutations: Researchers are looking into whether there is a link between changes in certain genes (oncogenes - genes that promote cell growth) and multiple myeloma (MM).
- Obesity: There is a suspicion that excessive body fat may also be a factor.
How to identify (SMM)? What kind of tests are performed?
Doctors may do several tests to confirm whether you have this condition. Remember, if a routine blood and/or urine test shows signs of M protein, that may be the first clue that you have multiple myeloma. Doctors will then do some baseline tests to see if your condition is progressing to multiple myeloma. These tests may include:
- Complete Blood Count (CBC): This measures the number of red blood cells, white blood cells, and platelets produced by your bone marrow.
- Blood chemistry test: This checks your creatinine level (to check how well your kidneys are working), albumin level (to check how well your kidneys and liver are working), and calcium level (to check for bone loss).
- Quantitative immunoglobulin test: This blood test measures the levels of M proteins (immune proteins) in your blood.
- Electrophoresis and serum immunofixation: These tests look for M proteins in your blood.
- Urine tests: Doctors may ask you to collect urine at home for 24 hours to check for M proteins.
- X-rays: X-rays are used to see if there is bone damage due to multiple myeloma.
- Computed Tomography (CT) scan: This is another way to see bone damage.
- Magnetic Resonance Imaging (MRI): This test uses radio waves and strong magnets to make detailed pictures of your bones and spine. This test can be used to look for evidence of early bone damage.
- Bone marrow biopsies: Doctors can take a sample of your bone marrow and analyze it to see the percentage of normal and abnormal plasma cells in it. They can also check the bone marrow sample for changes in your DNA that could lead to cancer.
What are the criteria for (SMM)?
When doctors talk about "criteria," they mean test results that meet the medical standards needed to make a diagnosis. The criteria for (SMM) are:
- A blood test showing a level of M protein greater than 3g/dl (3 grams per deciliter of blood).
- A 24-hour urine test showing 500 milligrams or more of protein. Or...
- A bone marrow biopsy shows that plasma cells make up between 10% and 59% of the total blood cells in your bone marrow. And...
- There are no signs of unusual bone lesions or kidney damage that can be caused by myeloma, your blood cell counts are normal, and your calcium levels are normal.
How is this condition treated?
Currently, the standard treatment for SMM is "watchful waiting." This involves doctors doing regular tests to monitor the levels of M protein in your blood and the levels of plasma cells in your bone marrow. Like a sentinel, they are watching to see if the disease gets worse.
Some people may have a higher risk of developing active multiple myeloma. In such cases, some doctors may recommend starting multiple myeloma treatment early. If you have multiple myeloma (MM), your doctor is the best person to give you the information and treatment recommendations you need.
Can I reduce the risk of developing (SMM)?
Unfortunately, there is currently no known way to prevent the formation of (SMM).
How long can you live with (SMM)?
The way this condition affects everyone is different. Some people may have it but never develop multiple myeloma. Some people develop multiple myeloma months or years after being diagnosed. If you are worried about living with SMM, ask your doctor what you can expect. They are the best people to give you specific information.
How long can you live with multiple myeloma?
This is also a problem for many people. Approximately 40% to 82% of people with multiple myeloma are alive five years after diagnosis. This depends on many factors, including the type of disease and response to treatment.
How can I take care of my health?
If you have multiple myeloma, you may not need treatment right away – or ever. Your doctor will tell you to come in for regular checkups. This is to check if your condition has changed to multiple myeloma. Living with multiple myeloma can be stressful and anxiety-provoking . You may think, “Oh, I wish I could do something about this.” That’s normal. But there are some things you can do to take care of your overall health:
- Eat a well-balanced diet. If you are unsure about this, consult a nutritionist.
- If you are a smoker, please try to stop.
- Get enough rest.
- Protect yourself from infections. Ask your doctor about ways to prevent infections.
- Exercise regularly. But, talk to your doctor first to find out what kind of exercise is right for you and how much you should do. It's not good to do too much either.
- Pay attention to your mental health, too. If you're feeling sad or depressed about your condition, talk to your doctor about it. Be sure to tell them, especially if the sadness or depression lasts more than two weeks or interferes with your daily activities.
What questions should I ask my doctor?
If you have (SMM), here are some questions you can ask your doctor:
- Why did this happen to me?
- How does this affect my daily life?
- How long does it take for multiple myeloma to develop?
- Are there any specific symptoms that might indicate multiple myeloma, and should I be aware of them?
- Are there treatments to prevent the condition (SMM) from developing into multiple myeloma?
Finally, what to remember (Take-Home Message)
Smoldering Multiple Myeloma (SMM) is a pre-cancerous condition of multiple myeloma (MM). However, not everyone with SMM will develop active multiple myeloma. People with SMM often want to know if they will develop active multiple myeloma, and if so, when. These are really difficult questions to answer. Doctors don't have all the answers yet.
However, recent research shows that by mapping changes in certain genes, it may be possible to predict to some extent whether (SMM) will develop into multiple myeloma, and if so, when.
If you have this condition, ask your doctor if there is any new information related to your condition. They will be more than happy to help you. The most important thing is to follow your doctor's advice and stay mentally strong.
` Smoldering Multiple Myeloma, SMM, Multiple Myeloma, cancer, blood disease, bone marrow, M protein, blood cancer, plasma cells
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