Despite all of the innovative and diverse treatments that oncologists employ to treat myeloma, it can come back, or relapse. Why does myeloma relapse? Dr. Kenneth Anderson, Director of Dana Farber Cancer Institute's Multiple Myeloma Center, explains, "It usually means that there were residual cells, even in very small numbers. They were either resistant to the treatment from the start or they acquired resistance as the treatment was growing." In other words, not every myeloma cell in your body is exactly the same. Some start out with a set of mutations that can give them resistance to treatments and make them more likely to relapse, whereas others develop mutations as a result of treatment. What are the signs of relapse in multiple myeloma?
Well, your physicians likely have been monitoring your body ever since you ended treatment for signals that it has relapsed. There's a variety of signs that can indicate the disease has returned:
- Increased levels of monoclonal antibodies: myeloma cells are cancerous plasma cells in the bone marrow which overgrow and produce abnormal proteins. These abnormal proteins are released in the blood and can be detected by physicians. When the levels of these increase substantially, that can be a sign multiple myeloma has relapsed.
- Increase in plasma cells in the bone marrow: oncologists can use magnetic imaging, like MRI or PET scans, to see if there are a greater than normal level of plasma cells in the bone marrow, typical of overly dividing myeloma cells.
- Bone fractures and lesions: myeloma cells activate the cells that break down bones and deactivate the cells that build up bones, which can result in fractures or small holes in bones. Oncologists can use X-rays or CT scans to pick up on bone damage that is indicative of relapse.
(For more on relapse)
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