Introduction
Myeloma is a type of blood cancer characterized by symptoms like the destruction of bones, anemia, and hypercalcemia. This condition is currently incurable although scientists have made great attempts in morbidity. Today, in clinical treatments, physicians use immunomodulatory drugs like lenalidomide, thalidomide, and pomalidomide. In non-clinical treatment attempts, physicians use proteasome inhibitors, and bortezomib. In addition, they also apply conformational chemotherapy that is integrated with supportive therapy. Since myeloma is an integral condition in human health, nurses should always be updated on the treatment and side effects of this disease. This paper seeks to discuss myeloma and its treatment.
Discussion
According to Devenney &Erickson (2004, p.401), myeloma is the second most prevailing blood cancer. This cancer arises from the uncontrolled growth and multiplication of blood plasma cells. The major characteristics of this cancer are renal failure, anemia, lytic lesions on the bones, and excess monoclonal immunoglobulin. According to Dvorak (2006, p.190), myeloma is more prevalent in older persons especially between 65 years and 68 years.
Though rare, this cancer can also affect young persons. Turesson et al. (2010, p. 225) argue that the effect of myeloma increases with an increase in age. Although the actual cause of myeloma is not known, radiations and exposure to agrochemicals have been cited as causative factors. Myeloma development prevalence can be either genetically or environmentally associated with certain families. Asymptomatic disorders of the plasma can also grow to myeloma, for example, monoclonal gammopathy and smouldering myeloma.
There are several steps that are involved in the development of myeloma in the blood plasma. The body’s immune cells that fight infections start as stem cells and grow to form lymphoid and myeloids. Lymphoid cell divides to form T or B lymphocytes. Pathogens invading the body are killed by mature blood plasma cells called immunoglobulins. These are developed from B cells. Immunoglobulins are made of heavy and light chains. The Kappa and lambda make the light chains while the heavy chains constitute of 1gM, 1gA, 1gD, 1gE and 1gG. From an abnormal production of one of these five immunoglobulins myeloma is developed. The condition is characterized by more than 10% production of mature blood plasma cells usually in the bone marrow.
Myolema usually destroys bones. This is an outcome of osteolytic bone lesions that results to hypercalcaemia, bone fractures and pain. Myeloma cells produce osteoclast activating factors, cytokines that cause lesions on the bones in myeloma. According to Kyle (1999, p.35), the environment of the bone interacts with the myeloma cells causing diseases of the bone due to unmatched development between the two.
To diagnose myolema, serum, urine protein and bone marrow aspirate are analyzed. If there is any observation of paraprotein in serum or urine, then the disease is present. Myolema can also be noticed with presence of lytic lesion when X-ray is done. To detect skeletal myeloma radiotherapy technique is applied. The results are then subjected to tomography using computers in order to make clear any ambiguous findings. When osteoclast increases without marched bone development, excess calcium secretions result leading to hyercalcaemia. Myeloma patients may therefore experience nausea, confusion, lethargy and may even vomit.
The advance effect of hypercalcemia may be renal failure, cardiac arrest or patients may go into a coma. In some cases, renal failure may result due to the accumulation of insoluble fibrils in the renal tubules of the kidney. This may also result in renal swelling due to excess filtration of light chains. The major characteristics of renal insufficiency may include increased creatinine levels, urea, calcium and high levels of urea.
Medical practitioners, therefore, use sufficient hydration to treat renal failure though it only decreases the light chains prevalence. It is, therefore, necessary to also involve the use of antimyeloma to treat renal failure. Practitioners should also manage hypercalcaemia through biphosphonates when creatinine increases. According to Durie et al. (200, p.279), any opportunistic infection should also be treated on time without using steroids, anti-inflammatory drugs and contrast media dyes.
Patients are also characterized by anemic characteristics. According to Harousseau (2002, p.253), the patients experience fatigue, general body weakness and even dyspnoea. This is due to the replacement of red blood cells by plasma cells and increased destruction of red blood cells. In such cases, the patients should be given erythropoinetin when thorough treatment commences.
Conclusion
In conclusion, Myeloma is still a complicated illness to detect and treat. Better life styles and medical intervention are the best remedy for this disease. Though there is no exact cure, new knowledge of the disease is leading to more reliable therapies for treatment giving new and better hope for patients suffering from this disease. Nurses, who play a big role in therapy and treatment of multiple myeloma should therefore keep themselves updated with the current trends of its diagnosis and treatment.
References
Devenney, B., & Erickson, C. (2004). Multiple myeloma: an overview. Clin J Oncol Nurs 8(4): 401–5.
Durie, BGM, Kyle, R.A., Belch, A., et al. (2003). Myeloma management guidelines: a consensus report from the Scientific Advisors of the International Myeloma Foundation. Hematol J 4(6): 379–98.
Dvorak, C. (2006). Common complaints, difficult diagnosis: multiple myeloma. J Am Acad Nurse Pract 18(5): 190–4.
Harousseau, J.L. (2002). Management of multiple myeloma. Rev Clin Exp Hematol 6(3): 253–75.
Kyle, R.A. (1999). Maintenance therapy and supportive care for patients with multiple Myeloma. Semin Oncol 26(5): 35–42.
Turesson, I., Velez, R., Kristinsson, S.Y., Landgren, OLA. (2010). Patterns of multiple myeloma during the past 5 decades: Stable incidence rates for all age groups in the population but rapidly changing age distribution in the clinic. Mayo Clin Proc 85(3): 225–30.