SMALL STEPS, BIG IMPACT: REDUCING MYELOMA RISK.

Multiple myeloma, commonly referred to as myeloma, is a type of blood cancer that affects plasma cells, which are a type of white blood cell responsible for producing antibodies. While myeloma remains incurable, advances in research and treatment have significantly improved survival rates. However, prevention and risk reduction remain critical components in the fight against this disease. This essay explores the various ways individuals can reduce their risk of developing myeloma through lifestyle changes, early detection, and awareness of risk factors.

UNDERSTANDING MYELOMA.

Myeloma is a cancer of plasma cells, which are found in the bone marrow. When these cells become cancerous, they multiply uncontrollably and produce abnormal antibodies called monoclonal proteins or M proteins. These proteins can build up in the body, causing damage to bones, kidneys, and the immune system. Myeloma is often diagnosed at an advanced stage because its symptoms, such as bone pain, fatigue, and frequent infections, are nonspecific and can be mistaken for other conditions.

The exact cause of myeloma is not well understood, but it is believed to result from a combination of genetic and environmental factors. While some risk factors, such as age and genetics, cannot be changed, there are several steps individuals can take to reduce their overall risk of developing myeloma.

AWARENESS OF RISK FACTORS

Before discussing preventive measures, it is important to understand the risk factors associated with myeloma. Some of these factors are non-modifiable, but awareness can lead to early detection and intervention.

1. Age:
   • Myeloma is more common in older adults, with most cases diagnosed in people over the age of 65. While age is a non-modifiable risk factor, older adults should be aware of the symptoms and undergo regular health check-ups.
2. Gender:
   • Men are slightly more likely to develop myeloma than women. While the reasons for this gender disparity are unclear, men should be particularly vigilant about their health and undergo regular screenings.
3. Race:
   • African Americans have a higher risk of developing myeloma compared to other racial groups. This disparity may be due to genetic factors, but it also underscores the importance of targeted awareness and prevention efforts in high-risk populations.
4. Family History:
   • Having a family history of myeloma or other blood cancers can increase an individual’s risk. Those with a family history should discuss their risk with their healthcare provider and consider genetic counseling.
5. Obesity:
   • Obesity has been linked to an increased risk of developing myeloma. Maintaining a healthy weight through diet and exercise can help reduce this risk.
6. Exposure to Certain Chemicals:
   • Exposure to certain chemicals, such as pesticides, herbicides, and benzene, has been associated with an increased risk of myeloma. Individuals who work in industries with potential chemical exposure should take precautions, such as using protective equipment and following safety guidelines.
7. Monoclonal Gammopathy of Undetermined Significance (MGUS):
   • MGUS is a condition in which there is an abnormal presence of monoclonal proteins in the blood, but without the symptoms of myeloma. MGUS is considered a precursor to myeloma, and individuals with MGUS should be monitored regularly by a healthcare provider.

LIFESTYLE CHANGES TO REDUCE MYELOMA RISK

While some risk factors for myeloma cannot be modified, there are several lifestyle changes that can help reduce the overall risk of developing the disease. These small steps can have a big impact on an individual’s health and well-being.

1. Maintaining a Healthy Weight:
   • Obesity is a known risk factor for many types of cancer, including myeloma. Excess body weight can lead to chronic inflammation and changes in hormone levels, which can increase the risk of cancer. Maintaining a healthy weight through a balanced diet and regular physical activity is one of the most effective ways to reduce cancer risk.
   • Dietary Recommendations:
     • A diet rich in fruits, vegetables, whole grains, and lean proteins is recommended to maintain a healthy weight and reduce cancer risk. Limiting the intake of processed foods, sugary drinks, and red and processed meats can also help lower the risk of myeloma and other cancers.
2. Regular Physical Activity:
   • Engaging in regular physical activity is associated with a lower risk of several types of cancer, including myeloma. Exercise helps regulate body weight, reduce inflammation, and improve immune function, all of which contribute to cancer prevention.
   • Exercise Recommendations:
     • Adults should aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week, as recommended by the World Health Organization (WHO). Activities such as walking, jogging, swimming, and cycling are excellent options for maintaining physical fitness.
3. Avoiding Tobacco Use:
   • Tobacco use is a leading cause of cancer worldwide. While the link between smoking and myeloma is not as strong as with other cancers, avoiding tobacco is crucial for overall cancer prevention and health. Smoking can weaken the immune system and increase the risk of developing various cancers, including myeloma.
4. Limiting Alcohol Consumption:
   • Excessive alcohol consumption has been linked to an increased risk of several types of cancer. While moderate alcohol consumption may not significantly increase the risk of myeloma, it is advisable to limit alcohol intake to reduce overall cancer risk. The American Cancer Society recommends no more than one drink per day for women and two drinks per day for men.
5. Reducing Exposure to Environmental Toxins:
   • Occupational exposure to certain chemicals, such as pesticides, herbicides, and industrial solvents, has been associated with an increased risk of myeloma. Individuals who work in industries with potential chemical exposure should take precautions to minimize their risk.
   • Protective Measures:
     • Using personal protective equipment, following safety guidelines, and reducing exposure to harmful chemicals can help lower the risk of developing myeloma. Additionally, advocating for safer work environments and stricter regulations on the use of carcinogenic chemicals is essential for cancer prevention.
6. Managing Chronic Infections and Inflammation:
   • Chronic infections and inflammation have been linked to an increased risk of cancer, including myeloma. Conditions such as hepatitis, HIV, and chronic inflammatory diseases can weaken the immune system and create an environment conducive to cancer development.
   • Preventive Measures:
     • Managing chronic infections through appropriate medical treatment, vaccinations, and lifestyle changes can help reduce the risk of myeloma. Regular medical check-ups and screenings are also important for early detection and management of chronic conditions.

EARLY DETECTION AND REGULAR SCREENING

Early detection of myeloma can significantly improve treatment outcomes and survival rates. While there is no standard screening test for myeloma in the general population, individuals at higher risk should be particularly vigilant about their health and undergo regular check-ups.

1. Awareness of Symptoms:
   • Recognizing the early signs and symptoms of myeloma is crucial for timely diagnosis. Common symptoms include bone pain, fatigue, frequent infections, unexplained weight loss, and kidney problems. Individuals experiencing these symptoms should seek medical attention promptly.
2. Regular Health Check-ups:
   • Regular health check-ups, including blood tests and physical examinations, can help detect abnormalities that may indicate myeloma or other health conditions. Early detection of conditions such as MGUS, which can progress to myeloma, allows for close monitoring and timely intervention.
3. Genetic Counseling and Testing:
   • Individuals with a family history of myeloma or other blood cancers may benefit from genetic counseling and testing. Genetic counseling can help assess an individual’s risk of developing myeloma and guide decision-making regarding preventive measures and monitoring.
4. Bone Density Scans:
   • Myeloma can cause bone damage, leading to fractures and osteoporosis. Bone density scans can help detect early signs of bone loss and guide treatment to prevent fractures and other complications.

RESEARCH AND ADVANCEMENTS IN MYELOMA PREVENTION

Ongoing research is essential for understanding the causes of myeloma and developing effective prevention strategies. Several areas of research are particularly promising for reducing myeloma risk and improving outcomes for individuals with the disease.

1. Genetic and Molecular Research:
   • Advances in genetic and molecular research are shedding light on the underlying causes of myeloma. Understanding the genetic mutations and pathways involved in the development of myeloma can lead to the development of targeted therapies and preventive strategies.
2. Immunotherapy:
   • Immunotherapy, which harnesses the body’s immune system to fight cancer, is a promising area of research for myeloma. Early studies suggest that certain immunotherapies may help prevent the progression of MGUS to myeloma and improve outcomes for individuals with early-stage disease.
3. Lifestyle Interventions:
   • Research into the impact of lifestyle interventions, such as diet, exercise, and weight management, on myeloma risk is ongoing. Studies are exploring how these factors influence cancer development and whether specific interventions can reduce the risk of myeloma and other cancers.
4. Environmental and Occupational Health:
   • Research into the role of environmental and occupational exposures in myeloma development is crucial for identifying risk factors and implementing preventive measures. Studies in this area can lead to stricter regulations on the use of harmful chemicals and improved safety practices in the workplace.

CONCLUSION.

While myeloma remains a challenging and incurable disease, small steps can make a big impact in reducing the risk of developing it. By maintaining a healthy lifestyle, being aware of risk factors, and undergoing regular health check-ups, individuals can significantly lower their risk of myeloma and improve their overall health. Additionally, ongoing research and advancements in understanding the causes of myeloma offer hope for more effective prevention and treatment strategies in the future. By taking proactive steps to reduce risk and promote early detection, individuals can make a meaningful difference in the fight against myeloma.

REFERENCES.

• American Cancer Society. (2021). Multiple Myeloma. Retrieved from https://www.cancer.org/cancer/multiple-myeloma.html
• Rajkumar, S. V. (2020). Multiple myeloma: 2020 update on diagnosis, risk-stratification, and management. American Journal of Hematology, 95(5), 548-567.
• Landgren, O., & Rajkumar, S. V. (2016). New Developments in Diagnosis, Prognosis, and Assessment of Response in Multiple Myeloma. Clinical Cancer Research, 22(22), 5428-5433.
• Kyle, R. A., & Rajkumar, S. V. (2004). Multiple myeloma. The New England Journal of Medicine, 351(18), 1860-1873.
• Rollig, C., Knop, S., & Bornhauser, M. (2015). Multiple myeloma. The Lancet, 385(9983), 2197-2208.
• International Myeloma Foundation. (2021). Myeloma Risk Factors. Retrieved from https://www.myeloma.org/what-is-myeloma/myeloma-risk-factors
• World Health Organization. (2020). Physical activity guidelines. Retrieved from https://www.who.int/news-room/fact-sheets/detail/physical-activity
• National Institute for Occupational Safety and Health (NIOSH). (2018). Chemical Hazards. Retrieved from https://www.cdc.gov/niosh/topics/chemical-safety/
• Mateos, M. V., & San Miguel, J. F. (2017). Management of multiple myeloma in the elderly. Blood Reviews, 31(3), 163-178.
• National Cancer Institute. (2021). Multiple Myeloma Prevention (PDQ®)–Health Professional Version. Retrieved from https://www.cancer.gov/types/myeloma/hp/myeloma-prevention-pdq

Written by Fawzi Rufai, Medically Reviewed by Sesan Kareem